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Haloperidol Disease Interactions

There are 21 disease interactions with haloperidol.

Major

Atypical antipsychotic agents (applies to haloperidol) dementia

Major Potential Hazard, High plausibility.

Older patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; although the causes were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. A causal relationship with antipsychotic use has not been established. In controlled trials in older patients with dementia-related psychosis, patients randomized to risperidone, aripiprazole, and olanzapine had higher incidence of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, compared to patients treated with placebo. These agents are not approved for the treatment of patients with dementia-related psychosis.

References

  1. (2001) "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals
  2. (2001) "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals
  3. (2001) "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company
  4. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  5. (2001) "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals
  6. (2002) "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb
  7. (2007) "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals
  8. (2009) "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc
  9. (2009) "Product Information. Saphris (asenapine)." Schering-Plough Corporation
  10. (2010) "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc
  11. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
  12. (2015) "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc.
  13. (2016) "Product Information. Nuplazid (pimavanserin)." Accelis Pharma
  14. (2022) "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc., SUPPL-9
View all 14 references
Major

Haloperidol (applies to haloperidol) hyperthyroidism

Major Potential Hazard, Low plausibility.

The use of neuroleptic agents in the presence of thyrotoxicosis has been associated with severe neurotoxicity that includes rigidity and inability to walk or talk. Therapy with haloperidol should be administered cautiously in patients with thyrotoxicosis or hyperthyroidism.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
Major

Haloperidol (applies to haloperidol) parkinsonism

Major Potential Hazard, Moderate plausibility.

The use of neuroleptic agents is associated with pseudo- parkinsonian symptoms such as akinesia, bradykinesia, tremors, pill- rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. The onset is usually 1 to 2 weeks following initiation of therapy or an increase in dosage. Older neuroleptic agents such as haloperidol are more likely to induce these effects. The manufacturers of haloperidol consider its use to be contraindicated in patients with Parkinson's disease.

References

  1. Moleman P, Janzen G, von Bargen BA, et al. (1986) "Relationship between age and incidence of parkinsonism in psychiatric patients treated with haloperidol." Am J Psychiatry, 143, p. 232-4
  2. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  3. Bransgrove LL, Kelly MW (1994) "Movement disorders in patients treated with long-acting injectable antipsychotic drugs." Am J Hosp Pharm, 51, p. 895-9
  4. Sheppard C, Merlis S (1967) "Drug-induced extrapyramidal symptoms: their incidence and treatment." Am J Psychiatry, 123, p. 886-9
  5. Boston Collaborative Drug Surveillance Program (1973) "Drug-induced extrapyramidal symptoms." JAMA, 224, p. 889-91
  6. Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG (1999) "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange
View all 6 references
Major

Miscellaneous antipsychotics (applies to haloperidol) CNS depression/coma

Major Potential Hazard, Moderate plausibility. Applicable conditions: Altered Consciousness, Acute Alcohol Intoxication

The use of most miscellaneous antipsychotics is contraindicated in patients with severe central nervous system depression or comatose states from any cause (e.g., lesion, disease, drug or alcohol induced).

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  2. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  3. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  4. (2015) "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA
View all 4 references

Elderly patients with dementia- related psychosis treated with antipsychotic drugs are at increased risk of death. Most of these drugs are not approved for the treatment of patients with dementia- related psychosis.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  2. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  3. (2015) "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA
Major

Miscellaneous antipsychotics (applies to haloperidol) previous neuroleptic malignant syndrome (NMS)

Major Potential Hazard, Moderate plausibility.

Neuroleptic Malignant Syndrome (NMS), a potentially fatal symptom complex, has been reported in association with the use of antipsychotic drugs. The diagnostic evaluation is complicated and the management requires immediate discontinuation of the antipsychotic therapy and intensive symptomatic treatment and medical monitoring. If a patient that has recovered from NMS requires antipsychotic drug treatment again, the reintroduction of therapy should be carefully considered as NMS recurrences have been reported.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  2. (2002) "Product Information. Eskalith (lithium)." SmithKline Beecham
  3. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  4. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  5. (2015) "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA
View all 5 references
Major

Miscellaneous antipsychotics (applies to haloperidol) seizure disorders

Major Potential Hazard, Moderate plausibility. Applicable conditions: CNS Disorder, Alcoholism

Antipsychotics can lower the seizure threshold and trigger seizures in a dose-dependent manner. Seizures have been reported in patients receiving antipsychotic therapy and may occur in epileptic patients even with maintenance of routine anticonvulsant treatment. Therapy with antipsychotics should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism. High dosages should be avoided if possible.

References

  1. Markowitz J, Brown R (1987) "Seizures with neuroleptics and antidepressants." Gen Hosp Psychiatry, 9, p. 135-41
  2. Lowry MR, Dunner FJ (1980) "Seizures during tricyclic therapy." Am J Psychiatry, 137, p. 1461-2
  3. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  4. (2002) "Product Information. Eskalith (lithium)." SmithKline Beecham
  5. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  6. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  7. (2022) "Product Information. Loxitane C (loxapine)." Apothecon Inc
View all 7 references
Major

Neuroleptics (applies to haloperidol) acute alcohol intoxication

Major Potential Hazard, High plausibility. Applicable conditions: Alcoholism

The use of neuroleptic agents is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of neuroleptic agents may be additive with those of alcohol. Severe respiratory depression and respiratory arrest may occur. Therapy with neuroleptic agents should be administered cautiously in patients who might be prone to acute alcohol intake.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  2. (2001) "Product Information. Navane (thiothixene)." Roerig Division
  3. (2001) "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals
  4. (2001) "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals
  5. (2001) "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company
  6. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  7. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  8. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  9. (2001) "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals
  10. (2022) "Product Information. Loxitane C (loxapine)." Apothecon Inc
View all 10 references
Major

Neuroleptics (applies to haloperidol) cardiovascular disease

Major Potential Hazard, High plausibility. Applicable conditions: Cerebrovascular Insufficiency, History - Cerebrovascular Disease, History - Myocardial Infarction, Hypotension, Heart Disease

Neuroleptic agents may cause hypotension (including orthostatic hypotension), reflex tachycardia, increased pulse rate, syncope and dizziness, particularly during initiation of therapy or rapid escalation of dosage. Tolerance to the hypotensive effects often develops after a few doses to a few weeks. Rarely, fatal cardiac arrest has occurred secondary to severe hypotension. Other reported adverse cardiovascular effects include hypertension, edema, arrhythmias, thrombophlebitis, myocarditis, angina, myocardial infarction, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation, diffuse T-wave flattening, and ST segment depression. Therapy with neuroleptic agents should be administered cautiously in patients with severe cardiovascular disease, pheochromocytoma, a predisposition to hypotension, or conditions that could be exacerbated by hypotension such as a history of myocardial infarction, angina, or ischemic stroke. Close monitoring of cardiovascular status, including ECG changes, is recommended at all dosages. If parenteral therapy is given, patients should be in a supine position during administration and for at least 30 to 60 minutes afterwards. Patients who experience orthostatic hypotension should be cautioned not to rise too abruptly. Occasionally, when severe, hypotension may require treatment with vasoconstrictive agents such as norepinephrine or phenylephrine. Epinephrine should not be used, however, since neuroleptic agents can reverse its vasopressor effects and cause a further lowering of blood pressure.

References

  1. Huyse F, van Schijndel RS (1988) "Haloperidol and cardiac arrest." Lancet, 2, p. 568-9
  2. McCance-Katz EF (1991) "New onset Raynaud's phenomenon in a schizophrenic patient ." J Clin Psychiatry, 52, p. 89-90
  3. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  4. (2001) "Product Information. Navane (thiothixene)." Roerig Division
  5. Tueth M (1993) "Side effects of clozipine (Clozaril) requiring emergency treatment." Am J Emerg Med, 11, p. 312-3
  6. Lieberman JA, Safferman AZ (1992) "Clinical profile of clozapine: adverse reactions and agranulocytosis." Psychiatr Q, 63, p. 51-70
  7. Heel RC, Brogden RN, Speight TM, Avery GS (1978) "Loxapine: a review of its pharmacological properties and therapeutic efficacy as an antipsychotic agent." Drugs, 15, p. 198-217
  8. Wilt JL, Minnema AM, Johnson RF, Rosenblum AM (1993) "Torsade de pointes associated with the use of intravenous haloperidol." Ann Intern Med, 119, p. 391-4
  9. Metzger E, Friedman R (1993) "Prolongation of the corrected QT and torsades de pointes cardiac arrhythmia associated with intravenous haloperidol in the medically ill." J Clin Psychopharmacol, 13, p. 128-32
  10. (2001) "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals
  11. (2001) "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals
  12. Kerwin R (1993) "Adverse reaction reporting and new antipsychotics." Lancet, 342, p. 1440
  13. Gupta S (1994) "Paradoxical hypertension associated with clozapine." Am J Psychiatry, 151, p. 148
  14. Centorrino F, Baldessarini RJ, Kando JC, Frankenburg FR, Volpicelli SA, Flood JG (1994) "Clozapine and metabolites - concentrations in serum and clinical findings during treatment of chronically psychotic patients." J Clin Psychopharmacol, 14, p. 119-25
  15. Marinkovic D, Timotijevic I, Babinski T, Totic S, Paunovic VR (1994) "The side-effects of clozapine: a four year follow-up study." Prog Neuropsychopharmacol Biol Psychiatry, 18, p. 537-44
  16. Testani M (1994) "Clozapine-induced orthostatic hypotension treated with fludrocortisone." J Clin Psychiatry, 55, p. 497-8
  17. Aronowitz JS, Umbricht DSG, Safferman AZ (1995) "Clozapine and new-onset ECG abnormalities." Psychosomatics, 36, p. 82-3
  18. (2001) "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company
  19. Baldassano CF, Ghaemi SN (1996) "Generalized edema with risperidone: divalproex sodium treatment." J Clin Psychiatry, 57, p. 422
  20. Ravin DS, Levenson JW (1997) "Fatal cardiac event following initiation of risperidone therapy." Ann Pharmacother, 31, p. 867-70
  21. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  22. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  23. O'Brien JM, Rockwood RP, Suh KI (1999) "Haloperidol-induced torsade de pointes." Ann Pharmacother, 33, p. 1046-9
  24. Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG (1999) "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange
  25. (2001) "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals
  26. (2022) "Product Information. Loxitane C (loxapine)." Apothecon Inc
  27. Hatta K, Takahashi T, Nakamura H, Yamashiro H, Asukai N, Matsuzaki I, Yonezawa Y (2001) "The association between intravenous haloperidol and prolonged QT interval." J Clin Psychopharmacol, 21, p. 257-61
  28. La Grenade L, Graham D, Trontell A (2001) "Myocarditis and cardiomyopathy associated with clozapine use in the United States." N Engl J Med, 345, p. 224-5
View all 28 references
Major

Neuroleptics (applies to haloperidol) CNS depression

Major Potential Hazard, High plausibility. Applicable conditions: Altered Consciousness, Respiratory Arrest

The use of neuroleptic agents is contraindicated in comatose patients and patients with severe central nervous system depression. Neuroleptic agents may potentiate the CNS and respiratory depression in these patients.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  2. (2001) "Product Information. Navane (thiothixene)." Roerig Division
  3. Vetter PH, Proppe DG (1992) "Clozapine-induced coma." J Nerv Ment Dis, 180, p. 58-9
  4. (2001) "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals
  5. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  6. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  7. (2022) "Product Information. Loxitane C (loxapine)." Apothecon Inc
View all 7 references
Major

Neuroleptics (applies to haloperidol) NMS

Major Potential Hazard, High plausibility. Applicable conditions: Neuroleptic Malignant Syndrome

The central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). NMS is observed most frequently when high-potency agents like haloperidol are administered intramuscularly, but may occur with any neuroleptic agent given for any length of time. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Neuroleptic agents should not be given to patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of neuroleptic agents should be carefully considered, since NMS may recur.

References

  1. Hermesh H, Sirota P, Eviatar J (1989) "Recurrent neuroleptic malignant syndrome due to haloperidol and amantadine." Biol Psychiatry, 25, p. 962-5
  2. Ryken TC, Merrell AN (1989) "Haloperidol-induced neuroleptic malignant syndrome in a 67-year-old woman with parkinsonism." West J Med, 151, p. 326-8
  3. Levitt AJ, Midha R, Craven JL (1990) "Neuroleptic malignant syndrome with intravenous haloperidol." Can J Psychiatry, 35, p. 789
  4. Aisen PS, Lawlor BA (1992) "Neuroleptic malignant syndrome induced by low-dose haloperidol." Am J Psychiatry, 149, p. 844
  5. Caroff SN (1980) "The neuroleptic malignant syndrome." J Clin Psychiatry, 41, p. 79-83
  6. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  7. (2001) "Product Information. Navane (thiothixene)." Roerig Division
  8. Miller DD, Sharafuddin MJ, Kathol RG (1991) "A case of clozapine-induced neuroleptic malignant syndrome." J Clin Psychiatry, 52, p. 99-101
  9. DasGupta K, Young A (1991) "Clozapine-induced neuroleptic malignant syndrome." J Clin Psychiatry, 52, p. 105-7
  10. Anderson ES, Powers PS (1991) "Neuroleptic malignant syndrome associated with clozapine use." J Clin Psychiatry, 52, p. 102-4
  11. (2001) "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals
  12. (2001) "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals
  13. Nemecek D (1993) "Atropism may precipitate neuroleptic malignant syndrome during treatment with clozapine." Am J Psychiatry, 150, p. 1561
  14. Ewert AL, Kloek J, Wells B, Phelps S (1983) "Neuroleptic malignant syndrome associated with loxapine" J Clin Psychiatry, 44, p. 37-8
  15. Chong LS, Abbott PM (1991) "Neuroleptic malignant syndrome secondary to loxapine." Br J Psychiatry, 159, p. 572-3
  16. Padgett R, Lipman E (1989) "Use of neuroleptics after an episode of neuroleptic malignant syndrome" Can J Psychiatry, 34, p. 323-5
  17. Webster P, Wijeratne C (1994) "Risperidone-induced neuroleptic malignant syndrome." Lancet, 344, p. 1228-9
  18. Campellone JV, Mccluskey LF, Greenspan D (1995) "Fatal outcome from neuroleptic malignant syndrome associated with clozapine." Neuropsychiatry Neuropsychol Behav Neurol, 8, p. 70-3
  19. Raitasuo V, Vataja R, Elomaa E (1994) "Risperidone-induced neuroleptic malignant syndrome in young patient." Lancet, 344, p. 1705
  20. Dave M (1995) "Two cases of risperidone-induced neuroleptic malignant syndrome." Am J Psychiatry, 152, p. 1233-4
  21. Singer S, Richards C, Boland RJ (1995) "Two cases of risperidone-induced neuroleptic malignant syndrome." Am J Psychiatry, 152, p. 1234
  22. Najara JE, Enikeev ID (1995) "Risperidone and neuroleptic malignant syndrome: a case report." J Clin Psychiatry, 56, p. 534-5
  23. Tarsy D (1996) "Risperidone and neuroleptic malignant syndrome." JAMA, 275, p. 446
  24. Kern JL, Cernek PK (1996) "Delayed risperidone-induced malignant syndrome." Ann Pharmacother, 30, p. 300
  25. Sharma R, Trappler B, Ng YK, Leeman CP (1996) "Risperidone-induced neutroleptic malignant syndrome." Ann Pharmacother, 30, p. 775-8
  26. (2001) "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company
  27. Gleason PP, Conigliaro RL (1997) "Neuroleptic malignant syndrome with risperidone." Pharmacotherapy, 17, p. 617-21
  28. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  29. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  30. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  31. Moltz DA, Coeytaux RR (1998) "Case report: Possible neuroleptic malignant syndrome associated with olanzapine." J Clin Psychopharmacol, 18, p. 485-6
  32. Burkhard PR, Vingerhoets FJG (1999) "Olanzapine induced neuroleptic malignant syndrome." Arch Gen Psychiat, 56, p. 101-2
  33. Johnson V, Bruxner G (1998) "Neuroleptic malignant syndrome associated with olanzapine." Aust N Z J Psychiat, 32, p. 884-6
  34. Margolese HC, Chouinard G (1999) "Olanzapine-induced neuroleptic malignant syndrome with mental retardation." Am J Psychiat, 156, p. 1115-6
  35. Levenson JL (1999) "Neuroleptic malignant syndrome after the initiation of olanzapine." J Clin Psychopharmacol, 19, p. 477-8
  36. Nyfort-Hansen K, Alderman CP (2000) "Possible neuroleptic malignant syndrome associated with olanzapine." Ann Pharmacother, 34, p. 667
  37. SierraBiddle D, Herran A, DiezAja S, GonzalezMata JM, Vidal E, DiezManrique F, VazquezBarquero JL (2000) "Neuroleptic malignant syndrome and olanzapine." J Clin Psychopharmacol, 20, p. 704-5
  38. (2001) "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals
  39. (2022) "Product Information. Loxitane C (loxapine)." Apothecon Inc
  40. (2002) "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb
  41. (2007) "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals
  42. (2009) "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc
  43. (2009) "Product Information. Saphris (asenapine)." Schering-Plough Corporation
  44. (2010) "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc
  45. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
  46. (2015) "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc.
View all 46 references
Moderate

Antipsychotic/neuroleptic agents (applies to haloperidol) seizure

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Alcoholism, Head Injury, Seizures

Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.

References

  1. (2001) "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals
  2. (2001) "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals
  3. (2001) "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company
  4. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  5. (2001) "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals
  6. (2002) "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb
  7. (2007) "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals
  8. (2009) "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc
  9. (2009) "Product Information. Saphris (asenapine)." Schering-Plough Corporation
  10. (2010) "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc
  11. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
  12. (2015) "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc.
  13. (2022) "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc., SUPPL-9
View all 13 references
Moderate

Haloperidol (applies to haloperidol) alcohol

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Alcoholism

The use of alcohol with haloperidol should be avoided due to possible additive effects and hypotension.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
Moderate

Haloperidol (applies to haloperidol) cardiovascular disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Angina Pectoris

Haloperidol should be administered cautiously to patients with severe cardiovascular disorders because of the possibility of transient hypotension and/or precipitation of anginal pain. In the presence of severe hypotension requiring vasopressor therapy, the preferred drugs may be norepinephrine, phenylephrine, or metaraminol, as usual doses of epinephrine may be ineffective since haloperidol inhibits its vasopressor effect.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
Moderate

Haloperidol (applies to haloperidol) QT prolongation

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Long QT Syndrome, Hypokalemia, Hypothyroidism

Cases of sudden death, QT interval prolongation and ventricular arrhythmias including Torsade de Pointes have been reported in patients using haloperidol. Although cases have been reported even in the absence of predisposing factors, special caution is advised in treating patients with other QT- prolonging conditions (including electrolyte imbalance such as hypokalemia and hypomagnesemia), using QT- prolonging drugs, with underlying cardiac abnormalities, hypothyroidism and familial long QT syndrome. Consider periodic EKG assessment on these patients. Treatment should be discontinued and a cardiac evaluation should be considered if a patient develops signs or symptoms of ventricular arrhythmia.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
Moderate

Haloperidol (applies to haloperidol) renal/liver disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

Haloperidol appears to be primarily converted in the liver to several metabolites, one of which is believed to be pharmacologically active. The metabolites and approximately 1% of the parent drug are excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects due to drug and metabolite accumulation. Therapy with haloperidol should be administered cautiously in such patients. Lower initial dosages and slower titration may be appropriate.

References

  1. Lam YW, Chang W-H, Jann MW, Chen H (1992) "Interindividual variabilities in haloperidol interconversion and the reduced haloperidol/haloperidol ratio." Neuropsychopharmacology, 7, p. 33-9
  2. Jann MW, Lam YW, Chang WH (1990) "Reversible metabolism of haloperidol and reduced haloperidol in Chinese schizophrenic patients." Psychopharmacology (Berl), 101, p. 107-11
  3. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
Moderate

Miscellaneous antipsychotics (applies to haloperidol) hyperprolactinemia/breast cancer

Moderate Potential Hazard, Moderate plausibility.

Antipsychotic drugs can elevate serum prolactin concentrations, and this elevation persists during chronic administration. This should be considered if therapy will be prescribed in patients with previously detected breast cancer as one-third of human breast cancers are prolactin-dependent in vitro. Associated disturbances such as galactorrhea, amenorrhea, gynecomastia, and impotence have been reported. Appropriate laboratory testing and follow-up is advised.

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  2. (2002) "Product Information. Eskalith (lithium)." SmithKline Beecham
  3. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  4. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  5. (2015) "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA
View all 5 references
Moderate

Miscellaneous antipsychotics (applies to haloperidol) neutropenia

Moderate Potential Hazard, Moderate plausibility.

The use of antipsychotics has been associated with events of leukopenia, neutropenia and agranulocytosis. Possible risk factors include preexisting low white blood cell count, and history of drug induced leukopenia/neutropenia. Patients with these risk factors should have complete blood count monitored frequently during the first few months of therapy. Patients should also be monitored for any signs or symptoms of infection. Treatment should be discontinued in any patient who develops a sore throat, fever, stomatitis, or other signs of infection along with a low WBC count or severe neutropenia (ANC < 1000/mm3).

References

  1. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  2. (2002) "Product Information. Eskalith (lithium)." SmithKline Beecham
  3. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  4. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  5. (2015) "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA
View all 5 references
Moderate

Neuroleptics (applies to haloperidol) dehydration

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diarrhea, Vomiting

Neuroleptic agents may cause hypotension (including orthostatic hypotension) and associated reflex tachycardia, syncope or dizziness, particularly during initiation of therapy or rapid escalation of dosage. Tolerance to the hypotensive effects often develops after a few doses to a few months. Rarely, fatal cardiac arrest has occurred secondary to severe hypotension. Therapy with neuroleptic agents should be administered cautiously in patients with conditions that would predispose them to hypotension, such as hypovolemia or dehydration (e.g., due to severe diarrhea or vomiting). In addition, neuroleptic agents can interfere with the body's ability to regulate core body temperature, occasionally producing hyperthermia during strenuous exercise, exposure to hot weather, and concomitant treatment with anticholinergic medications. Patients who are dehydrated may be particularly susceptible.

References

  1. (2001) "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company
  2. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  3. (2001) "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals
Moderate

Neuroleptics (applies to haloperidol) hyperprolactinemia

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Breast Cancer

The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Caution is also advised in patients with preexisting hyperprolactinemia. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds; however, the clinical significance of elevated serum prolactin levels is unknown for most patients. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male patients.

References

  1. Meco G, Falaschi P, Casacchia M, et al. (1985) "Neuroendocrine effects of haloperidol decanoate in patients with chronic schizophrenia." Adv Biochem Psychopharmacol, 40, p. 89-93
  2. Ash PR, Bouma D (1981) "Exaggerated hyperprolactinemia in response to thiothixene ." Arch Neurol, 38, p. 534-5
  3. (2002) "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical
  4. (2001) "Product Information. Navane (thiothixene)." Roerig Division
  5. Huang ML, Van Peer A, Woestenborghs R, De Coster R, Heykants J, Jansen AA, Zylicz Z, Visscher HW, Jonkman JH (1993) "Pharmacokinetics of the novel antipsychotic agent risperidone and the prolactin response in healthy subjects." Clin Pharmacol Ther, 54, p. 257-68
  6. (2001) "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals
  7. (2001) "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals
  8. (2001) "Product Information. Compazine (prochlorperazine)." SmithKline Beecham
  9. Dickson RA, Dalby JT, Williams R, Edwards AL (1995) "Risperidone-induced prolactin elevations in premenopausal women with schizophrenia." Am J Psychiatry, 152, p. 1102-3
  10. (2001) "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company
  11. (2001) "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals
  12. (2001) "Product Information. Moban (molindone)." Gate Pharmaceuticals
  13. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  14. (2001) "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals
  15. (2022) "Product Information. Loxitane C (loxapine)." Apothecon Inc
  16. Bai YM, Ciu HJ, Guo ZZ (2002) "Risperidone-induced hyperprolactinemia in an elderly woman." Am J Psychiatry, 159, p. 2112
View all 16 references
Moderate

Neuroleptics (applies to haloperidol) tardive dyskinesia

Moderate Potential Hazard, High plausibility.

Tardive dyskinesia (TD) has occurred in patients treated with antipsychotic drugs; the syndrome consists of potentially irreversible, involuntary, dyskinetic movements. The risk appears highest in older patients (particularly older women) but it is not possible to predict which patients are likely to develop TD; whether antipsychotic drugs differ in their potential to cause TD is unknown. The risk of TD and the likelihood that it will become irreversible increase with the duration of therapy and the total cumulative dose. The syndrome can develop after relatively brief treatment periods, even at low dosages; it may also occur after discontinuation of therapy. TD may remit (partially or completely) upon discontinuation of antipsychotic therapy, although antipsychotic therapy itself may suppress (or partially suppress) signs/symptoms of TD, possibly masking the underlying process; the effect of symptomatic suppression on the long-term course of TD is unknown. In patients with preexisting drug-induced TD, initiating or increasing the dosage of antipsychotic therapy may temporarily mask the symptoms of TD but could eventually worsen the condition. In patients requiring chronic therapy, the lowest dose and shortest duration of therapy producing a satisfactory clinical response are recommended; the need for continued therapy should be reassessed periodically. If signs/symptoms of TD occur during antipsychotic therapy, discontinuation of the offending agent should be considered; however, some patients may require treatment despite the presence of TD.

References

  1. (2020) "Product Information. Abilify (ARIPiprazole)." Otsuka American Pharmaceuticals Inc, SUPPL-45
  2. (2021) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc, SUPPL-7
  3. (2019) "Product Information. Vraylar (cariprazine)." Allergan Inc, SUPPL-6
  4. (2019) "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc, SUPPL-35
  5. (2022) "Product Information. Seroquel (QUEtiapine)." Astra-Zeneca Pharmaceuticals, SUPPL-72
  6. (2022) "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc., SUPPL-9
  7. (2020) "Product Information. Haldol (haloperidol)." Janssen Pharmaceuticals, SUPPL-76
  8. (2022) "Product Information. Thiothixene (thiothixene)." Amneal Pharmaceuticals LLC
  9. (2021) "Product Information. Clozaril (cloZAPine)." HLS Therapeutics Inc, SUPPL-88
  10. (2021) "Product Information. RisperDAL (risperiDONE)." Janssen Pharmaceuticals, SUPPL-83
  11. (2020) "Product Information. ZyPREXA (OLANZapine)." Lilly, Eli and Company, SUPPL-74
  12. (2017) "Product Information. Moban (molindone)." Endo Laboratories LLC, SUPPL-68
  13. (2017) "Product Information. Pimozide (pimozide)." Par Pharmaceutical Inc
  14. (2022) "Product Information. Geodon (ziprasidone)." Pfizer Inc., SUPPL-63
  15. (2016) "Product Information. Loxapine Succinate (loxapine)." Actavis U.S. (Amide Pharmaceutical Inc)
  16. (2022) "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals, SUPPL-39
  17. (2017) "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc, SUPPL-21
  18. (2017) "Product Information. Saphris (asenapine)." Schering-Plough Corporation, SUPPL-22
View all 18 references

Haloperidol drug interactions

There are 740 drug interactions with haloperidol.

Haloperidol alcohol/food interactions

There is 1 alcohol/food interaction with haloperidol.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.