Can you take Haloperidol with Strattera?
1 drug interaction and 51 additional warnings found for the following 2 drugs:
- haloperidol
- Strattera (atomoxetine)
Drug interactions
Major drug interactions
Major:
haloperidol atomoxetine
Applies to: haloperidol and Strattera (atomoxetine)
Using haloperidol together with atomoxetine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
haloperidol Food/Lifestyle
Applies to: haloperidol
Alcohol can increase the nervous system side effects of haloperidol such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with haloperidol. Do not use more than the recommended dose of haloperidol, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.
Moderate:
haloperidol Nicotine
Applies to: haloperidol
As you stop smoking during treatment with nicotine, your dosage requirement of haloperidol may need to be changed. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
49 potential interactions Applies to: 37 conditions, including High Blood Pressure, Depression, Bipolar Disorder, Underactive Thyroid, and Angina.
Acute Alcohol Intoxication
Major:
haloperidol
Haloperidol has a major potential interaction with 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).
Alcoholism
Major:
haloperidol
Haloperidol has a major potential interaction with 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.
Major:
haloperidol
Haloperidol has a major potential interaction with 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.
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Alcoholism.
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.
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Alcoholism.
The use of alcohol with haloperidol should be avoided due to possible additive effects and hypotension.
Altered Consciousness
Major:
haloperidol
Haloperidol has a major potential interaction with Altered Consciousness.
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.
Major:
haloperidol
Haloperidol has a major potential interaction with Altered Consciousness.
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).
Angina
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Angina.
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.
Bipolar Disorder
Major:
Strattera
The atomoxetine in Strattera has a major potential interaction with Bipolar Disorder.
Atomoxetine increased the risk of suicidal ideation in pediatric patients with ADHD, and patients should be monitored closely for suicidal thoughts and behavior, clinical worsening, or unusual behavioral changes, especially during initial therapy or dosage changes. Before initiating atomoxetine, patients should be screened for bipolar disorder risk factors, and discontinuation should be considered if treatment-emergent psychotic or manic symptoms occur.
Breast Cancer
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Breast Cancer.
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.
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with 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.
Cardiovascular Conditions and Disorders
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Cardiovascular Conditions and Disorders.
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.
Moderate:
Strattera
The atomoxetine in Strattera has a moderate potential interaction with Cardiovascular Conditions and Disorders.
Atomoxetine should be used with caution both in patients with conditions that may predispose them to hypotension or abrupt changes in heart rate or blood pressure, and in patients with underlying medical conditions that could be worsened by increases in blood pressure or heart rate, such as hypertension, tachycardia, cardiovascular disease, or cerebrovascular disease. Heart rate and blood pressure should be measured at baseline, following atomoxetine dosage increases, and periodically during therapy to detect clinically important increases.
Central Nervous System Disorders
Major:
haloperidol
Haloperidol has a major potential interaction with Central Nervous System Disorders.
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.
Cerebral Vascular Disorder
Moderate:
Strattera
The atomoxetine in Strattera has a moderate potential interaction with Cerebral Vascular Disorder.
Atomoxetine should be used with caution both in patients with conditions that may predispose them to hypotension or abrupt changes in heart rate or blood pressure, and in patients with underlying medical conditions that could be worsened by increases in blood pressure or heart rate, such as hypertension, tachycardia, cardiovascular disease, or cerebrovascular disease. Heart rate and blood pressure should be measured at baseline, following atomoxetine dosage increases, and periodically during therapy to detect clinically important increases.
Cerebrovascular Insufficiency
Major:
haloperidol
Haloperidol has a major potential interaction with Cerebrovascular Insufficiency.
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.
Dehydration
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Dehydration.
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.
Dementia
Major:
haloperidol
Haloperidol has a major potential interaction with Dementia.
Antipsychotic drugs are not approved for the treatment of patients with dementia-related psychosis. 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.
Major:
haloperidol
Haloperidol has a major potential interaction with Dementia.
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.
Depression
Major:
Strattera
The atomoxetine in Strattera has a major potential interaction with Depression.
Atomoxetine increased the risk of suicidal ideation in pediatric patients with ADHD, and patients should be monitored closely for suicidal thoughts and behavior, clinical worsening, or unusual behavioral changes, especially during initial therapy or dosage changes. Before initiating atomoxetine, patients should be screened for bipolar disorder risk factors, and discontinuation should be considered if treatment-emergent psychotic or manic symptoms occur.
Diarrhea
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Diarrhea.
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.
Glaucoma, Narrow Angle
Major:
Strattera
The atomoxetine in Strattera has a major potential interaction with Glaucoma, Narrow Angle.
The use of atomoxetine is contraindicated in patients with narrow angle glaucoma. In clinical trials, atomoxetine use was associated with an increased risk of mydriasis.
Head Injury
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Head Injury.
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.
Heart Disease
Major:
haloperidol
Haloperidol has a major potential interaction with 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.
Major:
Strattera
The atomoxetine in Strattera has a major potential interaction with Heart Disease.
Atomoxetine is contraindicated in patients with severe cardiac or vascular disorders whose condition would be expected to deteriorate if they had clinically important increase in blood pressure (e.g., 15 to 20 mmHg) or heart rate (e.g., 20 beats per minute). Atomoxetine generally should not be used in pediatric patients with known serious structural cardiac abnormalities, cardiomyopathy, serious arrhythmias, or other serious cardiac problems, and clinicians should consider not treating adults with clinically significant cardiac abnormalities, due to the risk of sudden death. Carefully assess cardiovascular history and perform physical exam before treatment, conduct further cardiac evaluation when indicated, and stop atomoxetine pending prompt cardiac evaluation if exertional chest pain, unexplained syncope, or other symptoms suggestive of cardiac disease occur.
High Blood Pressure
Major:
Strattera
The atomoxetine in Strattera has a major potential interaction with High Blood Pressure.
CNS stimulants increase blood pressure and heart rate; the use of some agents may be contraindicated in patients with severe/uncontrolled hypertension. Caution should be used when administering to patients with preexisting high blood pressure (even mild hypertension) and other cardiovascular conditions. All patients under treatment should be regularly monitored for potential tachycardia and hypertension.
History - Cerebrovascular Disease
Major:
haloperidol
Haloperidol has a major potential interaction with History - Cerebrovascular 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.
History - Myocardial Infarction
Major:
haloperidol
Haloperidol has a major potential interaction with History - Myocardial Infarction.
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.
Hyperprolactinemia
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Hyperprolactinemia.
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.
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Hyperprolactinemia.
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.
Hyperthyroidism
Major:
haloperidol
Haloperidol has a major potential interaction with Hyperthyroidism.
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.
Hypokalemia
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Hypokalemia.
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.
Hypotension
Major:
haloperidol
Haloperidol has a major potential interaction with Hypotension.
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.
Moderate:
Strattera
The atomoxetine in Strattera has a moderate potential interaction with Hypotension.
Atomoxetine should be used with caution both in patients with conditions that may predispose them to hypotension or abrupt changes in heart rate or blood pressure, and in patients with underlying medical conditions that could be worsened by increases in blood pressure or heart rate, such as hypertension, tachycardia, cardiovascular disease, or cerebrovascular disease. Heart rate and blood pressure should be measured at baseline, following atomoxetine dosage increases, and periodically during therapy to detect clinically important increases.
Liver Disease
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Liver Disease.
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.
Moderate:
Strattera
The atomoxetine in Strattera has a moderate potential interaction with Liver Disease.
Atomoxetine can cause severe liver injury. Atomoxetine exposure is increased in patients with moderate or severe hepatic impairment, and a lower dosage is recommended in these patients. Atomoxetine should be permanently discontinued in patients with jaundice or laboratory evidence of liver injury. Liver enzyme and function tests should be obtained at the first symptom or sign of liver dysfunction.
Long QT Syndrome
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Long QT Syndrome.
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.
Neuroleptic Malignant Syndrome
Major:
haloperidol
Haloperidol has a major potential interaction with Neuroleptic Malignant Syndrome.
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.
Major:
haloperidol
Haloperidol has a major potential interaction with 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.
Neutropenia
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Neutropenia.
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).
Parkinsonism
Major:
haloperidol
Haloperidol has a major potential interaction with Parkinsonism.
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.
Pheochromocytoma
Major:
Strattera
The atomoxetine in Strattera has a major potential interaction with Pheochromocytoma.
Atomoxetine is contraindicated in patients with pheochromocytoma or a history of pheochromocytoma. Serious reactions, including elevated blood pressure and tachyarrhythmia, have been reported in patients with pheochromocytoma or a history of pheochromocytoma who received atomoxetine.
Psychosis
Major:
Strattera
The atomoxetine in Strattera has a major potential interaction with Psychosis.
Atomoxetine increased the risk of suicidal ideation in pediatric patients with ADHD, and patients should be monitored closely for suicidal thoughts and behavior, clinical worsening, or unusual behavioral changes, especially during initial therapy or dosage changes. Before initiating atomoxetine, patients should be screened for bipolar disorder risk factors, and discontinuation should be considered if treatment-emergent psychotic or manic symptoms occur.
Renal Dysfunction
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with 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.
Respiratory Arrest
Major:
haloperidol
Haloperidol has a major potential interaction with 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.
Seizures
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with 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.
Tardive Dyskinesia
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Tardive Dyskinesia.
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.
Underactive Thyroid
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with Underactive Thyroid.
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.
Vomiting
Moderate:
haloperidol
Haloperidol has a moderate potential interaction with 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.
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haloperidol
A total of 784 drugs are known to interact with haloperidol.
- Haloperidol is in the drug class miscellaneous antipsychotic agents.
- Haloperidol is used to treat the following conditions:
Strattera
A total of 444 drugs are known to interact with Strattera.
- Strattera is in the drug class adrenergic uptake inhibitors for ADHD.
- Strattera is used to treat ADHD.
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| 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. | |
| No interaction information available. |
Further information
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