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haloperidol injection

Pronunciation

Generic Name: haloperidol injection (HAL oh PER i dol)
Brand Name: Haldol, Haldol Decanoate

What is haloperidol injection?

Haloperidol injection is a long-acting antipsychotic medicine. It works by changing the actions of chemicals in your brain.

Haloperidol injection is used for long-term control of severe symptoms of psychosis, or mental illness such as schizophrenia. Haloperidol injection is sometimes used in people who cannot take antipsychotic medicine by mouth (orally).

Haloperidol injection is also used to control motor and speech tics in people with Tourette's syndrome.

Haloperidol may also be used for purposes not listed in this medication guide.

What is the most important information I should know about haloperidol injection?

You should not receive haloperidol injection if you have certain conditions that affect your central nervous system.

Haloperidol injection contains sesame oil and should not be given to a person who is allergic to peanuts.

Haloperidol is not approved for use in psychotic conditions related to dementia. Haloperidol may increase the risk of death in older adults with dementia-related conditions.

What should I discuss with my healthcare provider before receiving haloperidol injection?

Haloperidol is not approved for use in psychotic conditions related to dementia. Haloperidol may increase the risk of death in older adults with dementia-related conditions.

You should not receive this medicine if you are allergic to haloperidol, or if you have:

  • a peanut allergy (this medicine contains sesame oil); or

  • certain conditions that affect your central nervous system (such as severe drowsiness, or slowed thinking caused by taking other medicines or drinking alcohol).

To make sure haloperidol is safe for you, tell your doctor if you have:

  • Parkinson's disease;

  • liver disease;

  • kidney disease;

  • heart disease, angina (chest pain), coronary artery disease, history of stroke or blood clot;

  • high or low blood pressure;

  • a thyroid disorder;

  • epilepsy or other seizure disorder;

  • personal or family history of long QT syndrome; or

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).

It is not known whether haloperidol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while receiving this medicine.

Using antipsychotic medication during the last 3 months of pregnancy may cause problems in the newborn, such as withdrawal symptoms, breathing problems, feeding problems, fussiness, tremors, and limp or stiff muscles. However, you may have withdrawal symptoms or other problems if you stop using your medicine during pregnancy. Tell your doctor if you become pregnant while receiving haloperidol.

Haloperidol can pass into breast milk and may harm a nursing baby. You should not breast-feed while receiving this medicine.

Older adults may be more sensitive to the effects of this medicine.

How is haloperidol injection given?

You may be given haloperidol tablets or liquid to take by mouth for a short time before you are treated with haloperidol injection. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Haloperidol is injected into a muscle. A healthcare provider will give you this injection.

Haloperidol injection is usually given once every 3 to 4 weeks as needed.

If you use this medicine long-term, you may need frequent medical tests or vision exams.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your haloperidol injection.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if you have overdose symptoms (extreme drowsiness, severe tremors or muscle stiffness, weak or shallow breathing, fainting). An overdose of haloperidol can be fatal.

What should I avoid while receiving haloperidol injection?

Haloperidol may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid drinking alcohol. Dangerous side effects could occur.

Avoid becoming overheated or dehydrated during exercise and in hot weather. You may be more prone to heat stroke while you are using haloperidol.

Haloperidol injection side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

High doses or long-term use of haloperidol can cause a serious movement disorder that may not be reversible. The longer you receive haloperidol, the more likely you are to develop a serious movement disorder. The risk of this side effect is higher in women and older adults.

Call your doctor at once if you have:

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);

  • tremors in your arms or legs, inability to sit still;

  • stiffness in your neck, tightness in your throat, trouble breathing or swallowing;

  • stabbing chest pain, cough with yellow or green mucus;

  • headache with chest pain and severe dizziness or fainting;

  • vision changes, skin changes;

  • jaundice (yellowing of the skin or eyes);

  • unusual changes in mood or behavior;

  • sudden weakness or ill feeling, fever, chills, sore throat, painful mouth sores, cold or flu symptoms;

  • seizure (convulsions); or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects may include:

  • drowsiness;

  • weight gain;

  • dry mouth; or

  • constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Haloperidol injection dosing information

Usual Adult Dose for Psychosis:

Oral Haloperidol Formulations:
Moderate symptomology: 0.5 to 2 mg orally 2 to 3 times a day
Severe symptomology: 3 to 5 mg orally 2 to 3 times a day
-Initial doses of up to 100 mg/day have been necessary in some severely resistant cases.
Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control

Haloperidol Lactate for Injection:
Prompt control acute agitation: 2 to 5 mg IM every 4 to 8 hours
-The frequency of IM administration should be determined by patient response and may be given as often as every hour.
Maximum dose: 20 mg/day

Comments:
-Oral formulations should be used as soon as practical.
-The total parenteral dose in the preceding 24 hours may be used to approximate an initial oral total daily dose. Initial oral doses should be given within 12 to 24 hours after the last parenteral dose.
-The safety of prolonged oral doses of 100 mg/day or greater has not been studied.

Haloperidol Decanoate for Injection:
Initial dose of-Maximum initial dose: 100 mg; if greater than 100 mg is needed, the dose should be administered in 2 separate injections (100 mg followed by the balance in 3 to 7 days)
Maintenance dose: 10 to 15 times the previous daily oral dose IM once a month, titrated to response
r patients stabilized on low daily oral doses (up to 10 mg/day): 10 to 15 times the daily oral dose IM once a month
Initial dose for patients stabilized on higher daily oral doses, tolerant to oral treatment, or at risk of relapse: 20 times the daily oral dose IM once a month
-Maximum initial dose: 100 mg; if greater than 100 mg is needed, the dose should be administered in 2 separate injections (100 mg followed by the balance in 3 to 7 days)
Maintenance dose: 10 to 15 times the previous daily oral dose IM once a month, titrated to response
-Maximum monthly dose: 450 mg

Comments:
-Patients should be stabilized on antipsychotic medication before starting prolonged parenteral therapy.
-Monitor closely during initiation and stabilization to minimize the risk of overdosage or reappearance of psychotic symptoms; short acting formulations may be used during this period of adjustment.
-Extended-release injections are generally administered once a month or every 4 weeks, however, the dosing interval as well as dose may be adjusted to best suit the patient.
-Clinical experience with doses greater than 450 mg per months is limited.

Uses:
-Treatment of patients with schizophrenia who require prolonged parenteral antipsychotic therapy
-Management of manifestations of psychotic disorders

Usual Adult Dose for Schizophrenia:

Oral Haloperidol Formulations:
Moderate symptomology: 0.5 to 2 mg orally 2 to 3 times a day
Severe symptomology: 3 to 5 mg orally 2 to 3 times a day
-Initial doses of up to 100 mg/day have been necessary in some severely resistant cases.
Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control

Haloperidol Lactate for Injection:
Prompt control acute agitation: 2 to 5 mg IM every 4 to 8 hours
-The frequency of IM administration should be determined by patient response and may be given as often as every hour.
Maximum dose: 20 mg/day

Comments:
-Oral formulations should be used as soon as practical.
-The total parenteral dose in the preceding 24 hours may be used to approximate an initial oral total daily dose. Initial oral doses should be given within 12 to 24 hours after the last parenteral dose.
-The safety of prolonged oral doses of 100 mg/day or greater has not been studied.

Haloperidol Decanoate for Injection:
Initial dose of-Maximum initial dose: 100 mg; if greater than 100 mg is needed, the dose should be administered in 2 separate injections (100 mg followed by the balance in 3 to 7 days)
Maintenance dose: 10 to 15 times the previous daily oral dose IM once a month, titrated to response
r patients stabilized on low daily oral doses (up to 10 mg/day): 10 to 15 times the daily oral dose IM once a month
Initial dose for patients stabilized on higher daily oral doses, tolerant to oral treatment, or at risk of relapse: 20 times the daily oral dose IM once a month
-Maximum initial dose: 100 mg; if greater than 100 mg is needed, the dose should be administered in 2 separate injections (100 mg followed by the balance in 3 to 7 days)
Maintenance dose: 10 to 15 times the previous daily oral dose IM once a month, titrated to response
-Maximum monthly dose: 450 mg

Comments:
-Patients should be stabilized on antipsychotic medication before starting prolonged parenteral therapy.
-Monitor closely during initiation and stabilization to minimize the risk of overdosage or reappearance of psychotic symptoms; short acting formulations may be used during this period of adjustment.
-Extended-release injections are generally administered once a month or every 4 weeks, however, the dosing interval as well as dose may be adjusted to best suit the patient.
-Clinical experience with doses greater than 450 mg per months is limited.

Uses:
-Treatment of patients with schizophrenia who require prolonged parenteral antipsychotic therapy
-Management of manifestations of psychotic disorders

Usual Adult Dose for Agitated State:

Oral Haloperidol Formulations:
Moderate symptomology: 0.5 to 2 mg orally 2 to 3 times a day
Severe symptomology: 3 to 5 mg orally 2 to 3 times a day
-Initial doses of up to 100 mg/day have been necessary in some severely resistant cases.
Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control

Haloperidol Lactate for Injection:
Prompt control acute agitation: 2 to 5 mg IM every 4 to 8 hours
-The frequency of IM administration should be determined by patient response and may be given as often as every hour.
Maximum dose: 20 mg/day

Comments:
-Oral formulations should be used as soon as practical.
-The total parenteral dose in the preceding 24 hours may be used to approximate an initial oral total daily dose. Initial oral doses should be given within 12 to 24 hours after the last parenteral dose.
-The safety of prolonged oral doses of 100 mg/day or greater has not been studied.

Uses:
-Management of manifestations of psychotic disorders
-Prompt control of acute agitation in patients with schizophrenia with moderately severe to severe symptoms

Usual Adult Dose for Agitation:

Oral Haloperidol Formulations:
Moderate symptomology: 0.5 to 2 mg orally 2 to 3 times a day
Severe symptomology: 3 to 5 mg orally 2 to 3 times a day
-Initial doses of up to 100 mg/day have been necessary in some severely resistant cases.
Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control

Haloperidol Lactate for Injection:
Prompt control acute agitation: 2 to 5 mg IM every 4 to 8 hours
-The frequency of IM administration should be determined by patient response and may be given as often as every hour.
Maximum dose: 20 mg/day

Comments:
-Oral formulations should be used as soon as practical.
-The total parenteral dose in the preceding 24 hours may be used to approximate an initial oral total daily dose. Initial oral doses should be given within 12 to 24 hours after the last parenteral dose.
-The safety of prolonged oral doses of 100 mg/day or greater has not been studied.

Uses:
-Management of manifestations of psychotic disorders
-Prompt control of acute agitation in patients with schizophrenia with moderately severe to severe symptoms

Usual Adult Dose for Tourette's Syndrome:

Oral Haloperidol Formulations:
Initial dose:
-Moderate symptomology: 0.5 to 2 mg orally 2 to 3 times a day
-Severe symptomology: 3 to 5 mg orally 2 to 3 times a day
Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control

Haloperidol Lactate for Injection:
Prompt control acute agitation: 2 to 5 mg IM every 4 to 8 hours
-The frequency of IM administration should be determined by patient response and may be given as often as every hour.
Maximum dose: 20 mg/day

Comments:
-Oral formulations should be used as soon as practical.
-The total parenteral dose in the preceding 24 hours may be used to approximate an initial oral total daily dose. Initial oral doses should be given within 12 to 24 hours after the last parenteral dose.
-The safety of prolonged oral doses of 100 mg/day or greater has not been studied.
-Patients with chronic/resistant cases should be given the severe symptom dose.

Use:
-Control of tics and vocal utterances of Tourette's disorder

Usual Geriatric Dose for Schizophrenia:

Oral Haloperidol Formulations:
Moderate symptomology: 0.5 to 2 mg orally 2 to 3 times a day
Severe symptomology: 3 to 5 mg orally 2 to 3 times a day
-Initial doses of up to 100 mg/day have been necessary in some severely resistant cases.
Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control

Haloperidol Lactate for Injection:
-Recommended dose: 2 to 5 mg IM every 4 to 8 hours
-The frequency of IM administration should be determined by patient response and may be given as often as every hour.
-Maximum dose: 20 mg/day

Comments:
-Oral formulations should be used as soon as practical.
-The total parenteral dose in the preceding 24 hours may be used to approximate an initial oral total daily dose. Initial oral doses should be given within 12 to 24 hours after the last parenteral dose.
-The safety of prolonged oral doses of 100 mg/day or greater has not been studied.

Haloperidol Decanoate for Injection:
-Initial dose: 10 to 15 times the daily oral dose IM once
-Maintenance dose: 10 to 15 times the previous daily oral dose IM once a month
-Maximum initial dose: 100 mg; if greater than 100 mg is needed, the dose should be administered in 2 separate injections (100 mg followed by the balance in 3 to 7 days)
-Maximum monthly dose: 450 mg

Comments:
-Patients should be stabilized on antipsychotic medication before starting prolonged parenteral therapy.
-Monitor closely during initiation and stabilization to minimize the risk of overdosage or reappearance of psychotic symptoms; short acting formulations may be used during this period of adjustment.
-Extended-release injections are generally administered once a month or every 4 weeks, however, the dosing interval as well as dose may be adjusted to best suit the patient.
-Clinical experience with doses greater than 450 mg per months is limited.

Uses:
-Treatment of patients with schizophrenia who require prolonged parenteral antipsychotic therapy
-Treatment of schizophrenia

Usual Pediatric Dose for Psychosis:

3 to 12 years and 15 to 40 kg:
Initial dose: 0.5 mg/day orally in 2 to 3 divided doses
-Adjust in increments of 0.5 mg every 5 to 7 days until desired effect is achieved
Maintenance dose: 0.05 to 0.15 mg/kg/day in 2 to 3 divided doses

13 years and older and greater than 40 kg:
Initial dose:
-Moderate symptomology: 0.5 to 2 mg orally 2 to 3 times a day
-Severe symptomology: 3 to 5 mg orally 2 to 3 times a day
Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control

Comment:
-Severely disturbed patients may require higher doses.

Use:
-Management of manifestations of psychotic disorders

Usual Pediatric Dose for Tourette's Syndrome:

3 to 12 years and 15 to 40 kg:
-Initial dose: 0.5 mg/day orally in 2 to 3 divided doses
-Maintenance dose: 0.05 to 0.075 mg/kg/day

13 years and older and greater than 40 kg
Initial dose:
-Moderate symptomology: 0.5 to 2 mg orally 2 to 3 times a day
-Severe symptomology: 3 to 5 mg orally 2 to 3 times a day
Maintenance dose: After achieving a satisfactory response, the dose should be adjusted as practical to achieve optimum control

Comment:
-The daily dose may be increased every 5 to 7 days in 0.5 mg increments in patients 3 to 12 years of age and 15 to 40 kg.

Use:
-Control of tics and vocal utterances of Tourette's disorder

Usual Pediatric Dose for Agitated State:

3 to 12 years and 15 to 40 kg:
-Initial dose: 0.5 mg/day orally in 2 to 3 divided doses
-Maintenance dose: 0.05 to 0.075 mg/kg/day

Comments:
-The daily dose may be increased every 5 to 7 days in 0.5 mg increments.
-There is little evidence that behavior improvement is further enhanced by doses greater than 6 mg/day.
-Limitation of use: Treatment should be reserved for patients with severe behavior problems and/or hyperactive children only after failure to respond to psychotherapy or medications (other than antipsychotics).

Uses:
-Treatment of severe behavior problems in children, including combative, explosive hyperexcitability not accounted for by immediate provocation
-Short-term treatment of hyperactive children with excessive motor activity and accompanying conduct disorder with impulsivity, difficulty sustaining attention, aggressiveness, mood lability, and/or poor frustration tolerance.

Usual Pediatric Dose for Aggressive Behavior:

3 to 12 years and 15 to 40 kg:
-Initial dose: 0.5 mg/day orally in 2 to 3 divided doses
-Maintenance dose: 0.05 to 0.075 mg/kg/day

Comments:
-The daily dose may be increased every 5 to 7 days in 0.5 mg increments.
-There is little evidence that behavior improvement is further enhanced by doses greater than 6 mg/day.
-Limitation of use: Treatment should be reserved for patients with severe behavior problems and/or hyperactive children only after failure to respond to psychotherapy or medications (other than antipsychotics).

Uses:
-Treatment of severe behavior problems in children, including combative, explosive hyperexcitability not accounted for by immediate provocation
-Short-term treatment of hyperactive children with excessive motor activity and accompanying conduct disorder with impulsivity, difficulty sustaining attention, aggressiveness, mood lability, and/or poor frustration tolerance.

What other drugs will affect haloperidol injection?

Using haloperidol with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, prescription cough medicine, a muscle relaxer, or medicine for anxiety, depression, or seizures.

Many drugs can interact with haloperidol. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any you start or stop using, especially:

  • heart or blood pressure medication;

  • a blood thinner (warfarin, Coumadin, Jantoven);

  • an antibiotic or antifungal medicine;

  • anti-malaria medication;

  • cancer medicine;

  • medicine to treat Parkinson symptoms (such as levodopa); or

  • other antipsychotic medicines.

This list is not complete and many other drugs can interact with haloperidol injection. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about haloperidol.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.03.

Date modified: February 03, 2017
Last reviewed: September 19, 2016

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