Haloperidol: Difference between revisions
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==General== | ==General== | ||
*Type: | *Type: [[Antipsychotic]], first generation | ||
*Dosage Forms: PO, IM, IV | *Dosage Forms: PO, IM, IV | ||
*Common Trade Names: Haldol | *Common Trade Names: Haldol | ||
==Adult Dosing== | ==Adult Dosing== | ||
*Acute Agitation: | *Acute [[Agitation]]: | ||
**5-10mg IM, subsequent doses based on patient response dosed every 1 hour | **5-10mg IM, subsequent doses based on patient response dosed every 1 hour | ||
**0.5-10mg IV, depending on degree of agitation; may repeat bolus dose (with sequential doubling of initial bolus dose) q15-30mins until calm achieved | **0.5-10mg IV, depending on degree of agitation; may repeat bolus dose (with sequential doubling of initial bolus dose) q15-30mins until calm achieved | ||
*Psychosis: | *[[Psychosis]]: | ||
**0.5-2mg PO divided BID-TID, slowly titrate q7days to effect with Max 100mg/day | **0.5-2mg PO divided BID-TID, slowly titrate q7days to effect with Max 100mg/day | ||
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*[[ | *[[Pregnancy and lactation drug labeling|Lactation risk]]: Unknown | ||
*Renal Dosing | *Renal Dosing | ||
**Adult - none | **Adult - none | ||
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*Allergy to class/drug | *Allergy to class/drug | ||
*Parkinson's Disease | *Parkinson's Disease | ||
* | * Caution in QT prolongation | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Prolonged QT | *[[Prolonged QT]] → [[Torsades de pointes]] → Sudden Death | ||
*Hypotension | *[[Hypotension]] | ||
*[[Neuroleptic malignant syndrome]] | *[[Neuroleptic malignant syndrome]] | ||
*Seizure | *[[Seizure]] | ||
===Common=== | ===Common=== | ||
*Constipation | *[[Constipation]] | ||
*Xerostomia | *Xerostomia | ||
*Blurred vision | *Blurred vision | ||
*Urinary retention | *[[Urinary retention]] | ||
*Leukopenia | *Leukopenia | ||
*Neutropenia | *Neutropenia | ||
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==Comments== | ==Comments== | ||
==See Also== | ==See Also== | ||
*[[Antipsychotic toxicity]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category: | |||
[[Category:Pharmacology]] | |||
[[Category:Psychiatry]] | |||
Latest revision as of 20:08, 12 May 2022
General
- Type: Antipsychotic, first generation
- Dosage Forms: PO, IM, IV
- Common Trade Names: Haldol
Adult Dosing
- Acute Agitation:
- 5-10mg IM, subsequent doses based on patient response dosed every 1 hour
- 0.5-10mg IV, depending on degree of agitation; may repeat bolus dose (with sequential doubling of initial bolus dose) q15-30mins until calm achieved
- Psychosis:
- 0.5-2mg PO divided BID-TID, slowly titrate q7days to effect with Max 100mg/day
- Tourette Syndrome:
- 0.5-2mg PO divided BID-TID, slowly titrate q7days to effect with Max 100mg/day
- Agitation
- 0.5-10mg PO q1-4hrs, Max 100mg/day
Pediatric Dosing
- Acute Agitation:
- Injectable safety and effectiveness not established in pediatric patients <12yo
- Psychosis:
- 3-12yo - 0.05-0.15mg/kg/day PO divided BID-TID, slowly titrate q7days to effect with Max 0.15mg/kg/day
- >12 - 0.5mg-2mg PO divided BID-TID, slowly titrate q7days to effect with Max 100mg/day
- Tourette Syndrome:
- 3-12yo - 0.05-0.075mg/kg/day PO divided BID-TID, slowly titrate q7days to effect with Max 0.15mg/kg/day
- >12 - 0.5mg-5mg PO divided BID-TID, slowly titrate q7days to effect with Max 100mg/day
- Behavioral Disorders:
- 3-12yo - 0.05-0.075mg/kg/day PO divided BID-TID, slowly titrate q7days to effect with Max 0.15mg/kg/day
- >12 - 0.5mg-5mg PO divided BID-TID, slowly titrate q7days to effect with Max 100mg/day
- Agitation:
- 3-12yo - 0.01-0.03mg/kg/day PO divided BID-TID, slowly titrate q7days to effect with Max 0.15mg/kg/day
- >12 - 0.5mg-10mg PO divided BID-TID, Max 100mg/day
Special Populations
- Pregnancy Rating: C
- Lactation risk: Unknown
- Renal Dosing
- Adult - none
- Pediatric - none
- Hepatic Dosing
- Adult - Hepatic impairment
- Pediatric - Hepatic impairment
Contraindications
- Allergy to class/drug
- Parkinson's Disease
- Caution in QT prolongation
Adverse Reactions
Serious
- Prolonged QT → Torsades de pointes → Sudden Death
- Hypotension
- Neuroleptic malignant syndrome
- Seizure
Common
- Constipation
- Xerostomia
- Blurred vision
- Urinary retention
- Leukopenia
- Neutropenia
- Agranulocytosis
- Dystonia/Extrapyramidal Disease
- Blurred Vision
Pharmacology
- Half-life: 18 hours
- Metabolism: Hepatic - Glucuronidation and CYP3A4-mediated
- Excretion: Urine and Fecal
- Mechanism of Action: blocks postsynaptic mesolimbic dopaminergic D1 and D2 receptors in the brain, depressing depresses the release of hypothalamic and hypophyseal hormones leading to a depressed reticular activating system