Haloperidol

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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

Common

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

Comments

See Also

References