Haloperidol
Revision as of 20:08, 12 May 2022 by Rossdonaldson1 (talk | contribs)
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