IV. Class

  1. First Generation Antipsychotic

V. Dosing: Haloperidol

  1. Dose
    1. Adult: 5-10 mg PO, IM, or IV
    2. Peds: 0.5-1 mg PO, IM or IV
    3. Adolescent: 1-5 mg PO, IM or IV
    4. Elderly: 0.5-2 mg PO, IM or IV
  2. Intervals: Scheduled and repeated dosing intervals
    1. May repeat every 30-60 minutes
    2. Maximum: 300 mg/24 hours (avoid cummulative dose over 100 mg in 24 hours)
    3. May dose regularly every 6-8 hours
      1. Typical effective dose: 5 mg PO, IV, or IM tid (lower doses in the elderly)
    4. Total dose >3 mg/day is associated with Extrapyramidal Side Effects

VI. Dosing: Haloperidol decanoate (depot form)

  1. Haloperidol decanoate 100 mg IM every 4 weeks
  2. Cost effective (may be as low as $19 generic)

VII. Precautions

  1. Intravenous doses have a much shorter duration of action than other routes
  2. Antipsychotics are associated with increased mortality in the elderly

VIII. Adverse effects

  1. Serious
    1. See Extrapyramidal Side Effects (EPSE)
    2. Neuroleptic Malignant Syndrome
    3. Hypotension
    4. Dystonia
    5. Seizures
    6. Prolonged QT interval
      1. Risk of Torsades de Pointes
      2. Dose related effect with higher risk at higher doses
  2. Common
    1. Insomnia
    2. Restlessness
    3. Anxiety
    4. Sedation
    5. Headache
    6. Weight gain
    7. Hyperprolactinemia
    8. Blood dyscrasia

IX. Monitoring

  1. Serum Prolactin
    1. Obtain if indicated
  2. Complete Blood Count (indicated if history of Leukopenia)
    1. Baseline
    2. Monthly in first 3 months of therapy

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Cost: Medications

Haloperidol (on 6/18/2017 at Walmart.com)
Haloperidol 0.5mg #30 tablets for $4.00 $0.13 each
Haloperidol 0.5mg #90 tablets for $10.00 $0.11 each
Haloperidol 1mg #30 tablets for $4.00 $0.13 each
Haloperidol 1mg #90 tablets for $10.00 $0.11 each
Haloperidol 2mg #30 tablets for $4.00 $0.13 each
Haloperidol 2mg #90 tablets for $10.00 $0.11 each
Haloperidol 5mg #30 tablets for $4.00 $0.13 each
Haloperidol 5mg #90 tablets for $10.00 $0.11 each
haloperidol (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
HALOPERIDOL 0.5 MG TABLET Generic $0.22 each
HALOPERIDOL 1 MG TABLET Generic $0.27 each
HALOPERIDOL 10 MG TABLET Generic $0.57 each
HALOPERIDOL 2 MG TABLET Generic $0.35 each
HALOPERIDOL 20 MG TABLET Generic $1.38 each
HALOPERIDOL 5 MG TABLET Generic $0.45 each
HALOPERIDOL LAC 2 MG/ML CONC Generic $0.06 per ml
HALOPERIDOL LAC 5 MG/ML VIAL Generic $0.79 per ml

Ontology: Haloperidol (C0018546)

Definition (MSH) A phenyl-piperidinyl-butyrophenone that is used primarily to treat SCHIZOPHRENIA and other PSYCHOSES. It is also used in schizoaffective disorder, DELUSIONAL DISORDERS, ballism, and TOURETTE SYNDROME (a drug of choice) and occasionally as adjunctive therapy in INTELLECTUAL DISABILITY and the chorea of HUNTINGTON DISEASE. It is a potent antiemetic and is used in the treatment of intractable HICCUPS. (From AMA Drug Evaluations Annual, 1994, p279)
Definition (NCI_NCI-GLOSS) A drug used to treat certain mental and neurological disorders. It is also being studied in the treatment of nausea and vomiting caused by some cancer treatments. It is a type of antiemetic and a type of antipsychotic.
Definition (NCI) A phenylbutylpiperadine derivative with antipsychotic, neuroleptic, and antiemetic activities. Haloperidol competitively blocks postsynaptic dopamine (D2) receptors in the mesolimbic system of the brain, thereby eliminating dopamine neurotransmission and leading to antidelusionary and antihallucinagenic effects. Antagonistic activity mediated through D2 dopamine receptors in the chemoreceptive trigger zone (CTZ) accounts for its antiemetic activity.
Definition (CSP) USP lists as an antipsychotic and as an "antidyskinetic" used in Tourette syndrome.
Definition (PDQ) A phenylbutylpiperadine derivative with antipsychotic, neuroleptic and antiemetic effects. Haloperidol competitively blocks postsynaptic dopamine (D2) receptors in the mesolimbic system of the brain, thereby eliminating dopamine neurotransmission and leading to antidelusionary and antihallucinagenic effects. The antagonistic activity mediated through D2 dopamine receptors in the chemoreceptive trigger zone (CTZ) accounts for its antiemetic activity. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39474&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39474&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C537" NCI Thesaurus)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D006220
SnomedCT 321415008, 323259009, 10756001, 386837002
LNC LP16158-5, MTHU005005
English Haloperidol, 1-Butanone, 4-(4-(4-chlorophenyl)-4-hydroxy-1-piperidinyl)-1-(4-fluorophenyl)-, Haloperidol [antipsychotic], Haloperidol [tics, chorea], Haloperidol [tics, chorea] [see D47..], 4-[4-(4-Chlorophenyl)-4-hydroxy-1-piperidinyl]-1-(4-fluorophenyl)-1-butanone, HALOPERIDOL, haloperidol (medication), Haloperidol [Chemical/Ingredient], Haloperidol [tics, chorea] [see D47..] (product), Haloperidol [antipsychotic] (product), haloperidol, Haloperidol (product), Haloperidol (substance), Haloperidol [antipsychotic] (substance), Haloperidol [tics, chorea] [see D47..] (substance)
Swedish Haloperidol
Czech haloperidol
Finnish Haloperidoli
Russian GALOPERIDOL, ГАЛОПЕРИДОЛ
Japanese ハロペリドール
Croatian HALOPERIDOL
Polish Haloperidol
Spanish haloperidol [tics, corea] [véase D47..] (producto), haloperidol [antipsicótico], haloperidol [tics, corea] [véase D47..], haloperidol [antipsicótico] (producto), haloperidol (producto), haloperidol (sustancia), haloperidol, Haloperidol
French Halopéridol
German Haloperidol
Italian Aloperidolo
Portuguese Haloperidol

Ontology: haloperidol decanoate (C0062103)

Definition (NCI) The decanoate ester of haloperidol, a phenylbutylpiperadine derivative with antipsychotic, neuroleptic and antiemetic effects. Haloperidol competitively blocks postsynaptic dopamine (D2) receptors in the mesolimbic system of the brain leading to anti-delusionary and anti-hallucinogenic effects. The antagonistic activity mediated through D2 dopamine receptors in the chemoreceptive trigger zone (CTZ) account for its antiemetic activity.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C033563
SnomedCT 412196004, 321699007
English haloperidol decanoate, Haloperidol Decanoate, Haloperidol deconoate, haloperidol decanoate (discontinued) (medication), haloperidol decanoate (discontinued), haloperidol decanoate [Chemical/Ingredient], HALOPERIDOL DECANOATE, Haloperidol decanoate, Haloperidol decanoate (product), Haloperidol decanoate (substance), Haloperidol deconoate (substance)
Spanish decanoato de haloperidol (producto), decanoato de haloperidol, decanoato de haloperidol (sustancia)

Ontology: Haldol (C0591585)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D006220
English Haldol, haldol

Ontology: Haloperidol lactate (C0720809)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
SnomedCT 412197008
English haloperidol lactate, haloperidol lactate (medication), Haloperidol lactate, HALOPERIDOL LACTATE, Haloperidol Lactate, Haloperidol lactate (substance)
Spanish lactato de haloperidol (sustancia), lactato de haloperidol