HALPOL
HALOPERIDOL · by XENON
Composition
Liqd/Drop: Per ml: Haloperidol 2 mg. Inj 5 mg: Per ml amp: Haloperidol 5 mg. Inj 50 mg: Per ml amp: Haloperidol 50 mg. Inj 100 mg: Per ml amp: Haloperidol 100 mg. Tab 0.25 mg/1.5 mg/2 mg/5 mg
Indications & Dosage
Maintenance in schizophrenia and other psychoses: ORAL: Adult: Initially 1.5-3 mg daily, increasing as required for control, then decreasing for maintenance, usually 3-10 mg daily; max: 30 mg daily. Children 3-13 yrs: initially 500 mcg daily in 2-3 divided doses; usual target dose 1-4 mg daily in 2-3 divided doses, max 6 mg daily in 2-3 divided doses; 13-18 yr: initially 500 mcg daily in 2-3 divided doses; usual target dose 1-6 mg daily in 2-3 divided doses, max 10 mg daily in 2-3 divided doses. BY DEEP IM INJECTION: Adult: Initially 50 mg every 4 weeks, increased in steps of 50 mg if required, increased if necessary up to 300 mg every 4 weeks, dose to be administered into gluteal muscle, if 2-weekly administration preferred, doses should be halved. Elderly: Initially 12.5-25 mg every 4 weeks, if 2-weeklyadministration preferred, doses should be halved. Childhood behavioural disorders, especially when associated with hyperactivity and aggression, Gilles de la Tourette syndrome: ORAL: Children 3-13 yr: 250 mcg daily in 2-3 divided doses; usual target dose 0.5-3 mg daily in 2-3 di-vided doses, max 3 mg daily in 2-3 divided doses; 13-18 yr:250 mcg daily in 2-3 divided doses; usual target dose 2-6 mg daily in 2-3 divided doses, max 6 mg daily in 2-3 divided doses.
Administration
Administered by IM, although IV administration has been performed. Give haloperidol decanoate (long-acting form prepared in sesame oil to produce slow, sustained release) by deep IM injection into gluteal muscle using Z-track technique and 21G needle. Don't give more than 3 ml per site.
Compatibility
Dextrose 5%, NaCI 0.9%, 0.45%.
Stability
Stored at controlled room temperature and protect from light, freezing and temperature above 40 degree centigrade should be avoided.
Contraindications
Bradycardia, CNS depression, comatose states, lesions of the basal ganglia, Parkinsons disease, phaeochromocytoma, QT-interval, prolongation
Precautions
Renal or hepatic impairment, arteriosclerosis, hypocalcaemia, hypokalaemia, hypomagnesaemia, metabolic disturbances, subarachnoid haemorrhage, thyrotoxicosis, epilepsy, hyperthyroidism, severe cardiovascular disease, predisposing factors for ventricular arrhythmias or venous thromboembolism, stroke or convulsions, depression. Monitor serum electrolytes periodically.
Interactions
Adrenaline, alcohol, barbiturates, CNS depressants, other antipsychotics, anticholinergics, antacids, do-paminergics, lithium, oral hypoglycaemics, antihypertensives, anticonvulsants, rifampicin, propranolol, drugs that prolong the QT interval (e.g. anti-arrhythmics), diuretics, metoclopramide, Inhibitors of CYP3A4 or 2D6.
Pregnancy
Avoid unless potential benefit outweighs risk
Lactation
Contraindicated, avoid
Side Effects
Anticholinergic effects (e.g. dry mouth, blurred vision), rash, depression, weight loss, dyspnea, oedema,e rythema, hypertension, nodules, pain at injection site, Stevens-Johnson syndrome, somnolence, dizziness, drowsiness, visual disturbances, tachycardia, arrhythmias, ECG changes, altered LFTs, hypotension, convulsions, GI disturbance. Rare: Bronchospasm, hypoglycaemia, inappropriate antidiuretic hormone secretion, photosensitivity reactions, pigmentation, Sweating, swelling, toxic epidermal necrolysis