Home Drug Guide Haloperidol Lactate

Drug Guide

Generic Name

Haloperidol Lactate

Brand Names Haldol, Haloperidol, Haloperidol Intensol

Classification

Therapeutic: Antipsychotic (Neuroleptic)

Pharmacological: Butyrophenone Derivative

FDA Approved Indications

  • Schizophrenia
  • Acute psychosis
  • Tic disorders (e.g., Tourette syndrome)
  • Hiccups (off-label)

Mechanism of Action

Haloperidol blocks dopamine D2 receptors in the brain, reducing dopaminergic neurotransmission, which alleviates psychotic symptoms.

Dosage and Administration

Adult: Typically 2-10 mg orally two to three times daily; dosage adjusted based on clinical response and tolerability.

Pediatric: Dosing varies; usually 0.05-0.15 mg/kg/day divided into two or three doses, not to exceed 12 mg/day.

Geriatric: Start at lower doses, e.g., 0.5-1 mg twice daily, and titrate slowly.

Renal Impairment: Use with caution; no specific dose adjustment established, monitor for toxicity.

Hepatic Impairment: Use with caution; dose reduction may be necessary, monitor liver function.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Extensively metabolized in the liver by CYP3A4 and CYP2D6 enzymes.

Excretion: Primarily via urine as metabolites.

Half Life: Approximately 20 hours.

Contraindications

  • Parkinson's disease
  • Comcomitant use with linezolid or methylene blue (serotonin syndrome risk)
  • Known hypersensitivity to haloperidol

Precautions

  • History of seizures
  • Cardiovascular disease (QT prolongation risk)
  • Dementia-related psychosis (increased mortality risk in elderly)
  • Pregnancy and lactation: Use only if clearly needed; safety not established.

Adverse Reactions - Common

  • Extrapyramidal symptoms (dystonia, akathisia, Parkinsonism) (Common)
  • Sedation (Common)
  • Hypotension (Common)
  • Dry mouth, blurred vision, urinary retention (Common)

Adverse Reactions - Serious

  • QT prolongation and torsades de pointes (Rare)
  • Neuroleptic malignant syndrome (NMS) (Rare)
  • Leukopenia, neutropenia, agranulocytosis (Rare)
  • TD (Tardive dyskinesia) with long-term use (Potentially irreversible)

Drug-Drug Interactions

  • Other CNS depressants, including alcohol and opioids
  • Anticholinergic agents (potentiation of anticholinergic effects)
  • Metoclopramide, other dopamine antagonists

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of extrapyramidal symptoms, neuroleptic malignant syndrome, QT prolongation, vital signs, and mental status.

Diagnoses:

  • Risk for injury related to extrapyramidal symptoms or orthostatic hypotension.
  • Imbalanced nutrition: Less than body requirements due to sedation.

Implementation: Administer with food or milk to decrease gastrointestinal irritation. Monitor ECGs in at-risk patients. Adjust doses based on clinical response and side effects.

Evaluation: Assess for resolution of psychotic symptoms, minimize side effects, and ensure patient safety.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Notify healthcare provider if experiencing muscle stiffness, tremors, fever, or unusual movements.
  • Avoid alcohol and operating heavy machinery until stabilized.
  • Report any signs of abnormal heart rhythm, such as palpitations or dizziness.

Special Considerations

Black Box Warnings:

  • Elderly patients with dementia-related psychosis treated with antipsychotics are at increased risk of death.

Genetic Factors: Patients with CYP2D6 poor metabolizer phenotype may have increased plasma levels.

Lab Test Interference: May cause false positives in urinary catecholamine tests.

Overdose Management

Signs/Symptoms: Extrapyramidal symptoms, hypotension, altered mental status, seizures, coma.

Treatment: Supportive care, manage symptoms, activated charcoal if recent ingestion, and symptomatic treatment. Cardiac monitoring for QT prolongation.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable at room temperature for at least 24 months.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.