Haloperidol

Haloperidol Brand Name– Haldol | Haldol Decanoate

What is Haloperidol

Haloperidol is a high-potency conventional antipsychotic that is structurally related to droperidol.

Oral formulations of haloperidol and haloperidol lactate intramuscular injection solution are indicated for the symptomatic treatment of schizophrenia and to control tics and vocal utterances of Tourette’s Disorder.

The American Academy of Neurology practice guideline states that haloperidol is probably more likely than placebo to reduce tic severity in patients with Tourette’s syndrome or chronic tic disorders; however, there is insufficient evidence to determine the efficacy of haloperidol relative to other antipsychotics used to treat tics.

Oral haloperidol is also indicated in pediatric patients for the treatment of severe behavioral problems, manifested as impulsive, combative, or explosive hyperexcitability, that are unresponsive to behavioral or counseling therapy.

Haloperidol decanoate is a depot intramuscular injection indicated for adult schizophrenic patients who require prolonged parenteral antipsychotic treatment.

Conventional antipsychotics such as haloperidol have largely been replaced by atypical antipsychotics for various labeled indications. Haloperidol is still fairly commonly used in emergent or hospital settings for the treatment of agitation.

However, IV administration of haloperidol lactate injection solution is not FDA-approved and IV use is associated with an increased risk of QT prolongation and torsade de pointes (TdP); ECG monitoring is recommended if the drug is used by this route.

As with all antipsychotics, the haloperidol labels carry a boxed warning regarding an increased risk of death in elderly patients treated for dementia-related psychosis

Indications

1. agitation
2. attention-deficit hyperactivity disorder (ADHD)
3. autistic disorder
4. behavioral or psychological symptoms of dementia
5. chemotherapy-induced nausea/vomiting
6. delirium
7. mania
8. oppositional defiant disorder
9. schizophrenia
10. singultus (hiccups)
11. Tourette’s syndrome

Side Effects

1. abdominal pain
2. acneiform rash
3. agitation
4. agranulocytosis
5. akathisia
6. akinesia
7. alopecia
8. amenorrhea
9. anaphylactoid reactions
10. anemia
11. angioedema
12. anxiety
13. aplastic anemia
14. blurred vision
15. bronchospasm
16. cardiac arrest
17. cataracts
18. cholestasis
19. confusion
20. constipation
21. contact dermatitis
22. depression
23. diaphoresis
24. drowsiness
25. dyskinesia
26. dysmenorrhea
27. dysphagia
28. dyspnea
29. dystonic reaction
30. edema
31. ejaculation dysfunction
32. elevated hepatic enzymes
33. eosinophilia
34. euphoria
35. exfoliative dermatitis
36. fever
37. galactorrhea
38. gynecomastia
39. hallucinations
40. headache
41. heat intolerance
42. hemolytic anemia
43. hepatic failure
44. hepatitis
45. hyperammonemia
46. hyperglycemia
47. hyperkinesis
48. hyperprolactinemia
49. hypersalivation
50. hyperthermia
51. hypertonia
52. hypoglycemia
53. hyponatremia
54. hypotension
55. hypothermia
56. impotence (erectile dysfunction)
57. infection
58. infertility
59. injection site reaction
60. insomnia
61. jaundice
62. laryngeal edema
63. laryngospasm
64. lethargy
65. leukopenia
66. libido decrease
67. maculopapular rash
68. mastalgia
69. menorrhagia
70. menstrual irregularity
71. nausea
72. neonatal abstinence syndrome
73. neuroleptic malignant syndrome
74. neutropenia
75. nystagmus
76. orthostatic hypotension
77. osteopenia
78. pancytopenia
79. photosensitivity
80. polydipsia
81. priapism
82. pseudoparkinsonism
83. purpura
84. QT prolongation
85. rash
86. restlessness
87. retinal pigment changes
88. retinopathy
89. rhabdomyolysis
90. seizures
91. SIADH
92. sinus tachycardia
93. stroke
94. tardive dyskinesia
95. thrombocytopenia
96. torsade de pointes
97. torticollis
98. tremor
99. trismus
100. urinary retention
101. urticaria
102. vasculitis
103. ventricular fibrillation
104. ventricular tachycardia
105. vertigo
106. visual impairment
107. vomiting
108. water intoxication
109. weight gain
110. weight loss
111. withdrawal
112. xerostomia

Monitoring Parameters

• CBC
• ophthalmologic exam
• serum prolactin
• urinalysis

Contraindications

• abrupt discontinuation
• agranulocytosis
• ambient temperature increase
• angina
• apheresis
• AV block
• bradycardia
• breast cancer
• breast-feeding
• cardiomyopathy
• celiac disease
• closed-angle glaucoma
• CNS depression
• coadministration with other CNS depressants
• coma
• dehydration
• dementia
• dementia with Lewy bodies
• driving or operating machinery
• dysphagia
• ethanol ingestion
• females
• fever
• geriatric
• heart failure
• hematological disease
• hepatic disease
• human immunodeficiency virus (HIV) infection
• hyperparathyroidism
• hyperprolactinemia
• hyperthermia
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypotension
• hypothermia
• hypothyroidism
• increased intraocular pressure
• infertility
• intravenous administration
• leukopenia
• long QT syndrome
• myocardial infarction
• neonates
• neurological disease
• neutropenia
• orthostatic hypotension
• Parkinson’s disease
• pheochromocytoma
• pregnancy
• pregnancy testing
• prostatic hypertrophy
• pulmonary disease
• QT prolongation
• rheumatoid arthritis
• seizure disorder
• seizures
• sickle cell disease
• sleep deprivation
• strenuous exercise
• stroke
• systemic lupus erythematosus (SLE)
• tardive dyskinesia
• thyrotoxicosis
• tobacco smoking
• torsade de pointes
• urinary retention
• visual disturbance

Interactions

• Abarelix
• Abiraterone
• Acebutolol
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetazolamide
• Acrivastine; Pseudoephedrine
• Aldesleukin, IL-2
• Alfentanil
• Alfuzosin
• Aliskiren; Amlodipine
• Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
• Aliskiren; Hydrochlorothiazide, HCTZ
• Aliskiren; Valsartan
• Alprazolam
• Amifampridine
• Amiloride
• Amiloride; Hydrochlorothiazide, HCTZ
• Amiodarone
• Amitriptyline; Chlordiazepoxide
• Amlodipine
• Amlodipine; Atorvastatin
• Amlodipine; Benazepril
• Amlodipine; Celecoxib
• Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
• Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
• Amlodipine; Olmesartan
• Amlodipine; Telmisartan
• Amlodipine; Valsartan
• Amobarbital
• Amoxapine
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Amprenavir
• Anagrelide
• Angiotensin II receptor antagonists
• Angiotensin-converting enzyme inhibitors
• Anxiolytics; Sedatives; and Hypnotics
• Apalutamide
• Apomorphine
• Aprepitant, Fosaprepitant
• Aripiprazole
• Arsenic Trioxide
• Artemether; Lumefantrine
• Articaine; Epinephrine
• Asenapine
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atazanavir
• Atazanavir; Cobicistat
• Atenolol
• Atenolol; Chlorthalidone
• Atomoxetine
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Atropine; Difenoxin
• Atropine; Diphenoxylate
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Azilsartan
• Azilsartan; Chlorthalidone
• Azithromycin
• Barbiturates
• Bedaquiline
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Belladonna; Opium
• Benazepril; Hydrochlorothiazide, HCTZ
• Bendroflumethiazide; Nadolol
• Benzhydrocodone; Acetaminophen
• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Benztropine
• Bepridil
• Betaxolol
• Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Bisoprolol
• Bisoprolol; Hydrochlorothiazide, HCTZ
• Boceprevir
• Brexpiprazole
• Brimonidine; Timolol
• Bromocriptine
• Brompheniramine
• Brompheniramine; Carbetapentane; Phenylephrine
• Brompheniramine; Dextromethorphan; Guaifenesin
• Brompheniramine; Dextromethorphan; Phenylephrine
• Brompheniramine; Guaifenesin; Hydrocodone
• Brompheniramine; Hydrocodone; Pseudoephedrine
• Brompheniramine; Pseudoephedrine
• Bumetanide
• Buprenorphine
• Buprenorphine; Naloxone
• Bupropion
• Bupropion; Naltrexone
• Buspirone
• Butabarbital
• Butorphanol
• Cabergoline
• Candesartan
• Candesartan; Hydrochlorothiazide, HCTZ
• Cannabidiol
• Captopril; Hydrochlorothiazide, HCTZ
• Carbamazepine
• Carbetapentane; Chlorpheniramine
• Carbetapentane; Chlorpheniramine; Phenylephrine
• Carbetapentane; Diphenhydramine; Phenylephrine
• Carbetapentane; Guaifenesin
• Carbetapentane; Guaifenesin; Phenylephrine
• Carbetapentane; Phenylephrine
• Carbetapentane; Phenylephrine; Pyrilamine
• Carbetapentane; Pseudoephedrine
• Carbetapentane; Pyrilamine
• Carbidopa; Levodopa
• Carbidopa; Levodopa; Entacapone
• Carbinoxamine
• Carbinoxamine; Dextromethorphan; Pseudoephedrine
• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Carbinoxamine; Phenylephrine
• Carbinoxamine; Pseudoephedrine
• Cariprazine
• Carteolol
• Carvedilol
• Celecoxib
• Cenobamate
• Central-acting adrenergic agents
• Ceritinib
• Cetirizine
• Cetirizine; Pseudoephedrine
• Cetrorelix
• Cevimeline
• Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
• Chlophedianol; Guaifenesin; Phenylephrine
• Chloral Hydrate
• Chloramphenicol
• Chlorcyclizine
• Chlordiazepoxide
• Chlordiazepoxide; Clidinium
• Chloroquine
• Chlorothiazide
• Chlorpheniramine
• Chlorpheniramine; Codeine
• Chlorpheniramine; Dextromethorphan
• Chlorpheniramine; Dextromethorphan; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Phenylephrine
• Chlorpheniramine; Pseudoephedrine
• Chlorpromazine
• Chlorthalidone
• Chlorthalidone; Clonidine
• Cinacalcet
• Ciprofloxacin
• Cisapride
• Citalopram
• Clarithromycin
• Clemastine
• Clobazam
• Clofazimine
• Clonazepam
• Clonidine
• Clorazepate
• Clozapine
• Cobicistat
• Codeine
• Codeine; Guaifenesin
• Codeine; Phenylephrine; Promethazine
• Codeine; Promethazine
• COMT inhibitors
• Conivaptan
• Corticosteroids
• Crizotinib
• Cyproheptadine
• Dacomitinib
• Danazol
• Dantrolene
• Darifenacin
• Darunavir
• Darunavir; Cobicistat
• Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Dasatinib
• Degarelix
• Delavirdine
• Desflurane
• Desloratadine; Pseudoephedrine
• Desvenlafaxine
• Deutetrabenazine
• Dexchlorpheniramine
• Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
• Dexmethylphenidate
• Dextromethorphan; Diphenhydramine; Phenylephrine
• Dextromethorphan; Guaifenesin; Phenylephrine
• Dextromethorphan; Guaifenesin; Pseudoephedrine
• Dextromethorphan; Promethazine
• Dextromethorphan; Quinidine
• Diazepam
• Dihydrocodeine; Guaifenesin; Pseudoephedrine
• Diltiazem
• Dimenhydrinate
• Diphenhydramine
• Diphenhydramine; Hydrocodone; Phenylephrine
• Diphenhydramine; Ibuprofen
• Diphenhydramine; Naproxen
• Diphenhydramine; Phenylephrine
• Disopyramide
• Dofetilide
• Dolasetron
• Dolutegravir; Rilpivirine
• Donepezil
• Donepezil; Memantine
• Dopamine
• Dorzolamide; Timolol
• Doxazosin
• Doxercalciferol
• Doxylamine
• Doxylamine; Pyridoxine
• Dronabinol
• Dronedarone
• Droperidol
• Duloxetine
• Dutasteride; Tamsulosin
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Elbasvir; Grazoprevir
• Eliglustat
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
• Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
• Emtricitabine; Rilpivirine; Tenofovir alafenamide
• Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
• Enalapril; Felodipine
• Enalapril; Hydrochlorothiazide, HCTZ
• Encainide
• Encorafenib
• Enflurane
• Entacapone
• Entrectinib
• Enzalutamide
• Epinephrine
• Eplerenone
• Epoprostenol
• Eprosartan
• Eprosartan; Hydrochlorothiazide, HCTZ
• Eribulin
• Erythromycin
• Erythromycin; Sulfisoxazole
• Escitalopram
• Esketamine
• Esmolol
• Estazolam
• Eszopiclone
• Ethacrynic Acid
• Ethanol
• Ethosuximide
• Etomidate
• Everolimus
• Ezogabine
• Fedratinib
• Felodipine
• Fenfluramine
• Fentanyl
• Fexofenadine; Pseudoephedrine
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Fluoxetine; Olanzapine
• Fluphenazine
• Flurazepam
• Fluvoxamine
• food
• Fosamprenavir
• Foscarnet
• Fosinopril; Hydrochlorothiazide, HCTZ
• Fospropofol
• Furosemide
• Gabapentin
• Ganirelix
• Gemifloxacin
• Gemtuzumab Ozogamicin
• Gilteritinib
• Glasdegib
• Glycerol Phenylbutyrate
• Glycopyrrolate
• Glycopyrrolate; Formoterol
• Goserelin
• Granisetron
• Guaifenesin; Hydrocodone
• Guaifenesin; Hydrocodone; Pseudoephedrine
• Guaifenesin; Phenylephrine
• Guaifenesin; Pseudoephedrine
• Guanabenz
• Guanfacine
• Halofantrine
• Halogenated Anesthetics
• Halothane
• Histrelin
• Homatropine; Hydrocodone
• Hydantoins
• Hydralazine; Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ
• Hydrochlorothiazide, HCTZ; Irbesartan
• Hydrochlorothiazide, HCTZ; Lisinopril
• Hydrochlorothiazide, HCTZ; Losartan
• Hydrochlorothiazide, HCTZ; Methyldopa
• Hydrochlorothiazide, HCTZ; Metoprolol
• Hydrochlorothiazide, HCTZ; Moexipril
• Hydrochlorothiazide, HCTZ; Olmesartan
• Hydrochlorothiazide, HCTZ; Propranolol
• Hydrochlorothiazide, HCTZ; Quinapril
• Hydrochlorothiazide, HCTZ; Spironolactone
• Hydrochlorothiazide, HCTZ; Telmisartan
• Hydrochlorothiazide, HCTZ; Triamterene
• Hydrochlorothiazide, HCTZ; Valsartan
• Hydrocodone
• Hydrocodone; Ibuprofen
• Hydrocodone; Phenylephrine
• Hydrocodone; Potassium Guaiacolsulfonate
• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
• Hydromorphone
• Hydroxychloroquine
• Hydroxyzine
• Hyoscyamine
• Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
• Ibuprofen; Oxycodone
• Ibuprofen; Pseudoephedrine
• Ibutilide
• Idelalisib
• Iloperidone
• Iloprost
• Imatinib
• Indacaterol; Glycopyrrolate
• Indinavir
• Indocyanine Green
• Indomethacin
• Inotuzumab Ozogamicin
• Irbesartan
• Isavuconazonium
• Isoflurane
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Isradipine
• Itraconazole
• Ivosidenib
• Ketamine
• Ketoconazole
• Labetalol
• Lapatinib
• Lasmiditan
• Lefamulin
• Lenvatinib
• Letermovir
• Leuprolide
• Leuprolide; Norethindrone
• Levocetirizine
• Levodopa
• Levofloxacin
• Levomethadyl
• Levorphanol
• Lithium
• Lofexidine
• Lomefloxacin
• Long-acting beta-agonists
• Loop diuretics
• Loperamide
• Loperamide; Simethicone
• Lopinavir; Ritonavir
• Loratadine; Pseudoephedrine
• Lorazepam
• Losartan
• Loxapine
• Lumacaftor; Ivacaftor
• Lumacaftor; Ivacaftor
• Lumateperone
• Lurasidone
• Macimorelin
• Maprotiline
• Mecamylamine
• Meclizine
• Mefloquine
• Meperidine
• Meperidine; Promethazine
• Mephobarbital
• Meprobamate
• Mesoridazine
• Methadone
• Methazolamide
• Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
• Methohexital
• Methyclothiazide
• Methyldopa
• Methylphenidate
• Metoclopramide
• Metolazone
• Metoprolol
• Metronidazole
• Metyrapone
• Metyrosine
• Mexiletine
• Midazolam
• Midostaurin
• Mifepristone
• Mirabegron
• Mirtazapine
• Mitotane
• Molindone
• Morphine
• Morphine; Naltrexone
• Moxifloxacin
• Nabilone
• Nadolol
• Nafarelin
• Nalbuphine
• Naproxen; Pseudoephedrine
• Nebivolol
• Nebivolol; Valsartan
• Nefazodone
• Nelfinavir
• Nevirapine
• Nicardipine
• Nifedipine
• Nilotinib
• Nisoldipine
• Non-Ionic Contrast Media
• Norfloxacin
• Octreotide
• Ofloxacin
• Olanzapine
• Olmesartan
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Ondansetron
• Oritavancin
• Orphenadrine
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Oxazepam
• Oxcarbazepine
• Oxycodone
• Oxymorphone
• Ozanimod
• Palbociclib
• Paliperidone
• Panobinostat
• Paroxetine
• Pasireotide
• Pazopanib
• Peginterferon Alfa-2b
• Pemoline
• Penbutolol
• Pentamidine
• Pentazocine
• Pentazocine; Naloxone
• Pentobarbital
• Perampanel
• Pergolide
• Perindopril; Amlodipine
• Perphenazine
• Perphenazine; Amitriptyline
• Phenobarbital
• Phenoxybenzamine
• Phenylephrine
• Phenylephrine; Promethazine
• Pimavanserin
• Pimozide
• Pindolol
• Pitolisant
• Posaconazole
• Potassium-sparing diuretics
• Pramipexole
• Prazosin
• Pregabalin
• Prilocaine; Epinephrine
• Primaquine
• Primidone
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Propofol
• Propoxyphene
• Propranolol
• Pseudoephedrine
• Quazepam
• Quetiapine
• Quinidine
• Quinine
• Ramelteon
• Ranolazine
• Rasagiline
• Remifentanil
• Reserpine
• Ribociclib
• Ribociclib; Letrozole
• Rifabutin
• Rifampin
• Rifapentine
• Rilpivirine
• Risperidone
• Ritonavir
• Rolapitant
• Romidepsin
• Ropinirole
• Rotigotine
• Rucaparib
• Sacubitril; Valsartan
• Safinamide
• Saquinavir
• Secobarbital
• Selpercatinib
• Sertraline
• Sevoflurane
• Short-acting beta-agonists
• Sibutramine
• Simeprevir
• Siponimod
• Sodium Phenylbutyrate
• Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
• Solifenacin
• Sorafenib
• Sotalol
• Sparfloxacin
• Spironolactone
• St. John’s Wort, Hypericum perforatum
• Sufentanil
• Sunitinib
• Tacrine
• Tacrolimus
• Tamoxifen
• Tamsulosin
• Tapentadol
• Telaprevir
• Telavancin
• Telithromycin
• Telmisartan
• Telotristat Ethyl
• Temazepam
• Terazosin
• Terbinafine
• Tetrabenazine
• Thalidomide
• Thiazide diuretics
• Thiopental
• Thioridazine
• Thiothixene
• Timolol
• Tipranavir
• tobacco
• Tolcapone
• Tolterodine
• Toremifene
• Torsemide
• Tramadol
• Trandolapril; Verapamil
• Trazodone
• Treprostinil
• Triamterene
• Triazolam
• Triclabendazole
• Tricyclic antidepressants
• Trifluoperazine
• Trihexyphenidyl
• Triprolidine
• Triptorelin
• Tucatinib
• Valproic Acid, Divalproex Sodium
• Valsartan
• Vandetanib
• Vardenafil
• Vasodilators
• Vasopressin, ADH
• Vemurafenib
• Venlafaxine
• Verapamil
• Voriconazole
• Vorinostat
• Warfarin
• Zafirlukast
• Zaleplon
• Ziconotide
• Ziprasidone
• Zolpidem
• Zonisamide