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Haloperidol (Haldol)
(hah-low- PAIR-ih-dohl)
Pregnancy Category: C Apo-Haloperidol Haldol Novo-Peridol Peridol PMS Haloperidol PMS Haloperidol LA (Rx)
Haloperidol decanoate
Haloperidol decanoate (Haldol Decanoate)
(hah-low- PAIR-ih-dohl)
Pregnancy Category: C (decanoate form) Haldol Decanoate 50 and 100 Haldol LA Rho-Haloperidol Decanoate (Rx)
Haloperidol lactate
Haloperidol lactate (Haldol Lactate)
(hah-low- PAIR-ih-dohl)
Pregnancy Category: C Haldol Lactate (Rx)

Classification: Antipsychotic, butyrophenone

Action/Kinetics: Precise mechanism not known. Competitively blocks dopamine receptors in the tuberoinfundibular system to cause sedation. Also causes alpha-adrenergic blockade, decreases release of growth hormone, and increases prolactin release by the pituitary. Causes significant extrapyramidal effects, as well as a low incidence of sedation, anticholinergic effects, and orthostatic hypotension. Narrow margin between the therapeutically effective dose and that causing extrapyramidal symptoms. Also has antiemetic effects. Peak plasma levels: PO, 3-5 hr; IM, 20 min; IM, decanoate: approximately 6 days. Therapeutic serum levels: 3-10 ng/mL. t 1/2, PO: 12-38 hr; IM: 13-36 hr; IM, decanoate: 3 weeks; IV: approximately 14 hr. Plasma protein binding: 90%. Metabolized in liver, slowly excreted in urine and bile.

Uses: Psychotic disorders including manic states, drug-induced psychoses, and schizophrenia. Severe behavior problems in children (those with combative, explosive hyperexcitability not accounted for by immediate provocation). Short-term treatment of hyperactive children who show excessive motor activity with accompanying conduct consisting of impulsivity, poor attention, aggression, mood lability, or poor frustration tolerance. Control of tics and vocal utterances associated with Gilles de la Tourette's syndrome in adults and children. The decanoate is used for prolonged therapy in chronic schizophrenia.
Investigational: Antiemetic for cancer chemotherapy, phencyclidine (PCP) psychosis, intractable hiccoughs, infantile autism. IV for acute psychiatric conditions.

Contraindications: Use with extreme caution, or not at all, in clients with parkinsonism. Lactation.

Special Concerns: PO dosage has not been determined in children less than 3 years of age; IM dosage is not recommended in children. Geriatric clients are more likely to exhibit orthostatic hypotension, anticholinergic effects, sedation, and extrapyramidal side effects (such as parkinsonism and tardive dyskinesia).

Side Effects: Extrapyramidal symptoms, especially akathisia and dystonias, occur more frequently than with the phenothiazines. Overdosage is characterized by severe extrapyramidal reactions, hypotension, or sedation. The drug does not elicit photosensitivity reactions like those of the phenothiazines.

Laboratory Test Alterations: Alkaline phosphatase, bilirubin, serum transaminase; PT (clients on coumarin), serum cholesterol.

Overdose Management: Symptoms: CNS depression, hypertension or hypotension, extrapyramidal symptoms, agitation, restlessness, fever, hypothermia, hyperthermia, seizures, cardiac arrhythmias changes in the ECG, autonomic reactions, coma. Treatment: Treat symptomatically. Antiparkinson drugs, diphenhydramine, or barbiturates can be used to treat extrapyramidal symptoms. Fluid replacement and vasoconstrictors (either norepinephrine or phen-ylephrine) can be used to treat hypotension. Ventricular arrhythmias can be treated with phenytoin. To treat seizures, use pentobarbital or diazepam. A saline cathartic can be used to hasten the excretion of sustained-release products.

Drug Interactions: Amphetamine / Amphetamine effect by uptake of drug at its site of action Anticholinergics / Effect of haloperidol Antidepressants, tricyclic / TCA effects R/T liver breakdown Barbiturates / Effect of haloperidol R/T liver breakdown Guanethidine / Guanethidine effect by uptake of drug at site of action Lithium / Toxicity of haloperidol Methyldopa / Toxicity of haloperidol Phenytoin / Effect of haloperidol due to liver breakdown

How Supplied: Haloperidol: Tablet: 0.5 mg, 1 mg, 2 mg, 5 mg, 10 mg, 20 mg. Haloperidol decanoate: Injection: 50 mg/mL, 100 mg/mL. Haloperidol lactate: Concentrate: 2 mg/mL; Injection: 5 mg/mL ; Solution: 1 mg/mL

?Oral Solution, Tablets Psychoses.
Adults: 0.5-2 mg b.i.d.-t.i.d. up to 3-5 mg b.i.d.-t.i.d. for severe symptoms; maintenance: reduce dosage to lowest effective level. Up to 100 mg/day may be required in some. Geriatric or debilitated clients: 0.5-2 mg b.i.d.-t.i.d. Pediatric, 3-12 years or 15-40 kg: 0.5 mg/day in two to three divided doses; if necessary the daily dose may be increased by 0.5-mg increments q 5-7 days for a total of 0.15 mg/kg/day for psychotic disorders.
Tourette's syndrome.
Adults, initial: 0.5-1.5 mg t.i.d., up to 10 mg daily. Adjust dose carefully to obtain the optimum response. Children, 3 to 12 years: 0.05-0.075 mg/kg/day. Higher doses may be needed for those severely disturbed.
Behavioral disorders/hyperactivity in children.
Children, 3 to 12 years: 0.05-0.075 mg/kg/day. Higher doses may be needed for those severely disturbed.
Intractable hiccoughs (investigational).
1.5 mg t.i.d.
Infantile autism (investigational).
0.5-4 mg/day.
?IM, Lactate Acute psychoses.
Adults and adolescents, initial: 2-5 mg to control acute agitation; may be repeated if necessary q 4-8 hr to a total of 100 mg/day. Switch to PO therapy as soon as possible.
?IM, Decanoate Chronic therapy.
Adults, initial dose: 10-15 times the daily PO dose, not to exceed 100 mg initially, regardless of the previous oral antipsychotic dose; then, repeat q 4 weeks (decanoate is not to be given IV).

Haloperidol Ratings

Overall Rating:



(based on 2 reviews)



Ease of Use:


Overall Satisfaction:





Effectiveness: *****

Ease of Use: *****

Overall Satisfaction: **


Wajiha, Wajiha - 01/13/2014

I have been a Nurse for 18 years, and hear exactly where you are comnig from from a lot of angles. I also have been in similar situations when working short staffed and require a special (one-on one) nursing to occur on a number of occasions. I can see many issues for improvement with in the content of the information you have written. And believe me this should not be taken in a way that and any means makes you feel like you are at fault, but constructive criticism and if you are anything like me your own worst critic.1. Q Staff shortages A Always a debatable topic essentially in a nut shell, under the Occupation Health and safety Act an employer has an obligation to provide a safe work environment. However debatable you have correctly identified a client that has posed imminent risk/danger not just to you, the other staff and other clients and escalated it up you your direct line manager.2. Resource co-ordinate's unable to assist with extra staff to allocate for a special nursing capacities. A As we know depending on if you work in private or public sectors there are budget constraints and bonuses given when comnig under. There are also staff that will not come in after a full shift has commenced and simply a shortage of staff in some locations I am unable to see a full picture with just what you have given,3. Q Intern prescribing of Haloperidol. A The recommended starting haloperidol dose for adults is 0.5 mg to 2 mg two to three times daily for moderate symptoms and 3 mg to 5 mg two to three times daily for severe symptoms. The haloperidol dosing guidelines will vary depending on several factors, such as the condition being treated, your age and weight, the severity of your condition, and other medications you may be taking. For three experienced RN's to become gob-smacked from an unrealistic order just simply indicates to me either lack of experience (In yourselves), lack of communication skills to not be able to at least express you have a psychotic client that should be given an IM dose, and an Intern that either would not listen or needed to be taken down a peg or two. All three RN's on that night knew that this dose was inappropriate under the circumstances (hence your reactions), did any one of you ask the intern to explain why he felt that was appropriate, I am unconvinced that you actually challenged with conviction?4. Q Your duty of care in this situation A You have not challenged the intern appropriately about his dosage to the unwell client and asked for further dosing instruction when this dose ceases to work?. I mean yelling if all else fails! (not that we should have to) at him/her and stating you will call his boss to ask for further advice, and that you will document his inappropriate actions in this case, because you do not believe he is making a competent and rational decision under the circumstances. All else fails call one of the other doctors involved in the immediate care never mind the time in the morning, they get paid good money to do that job, it will make an impact!(the treating Oncologist, GP, ED Dr)and explain the situation. The duty of care involved in not just your safety but the care of the patient is what drives nurses to not put there patients experiencing a psychotic episode at risk do no harm . I can guarantee you a union will back you all the way.5. Your injuries sustained A through your natural course of work this has occurred. Work Cover have a no fault statutory claim system, which is why your claim was accepted and paid for the time you required off (4 weeks) and your medical expenses paid for. I can guarantee you your employer knew about this because an employer has to be a contacted, and are held accountable to find appropriate suitable duties once medical advice has been obtained for an individual to return to work. Your injuries could not have been of a significant impairment to have returned for only 1 week of suitable duties. And it is legislated that all medical appointments are made in your own time, but most employer's will make reasonable alteration in ones attendance (for appt's if they are as early to the beginning of a shift, or at the end of the shift as possible) if they are a valued staff member. I think you may have picked up on my code word there . if you are deemed a trouble maker, consistently wanting more exceptions then everyone else on the ward, and you are all that the world revolves around, your NUM will not consider it (and if you make your bed you lye in it). Work cover will also never close a claim unless your GP deems you fit to return to normal duties (in consultation with you), or an independent medical specialist has enough evidence to state your work related component of your injury has resolved and is stable and stationary, with a permanent impairment assessment. If you do not agree with the outcome of a claim there are avenues for appeal/review/decision, and then industrial relations commission or common law.In conclusionYou have been injured in the course of your normal work environment through no fault of your own. This is regrettable as you have had to endure what a lot of other nurses have had also, and occupational violence has been indicated as an extremely high priority from all District's of health care. I am extremely appalled at what communities deem as acceptable behavior toward us as nurses, and it is ok, because a person is stressed or ill . However never the less, I see as a Team Leader for injury management an increased number of psychological injuries evolve from a physical ones. I am trying to determine from this scenario if the injured nurse simply wants to make awareness her priority (for Dr's and other staff), or to try to evaluate/justify her own part in the event as a form of debriefing, lack of support through her continued injury management, or vent her anger as to why she was not a valued staff member even worthy of a phone call from her NUM. All of which only she can explain. I can assure you by seeking legal advice, and going common law (it's like a luck draw every person wins a prize, shhhh! don't let it get around) and obtaining that large sum of money I foresee you acquiring (and you will), you may sleep a lot better at night (if this is what you need?). All I ask is that you learn from mistakes, use the professional services available to you (physical & psychological) to move forward with your life. As there is life after injury and only you can create that.