Haloperidol 10mg

 First Generation (typical) Antipsychotic

“ALERT: US Boxed Warning

​Increased mortality in elderly patients with dementia-related psychosis:

Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of 17 placebo-controlled trials (modal duration, 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was approximately 4.5%, compared with a rate of approximately 2.6% in the placebo group. Although the causes of death were varied, most of the deaths appeared to be cardiovascular (eg, heart failure, sudden death) or infectious (eg, pneumonia) in nature. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Haloperidol is not approved for the treatment of patients with dementia-related psychosis.”

CSA NA – FDA Approved – REMS (N) – Can Ship

Haloperidol, Haldol is a butyrophenone antipsychotic that nonselectively blocks postsynaptic dopaminergic D2 receptors in the brain.  The brains response to altered chemistry results in desired effects.

Haloperidol, Haldol is officially indicated for non-psychotic behavioral disorders, hyperactivity, schizophrenia, and tic management in Tourette’s syndrome.  (may be used for other conditions not listed)

Before starting Haloperidol, Haldol make sure your physician is aware of any allergies or medications you currently take, if you have Parkinson disease, severe CNS depression, dementia with Lewy bodies are in a significant depressive state, previous spastic diseases, cardiovascular disease, bipolar, dementia, myasthenia gravis, seizure, thyroid dysfunction.  Haloperidol use has been associated with serious adverse reactions such as altered cardiac conduction, anticholinergic effects, blood dyscrasias, central nervous system depression, esophageal dysmotility/aspiration, extrapyramidal symptoms, falls, hyperprolactinemia, neuroleptic malignant syndrome, orthostatic hypotension, and temperature regulation issues.

0.5 to 10 mg up to four times per day to a maximum of 30 mg/day. 

How to Take: Follow instructions provided by physician/pharmacy label, take consistently at same times each day unless otherwise directed, store at room temperature.   The decanoate injectable formulation should be administered IM only and volume should not exceed 3mL.  Experts recommend administering in the gluteal muscle by deep IM injection, however deltoid injection may also be acceptable.  Administer orally with food or milk to decrease GI distress.                                                                                

Extrapyramidal reaction, parkinsonism, dystonia, hypertonia, drowsiness, akathisia, headache, constipation, abdominal pain, xerostomia, sialorrhea, hyperkinetic muscle activity, tremor, bradykinesia, akinesia, oculogyric crisis                                                                                                 

Note- this is not a complete list of side effects, just the most common ones

1. What can I do if this medication sedates me too much?
   It is a common side effect but in most cases the tablet can be split for smaller dosages to alleviate fatigue.  Discuss with your pharmacist or physician a plan to manage this or potential alternative medications.
2. This medication has a lot of scary side effects, is it safe?
   All medications have side effects however this medication works on a lot of different neurotransmitter receptors in the brain which can lead to a variety of intentional and unintentional effects.  These are mostly dosage dependant and in lower doses the risk is minimal.  In all cases regular lab work will allow your physician to see if your blood sugar, cholesterol etc. start to move in the wrong direction so action can be taken before they become a problem.
3. What are extra-pyramidal reactions?
   Blocking dopamine in the extra-pyramidal system in the central nervous system that regulates posture and skeletal muscle tone may cause a variety of movement disorders.  This can include dystonic reactions (muscular spasms, usually repetitive), akathisia (motor restlessness/uneasiness), pseudoparkinsonism (drug induced Parkinsonism – tremor, rigidity, bradykinesia, etc.), tardive dyskinesia (involuntary complex muscle movements in lower face and extremities).  These side effects are generally dose dependant and generally occur with long term use of medications that block dopamine.  If any of these effects may be occurring, speak to your physician as soon as possible to discuss your options.
4. Why would my doctor give me an antipsychotic? Does this mean I am psychotic?
   This medication can be used for many conditions outside of its original classification.  It commonly is also used for nonpsychotic mood disorders, but this class of medication was given its name back when we knew a lot less about their capabilities.
5. What is Neuroleptic Malignant Syndrome?
   NMS is a rare but serious reaction from significant blockade of dopamine which can occur from antipsychotic medications or from being on high dosages of levodopa (dopamine analogue) and stopping suddenly.  Presents initially as muscle cramps, tremors, fever, unstable blood pressure, and sudden changes in mental status.  As it progresses over 8-40 hours it can lead to complications of rhabdomyolysis, hyperkalemia, kidney failure, or seizures.  Seek medical attention immediately if this reaction is suspected.