Halopid
Generic Name
Haloperidol
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Haloperidol is a potent antipsychotic agent belonging to the butyrophenone class. It is used in the management of schizophrenia, acute psychotic states, and Tourette's syndrome.
Uses & Indications
Dosage
Adults
Highly individualized. Typically 0.5 mg to 5 mg orally 2-3 times daily, adjusted as needed. Max 30 mg/day for chronic use; up to 100 mg/day for acute psychosis in hospital settings. IM doses for acute agitation usually 2-5 mg.
Elderly
Lower initial doses, usually 0.5 mg once or twice daily, with gradual titration based on response and tolerability.
Renal_impairment
No specific dose adjustment generally needed, but caution and close monitoring are advised in severe renal impairment.
How to Take
Can be taken orally with or without food. Intramuscular injection is available for acute situations. Follow physician's instructions precisely.
Mechanism of Action
Haloperidol primarily acts by blocking postsynaptic dopamine D2 receptors in the mesolimbic system, thereby reducing dopamine neurotransmission. It also has some alpha-adrenergic blocking effects.
Pharmacokinetics
Onset
Acute agitation control can be seen within minutes to hours (IM/IV), while full antipsychotic effects may take days to weeks to manifest.
Excretion
Approximately 40% of the dose is excreted in the urine and 15% in the feces, mainly as metabolites.
Half life
Plasma elimination half-life is typically 12-37 hours after oral administration and 14-24 hours after intramuscular administration.
Absorption
Well absorbed orally, with peak plasma concentrations reached within 2-6 hours. Bioavailability is approximately 60-70%.
Metabolism
Extensively metabolized in the liver, primarily via oxidative N-dealkylation and glucuronidation. CYP2D6 and CYP3A4 enzymes are involved.
Side Effects
Contraindications
- Parkinson's disease or other basal ganglia disorders
- Severe central nervous system (CNS) depression or comatose states
- Known hypersensitivity to haloperidol or any components of the formulation
- Prolonged QT interval or congenital long QT syndrome
- Recent acute myocardial infarction or uncompensated heart failure
Drug Interactions
Anticholinergic drugs
May exacerbate anticholinergic side effects and increase intraocular pressure.
Dopamine agonists (e.g., levodopa)
Haloperidol antagonizes the effects of dopamine agonists.
CNS depressants (alcohol, benzodiazepines)
Increased sedation and CNS depression.
CYP2D6 and CYP3A4 inhibitors (e.g., fluoxetine, paroxetine, ritonavir, quinidine)
May increase haloperidol plasma concentrations, leading to increased risk of adverse effects.
QT-prolonging drugs (e.g., antiarrhythmics, tricyclic antidepressants, some antibiotics)
Increased risk of QT prolongation and ventricular arrhythmias.
Storage
Store below 30°C (86°F), protected from light and moisture. Keep out of reach of children. Do not freeze oral solution.
Overdose
Symptoms of overdose include severe extrapyramidal reactions, profound sedation, hypotension, coma, respiratory depression, and cardiac arrhythmias (especially QT prolongation). Management is supportive: establish and maintain an airway, ensure adequate oxygenation and ventilation, monitor cardiac function and vital signs, and treat symptoms symptomatically (e.g., anticholinergics for severe EPS).
Pregnancy & Lactation
Pregnancy Category C. Use with caution during pregnancy; benefits must outweigh potential risks. Neonates exposed during the third trimester may develop extrapyramidal and/or withdrawal symptoms. Haloperidol is excreted in breast milk; caution is advised when administering to a nursing mother.
Side Effects
Contraindications
- Parkinson's disease or other basal ganglia disorders
- Severe central nervous system (CNS) depression or comatose states
- Known hypersensitivity to haloperidol or any components of the formulation
- Prolonged QT interval or congenital long QT syndrome
- Recent acute myocardial infarction or uncompensated heart failure
Drug Interactions
Anticholinergic drugs
May exacerbate anticholinergic side effects and increase intraocular pressure.
Dopamine agonists (e.g., levodopa)
Haloperidol antagonizes the effects of dopamine agonists.
CNS depressants (alcohol, benzodiazepines)
Increased sedation and CNS depression.
CYP2D6 and CYP3A4 inhibitors (e.g., fluoxetine, paroxetine, ritonavir, quinidine)
May increase haloperidol plasma concentrations, leading to increased risk of adverse effects.
QT-prolonging drugs (e.g., antiarrhythmics, tricyclic antidepressants, some antibiotics)
Increased risk of QT prolongation and ventricular arrhythmias.
Storage
Store below 30°C (86°F), protected from light and moisture. Keep out of reach of children. Do not freeze oral solution.
Overdose
Symptoms of overdose include severe extrapyramidal reactions, profound sedation, hypotension, coma, respiratory depression, and cardiac arrhythmias (especially QT prolongation). Management is supportive: establish and maintain an airway, ensure adequate oxygenation and ventilation, monitor cardiac function and vital signs, and treat symptoms symptomatically (e.g., anticholinergics for severe EPS).
Pregnancy & Lactation
Pregnancy Category C. Use with caution during pregnancy; benefits must outweigh potential risks. Neonates exposed during the third trimester may develop extrapyramidal and/or withdrawal symptoms. Haloperidol is excreted in breast milk; caution is advised when administering to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, depending on the formulation and manufacturer. Refer to the specific product packaging for exact expiry dates.
Availability
Pharmacies, Hospitals
Approval Status
FDA/DGDA Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Haloperidol has been extensively studied in numerous clinical trials since its introduction, demonstrating efficacy in various psychiatric conditions, particularly schizophrenia and acute psychosis. Ongoing research continues to evaluate its long-term safety and comparative effectiveness.
Lab Monitoring
- Baseline and periodic ECG (due to risk of QT prolongation)
- Electrolytes (especially potassium and magnesium)
- Liver function tests (LFTs)
- Complete Blood Count (CBC) with differential
- Blood glucose and lipid profile (for metabolic monitoring during long-term treatment)
- Evaluation for extrapyramidal symptoms and tardive dyskinesia
Doctor Notes
- Monitor patients closely for extrapyramidal symptoms (EPS), Neuroleptic Malignant Syndrome (NMS), and QT prolongation, especially at initiation and dose titration.
- Educate patients and caregivers on medication adherence, potential side effects, and the importance of reporting any unusual symptoms promptly.
- Gradual tapering is essential upon discontinuation to prevent withdrawal symptoms or symptom relapse.
Patient Guidelines
- Take your medication exactly as prescribed; do not stop abruptly without consulting your doctor.
- Avoid alcohol and other CNS depressants while on this medication.
- Be aware of potential for drowsiness, dizziness, and impaired judgment; avoid driving or operating heavy machinery until you know how it affects you.
- Report any unusual muscle movements, fever, or changes in heart rate immediately to your doctor.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
Missed Dose Advice
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not double your dose to make up for a missed one.
Driving Precautions
Haloperidol can cause drowsiness, dizziness, and blurred vision, which may impair your ability to drive or operate machinery. Do not drive or engage in hazardous activities until you know how this medication affects you.
Lifestyle Advice
- Maintain a healthy diet and engage in regular exercise to help manage potential weight gain.
- Stay well-hydrated to alleviate dry mouth.
- Avoid overheating and dehydration, especially during strenuous activity or in hot weather, as antipsychotics can affect body temperature regulation.
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