Haloperidol LACTATE (Haldol ®) - Intravenous (IV) Dilution

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haloperidol lactate im

Initially, 3—5 mg 2 or 3 times daily. Initially, manufacturers recommend 3—5 mg 2 or 3 times daily. Safety and efficacy not established years kg: Common Anticholinergic effects Sedation Weight gain Erectile dysfunction Oligomenorrhea or amenorrhea. Step Therapy Drugs that have step therapy associated with each prescription.

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Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription. Decreased serum cholesterol concentrations reported in patients receiving chemically related agents. Pharmacy and pharmacology portal Medicine portal. During long-term treatment of chronic psychiatric disorders, the daily dose should be reduced to the lowest level needed for maintenance of remission. A novel antipsychotic with balanced serotonin-dopamine antagonism, receptor occupancy profile, and pharmacologic activity". Acute encephalopathic syndrome reported occasionally in patients receiving lithium and an antipsychotic agent concurrently, especially when high serum lithium concentrations were present. Avian at Lloyd Center Pharmacy".

Use with caution in patients with known allergies or with a history of allergic reactions to drugs. Possible risk of seizures; may lower seizure threshold. Possible impairment of ability to perform activities requiring mental alertness or physical coordination e. Possible additive effects or potentiated action when used with alcohol or other CNS depressants.

Extrapyramidal symptoms occur frequently; if concomitant therapy with an antiparkinsonian drug is necessary to manage extrapyramidal symptoms, it may be necessary to continue the antiparkinsonian drug for a period of time after haloperidol discontinuance to prevent emergence of these symptoms. If used to control mania in patients with bipolar disorder, there may be a rapid mood swing to depression.

Possible transient dyskinetic signs after abrupt withdrawal in some patients receiving maintenance therapy; in some cases, dyskinetic movements are indistinguishable from tardive dyskinesia except for duration.

Elevated prolactin concentrations possible; may persist during long-term therapy. Although disturbances such as galactorrhea, amenorrhea, gynecomastia, and impotence have been reported, clinical importance of elevated prolactin concentrations for most patients has not been established.

Use with caution in patients with previously diagnosed breast cancer, since in vitro tests indicate that about one-third of such tumors are prolactin dependent.

Decreased serum cholesterol concentrations reported in patients receiving chemically related agents. Leukopenia and neutropenia temporally related to antipsychotic agents, including haloperidol, reported. Possible risk factors for leukopenia and neutropenia include preexisting low WBC count and a history of drug-induced leukopenia or neutropenia.

Carefully monitor patients with clinically significant neutropenia for fever or other signs and symptoms of infection and treat promptly if observed. Safety and efficacy of IM administration of haloperidol decanoate or lactate not established in pediatric patients. Hyperammonemia reported during postmarketing surveillance in a 5. Prevalence of tardive dyskinesia appears to be highest among geriatric patients, particularly geriatric women.

Pharmacokinetics of haloperidol in geriatric patients generally warrant use of reduced dosages. Geriatric patients with dementia-related psychosis treated with either conventional or atypical antipsychotic agents are at an increased risk of death. QT-interval prolongation and torsades de pointes reported; patients receiving higher than recommended dosages of any haloperidol preparation and those receiving the drug IV appear to be at higher risk. Increases in intraocular pressure may occur in patients receiving anticholinergic drugs, including antiparkinsonian agents, concurrently with haloperidol a b c d e.

Antagonism of anticoagulant activity of phenindione no longer commercially available in US reported in 1 patient b c d e. Possible additive effects or potentiated action of other CNS depressants a b c d e. An acute encephalopathic syndrome occasionally has occurred, especially when high serum lithium concentrations were present a b c d e. Observe patients receiving combined therapy for evidence of adverse neurologic effects; promptly discontinue if such signs or symptoms appear a b d e. Clinical importance of this possible interaction not determined; carefully observe patients for adverse psychiatric symptoms if used concurrently a.

Following discontinuance of rifampin in other schizophrenic patients treated with oral haloperidol, mean haloperidol concentrations increased 3. Careful monitoring of clinical status and appropriate dosage adjustment warranted whenever rifampin is initiated or discontinued in patients stabilized on haloperidol Well absorbed from GI tract following oral administration, but appears to undergo first-pass metabolism in the liver.

Following IM administration of haloperidol lactate, peak plasma haloperidol concentrations occur within 10—20 minutes. Following IM administration of haloperidol decanoate, plasma haloperidol concentrations are usually evident within 1 day and peak concentrations generally occur within about 6—7 days range: Following IM administration of haloperidol lactate, peak pharmacologic action occurs within 30—45 minutes; in acutely agitated patients, control of psychotic manifestations may become apparent within 30—60 minutes, with substantial improvement often occurring within 2—3 hours.

Esterification of haloperidol results in slow and gradual release of haloperidol decanoate from fatty tissues, thus prolonging duration of action; administration of the ester in a sesame oil vehicle further delays rate of release. Distribution into human body tissues and fluids not fully characterized. Following IM administration of haloperidol decanoate, the esterified compound is initially distributed into fatty tissue stores, from which the drug is then slowly and gradually released.

Exact metabolic fate not clearly established, but appears to be principally metabolized in the liver by oxidative N -dealkylation of the piperidine nitrogen to form fluorophenylcarbonic acids and piperidine metabolites which appear to be inactive , and by reduction of the butyrophenone carbonyl to the carbinol, forming hydroxyhaloperidol.

Limited data suggest that the reduced metabolite, hydroxyhaloperidol, has some pharmacologic activity, although its activity appears to be less than that of haloperidol. Excreted slowly in urine and feces as unchanged drug and metabolites. After IM administration of the decanoate, apparent half-life is approximately 3 weeks. Pharmacokinetics of haloperidol generally warrant the use of reduced dosages in geriatric patients.

Incompatible with sterile water for injection or sodium chloride injection and with other aqueous injections. May be compatible with some drugs for a short period of time after mixing, but at least one manufacturer recommends that the lactate not be mixed with other drugs. Principal pharmacologic effects are similar to those of piperazine-derivative phenothiazines. Precise mechanism of antipsychotic action is unclear, but appears to depress the CNS at the subcortical level of the brain, midbrain, and brain stem reticular formation; appears to inhibit the ascending reticular activating system of the brain stem possibly through the caudate nucleus , thereby interrupting the impulse between the diencephalon and the cortex.

May antagonize actions of glutamic acid within the extrapyramidal system. Appears to have strong central antidopaminergic and weak central anticholinergic activity. Precise mechanism of antiemetic action is unclear, but has been shown to directly affect the chemoreceptor trigger zone CTZ , apparently by blocking dopamine receptors in the CTZ. Like other dopamine receptor antagonists e. Importance of advising patients and caregivers that geriatric patients with dementia-related psychoses treated with antipsychotic agents are at an increased risk of death.

Potential for drug to impair mental alertness or physical coordination; use caution when driving or operating machinery. Importance of avoiding alcohol during therapy due to risk of additive effects and hypotension. Importance of informing patients and caregivers about the risk of NMS, which can cause high fever, stiff muscles, sweating, fast or irregular heart beat, change in BP, and confusion. Importance of informing patients in whom chronic haloperidol use is contemplated of risk of tardive dyskinesia.

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses. Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.

Importance of informing patients of other important precautionary information. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Haldol haloperidol decanoate for IM injection prescribing information. Spring House, PA; dated Aug. Medical Economics Company Inc; Product information summary on Haldol decanoate. Spring House, PA; Feb. Product information summary on Haldol. Spring House, PA; May. Haldol haloperidol tablets, concentrate, and injection prescribing information.

The United States pharmacopeia, 21st rev, and The national formulary, 15th ed. Future of depot neuroleptic therapy: Clinical pharmacokinetics of the depot antipsychotics. Tolerance and serum levels of haloperidol during parenteral and oral haloperidol treatment in geriatric patients.

Pharmacokinetics of haloperidol decanoate. Dosage strategies with long-acting injectable neuroleptics, including haloperidol decanoate. A clinical trial comparing intramuscular haloperidol decanoate and oral haloperidol in chronic schizophrenic patients: Haloperidol decanoate in schizophreniform disorders: Haloperidol and torsades de pointes.

Haloperidol decanoate as a replacement for maintenance therapy with intramuscular fluphenazine decanoate in schizophrenia and other chronic psychoses.

Intramuscular haloperidol decanoate for neuroleptic maintenance therapy. East Afr Med J. On the metabolism of haloperidol in man. Forsman A, Ohman R. Pharmacokinetic studies on haloperidol in man. Excretion and metabolism of intramuscularly administered [ 14 C]-haloperidol decanoate in rats.

The Pharmaceutical Press; Practice guideline for the treatment of patients with delirium. A double-blind trial of haloperidol, chlorpromazine, and lorazepam in the treatment of delirium in hospitalized AIDS patients.

Decreased extrapyramidal symptoms with intravenous haloperidol. Torsade de pointes associated withe use of intravenous haloperidol. Torsades de pointes associated with intravenous haloperidol in critically ill patients. Torsades de pointes and low-dose oral haloperidol.

Use of high-dose haloperidol in the treatment of agitated cardiac patients. High-dose intravenous haloperidol for agitated delirium following lung transplantation. US residents can call their local poison control center at Canada residents can call a provincial poison control center. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.

Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. Haloperidol Lactate Syringe Read Reviews 1. How to use Haloperidol Lactate Syringe Consult your pharmacist.

Side Effects Consult your pharmacist. In the US - Call your doctor for medical advice about side effects. Precautions Consult your pharmacist. In a comparison of 15 antipsychotics in schizophrenia, haloperidol demonstrated standard effectiveness. Data from animal experiments indicate haloperidol is not teratogenic , but is embryotoxic in high doses. In humans, no controlled studies exist.

Reports in pregnant women revealed possible damage to the fetus, although most of the women were exposed to multiple drugs during pregnancy. Following accepted general principles, haloperidol should be given during pregnancy only if the benefit to the mother clearly outweighs the potential fetal risk.

Haloperidol, when given to lactating women, is found in significant amounts in their milk. Breastfed children sometimes show extrapyramidal symptoms. If the use of haloperidol during lactation seems indicated, the benefit for the mother should clearly outweigh the risk for the child, or breastfeeding should be stopped.

During long-term treatment of chronic psychiatric disorders, the daily dose should be reduced to the lowest level needed for maintenance of remission. Sometimes, it may be indicated to terminate haloperidol treatment gradually.

The decanoate ester of haloperidol haloperidol decanoate, trade names Haldol decanoate, Halomonth, Neoperidole has a much longer duration of action, so is often used in people known to be noncompliant with oral medication.

A dose is given by intramuscular injection once every two to four weeks. Topical formulations of haloperidol should not be used as treatment for nausea because research does not indicate this therapy is more effective than alternatives. Sources for the following lists of adverse effects [31] [32] [33] [34]. As haloperidol is a high-potency typical antipsychotic, it tends to produce significant extrapyramidal side effects.

According to a meta-analysis of the comparative efficacy and tolerability of 15 antipsychotic drugs it was the most prone of the 15 for causing extrapyramidal side effects. Treatment is merely symptomatic and involves intensive care with stabilization of vital functions. In early detected cases of oral overdose, induction of emesis , gastric lavage , and the use of activated charcoal can all be tried. Epinephrine is avoided for treatment of hypotension and shock, because its action might be reversed.

In the case of a severe overdose, antidotes such as bromocriptine or ropinirole may be used to treat the extrapyramidal effects caused by haloperidol, acting as dopamine receptor agonists. In general, the prognosis of overdose is good, and lasting damage is not known, provided the person has survived the initial phase. An overdose of haloperidol can be fatal. Haloperidol is a typical butyrophenone type antipsychotic that exhibits high affinity dopamine D 2 receptor antagonism and slow receptor dissociation kinetics.

Given that antagonism of D 2 receptors is more beneficial on the positive symptoms of schizophrenia and antagonism of 5-HT 2 receptors on the negative symptoms, this characteristic underlies haloperidol's greater effect on delusions, hallucinations and other manifestations of psychosis. Haloperidol acts on these receptors: The drug is well and rapidly absorbed with a high bioavailability when injected intramuscularly.

The T max is 20 minutes in healthy individuals and The plasma concentrations of haloperidol decanoate reach a peak at about six days after the injection, falling thereafter, with an approximate half-life of three weeks. The apparent volume of distribution is between 9. If haloperidol is given as a slow IV infusion, the onset of action is slowed, and the duration of action is prolonged.

Plasma levels of four to 25 micrograms per liter are required for therapeutic action. The determination of plasma levels can be used to calculate dose adjustments and to check compliance, particularly in long-term patients. Plasma levels in excess of the therapeutic range may lead to a higher incidence of side effects or even pose the risk of haloperidol intoxication.

The concentration of haloperidol in brain tissue is about fold higher compared to blood levels. It is slowly eliminated from brain tissue, [51] which may explain the slow disappearance of side effects when the medication is stopped.

Haloperidol is heavily protein bound in human plasma, with a free fraction of only 7. The greatest proportion of the hepatic clearance is by glucuronidation, followed by reduction and CYP-mediated oxidation, primarily by CYP3A4. Haloperidol was discovered by Paul Janssen. Haloperidol was approved by the U. Haloperidol is also used on many different kinds of animals.

It appears to be particularly successful when given to birds, e. From Wikipedia, the free encyclopedia.

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haloperidol lactate im

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haloperidol lactate im

Overdose If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call Janssen; [cited Sep 29]. List Haloperidol Lactate Syringe side effects by likelihood and severity.

haloperidol lactate im

Rockville, MD; Jun Given that haloperidol lactate im of D 2 receptors is more beneficial on the positive symptoms of schizophrenia and antagonism of 5-HT 2 receptors on haloperidol lactate im negative symptoms, this characteristic underlies haloperidol's greater effect on delusions, hallucinations and other manifestations of psychosis. Carefully monitor patients with clinically significant neutropenia for fever or other signs hgh like supplements symptoms of infection ualoperidol treat promptly if observed. Blood and Lymphatic System Disorders: The plasma concentrations of haloperidol decanoate reach a peak at about six days after the injection, falling thereafter, with an approximate half-life of three weeks.