HALOPERIDOL decanoate injectable

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    Last updated: February 2024

     

    Prescription under medical supervision

     
     
    Due to the numerous and potentially severe adverse effects of haloperidol, patients should be kept under close surveillance.

     

    Therapeutic action

    • Long-acting antipsychotic

    Indications

    • Chronic psychosis, maintenance therapy after stabilisation with oral haloperidol

    Forms and strengths, route of administration

    • 50 mg in 1 ml ampoule (50 mg/ml) for IM injection
    • DO NOT ADMINISTER BY IV INJECTION.

    Dosage and duration

    • Adult: one injection every 3 to 4 weeks

    The initial dose of haloperidol decanoate corresponds to approximately 10 times the daily dose of oral haloperidol.

     

    Daily dose
    oral haloperidol    		 Monthly dose
    haloperidol decanoate IM    		 50 mg solution
    haloperidol decanoate IM
    2.5 mg 25 mg ½ amp
    5 mg 50 mg 1 amp
    10 mg 100 mg 2 amp
    15 mg 150 mg 3 amp

     

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with cardiac disorders (cardiac failure, recent myocardial infarction, conduction disorders, bradycardia, etc.), dementia (e.g. Alzheimer's disease), Parkinson's disease and history of neuroleptic malignant syndrome.
    • Administer with caution and carefully monitor use in older patients and patients with hypokalaemia, hypotension, hyperthyroidism, renal or hepatic impairment, history of seizures.
    • May cause: drowsiness (caution when driving/operating machinery), extrapyramidal syndrome, early or tardive dyskinesia, constipation, dry mouth, sexual dysfunction, QT-prolongation, ventricular arrhythmia, orthostatic hypotension.
    • In case of extrapyramidal symptoms, try reducing the dose of haloperidol decanoate or, if the extrapyramidal symptoms are severe, add biperiden or trihexyphenidyl.
    • Avoid or monitor combination with: 
      • fluoxetine, paroxetine, sertraline, promethazine, ritonavir (increased plasma concentrations of haloperidol); 
      • carbamazepine, rifampicin, phenobarbital, phenytoin (decreased plasma concentrations of haloperidol);
      • drugs that prolong the QT interval (amiodarone, chloroquine, erythromycin, fluconazole, mefloquine, pentamidine, quinine, etc.).
    • Avoid alcohol during treatment (increased risk of adverse effects).
    • Avoid in women of childbearing age or offer effective contraception.
    • Pregnancy and breastfeeding: avoid

    Remarks

    • Change buttock for each injection.

    Storage

     
    –  Below 25 °C 
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