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