HALOPERIDOL DECANOATE

Butyrophenones long-acting depot antipsychotic medicine

Dosage Forms

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Injection (oily)

50 mg/ml
100 mg/ml

Uses

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  • Maintenance in schizophrenia and other psychoses

Dose and Duration

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Maintenance in schizophrenia and other psychoses
Adult: by deep IM injection into the gluteal muscle, initially 50 mg every 4 weeks, increased by 50 mg increments to 300 mg every 4 weeks; higher doses may be needed in some patients.
Note: When changing a patient from another neuroleptic, 500 mg of oral chlorpromazine a day or 25 mg of fluphenazine decanoate every 2 weeks, is equivalent to 100 mg of haloperidol decanoate monthly.
Elderly: initially 12.5–25 mg every 4 weeks, increased according to the patient’s response.

Half dose if 2 weekly administration is preferred.

Contraindications

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  • Children
  • Comatose states
  • CNS depression
  • Parkinson’s disease
  • Known hypersensitivity to haloperidol or simsim oil
  • Lesions of basal ganglia
  • Clinically significant cardiac disorders
  • Concomitant use with other QT prolonging medicines

Side Effects

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  • Agitation, headache, insomnia, depression, psychotic disorder, dizziness, Torsades de pointes
  • Extrapyramidal symptoms, tardive dyskinesia
  • Visual disturbance, oculogyric crisis
  • Hypotension including orthostatic hypotension
  • Constipation, dry mouth, hypersalivation
  • Nausea, vomiting
  • Rash
  • Anaphylaxis
  • Urinary retention
  • Erectile dysfunction
  • Injection site reaction
  • Weight loss or gain
  • Neuroleptic malignant syndrome

Interactions

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  • Amitriptyline (increased concentration of amitriptyline and arrhythmias)
  • Artemether/ Lumefantrine
  • Carbamazepine (antagonism of anticonvulsant effect)
  • Ethosuximide(antagonism of anticonvulsant effect)
  • Fluoxetine (increased concentration of haloperidol)
  • Halothane, ketamine (increased hypotensive effect)
  • Nitrous oxide (increased hypotensive effect)
  • Phenobarbital (antagonism of anticonvulsant effect)
  • Phenytoin, (antagonism of anticonvulsant effect)
  • Rifampicin (reduced concentration of haloperidol)
  • Ritonavir (increased concentration of haloperidol)
  • Thiopental (increased hypotensive effect)
  • Valproic acid (antagonism of anticonvulsant effect)

Pregnancy

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  • Do not use

Breast-feeding

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  • Can be used

⚠️ Caution

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  • Do not give intravenously. No more than 3 ml should be injected at any one injection site. Preferably use a 2–2.5 inches long needle of at least 21 gauge
  • Individualise dose based on severity and amount of oral dose required to maintain patient before depot therapy
  • Use in elderly patients with dementia-related psychosis may be fatal
  • Perform a baseline ECG prior to initiation of haloperidol decanoate. Reduce dose if QT is prolonged during treatment and discontinue if QTc exceeds 500 ms
  • Do periodic electrolyte monitoring especially in patients taking diuretics or during intercurrent illness
  • Withdraw haloperidol decanoate immediately if hyperthermia develops as it often is an early sign of neuroleptic malignant syndrome, and start supportive therapy