Generic Name: Haloperidol

Brand Name: Haldol

General Action: It works by decreasing abnormal excitement in the brain.

Indications & Therapeutic Effects: Indicated for the treatment of the manifestations of several psychotic
disorders including schizophrenia, acute psychosis, Tourette syndrome, and other severe behavioural
states. For indications with oral dosing and for oral dosing in older adults and patients who are
debilitated. This help patients to think more clearly, feel less nervous, and take part in everyday life. It
can also help prevent suicide.

Mechanism of Action: It is believed that haloperidol competitively blocks post-synaptic dopamine (D2)
receptors in the brain, eliminating dopamine neurotransmission and leading to the relief of delusions
and hallucinations that are commonly associated with psychosis.

Dosage & Route of Administration: Initially, 0.5 to 2 mg PO BID or TID; increase gradually, as needed.
This isn’t approved for IV use.

Precautions & Contraindications:

 Use cautiously in older adults and patients who are debilitated; in patients with history of
seizures or EEG abnormalities, prolongs QT interval and other severe CV disorders, allergies,
glaucoma, or uterine retention, and in those taking anticonvulsants, anticoagulants,
antiparkinsonian drugs, or lithium.
 Use cautiously in patients at risk for falls, including those with diseases or conditions or who are
taking drugs that may cause somnolence, orthostatic hypotension, or motor or sensory
instability.
 Drugs appears in human milk. Breastfeeding isn’t recommended.
 Use during pregnancy only if benefits outweigh fetal risk. Use minimum effective maternal
dose.
 Contraindicated in patients hypertensive to drug and in those with dementia with Lewy bodies,
Parkinson disease, coma, or CNS depression.

Drug Interactions:

 Drug-drug:
o Anticholinergics – may increase anticholinergic effects and glaucoma.
o Antiparkinsonian drugs – may diminish therapeutic effects of both haloperidol and
antiparkinsonian drug. Avoid using together.
o Carbamazepine – may decrease haloperidol level. Monitor patients.
o CNS depressants – may increase CNS depression. Use together cautiously.
o Lithium – may enhance neurotoxic effects and cause lethargy and confusion after high
doses. Monitor patients.
o Opioids – may cause slow or difficult breathing, sedation, and death.
 Drug-food/lifestyle:
o Alcohol use, cannabidiol – may increase CNS depression. Discourage use together.
o Smoking – may decrease haloperidol serum concentration. Monitor therapy.
Side Effects:

 CNS: severe extrapyramidal reactions, tardive dyskinesia, seizures, sedation, lethargy, headache,
NMS, insomnia, confusion, vertigo, agitation, anxiety, depression, euphoria, hallucinations
 CV: tachycardia, hypotension, HTN, prolonged QT interval
 EENT: blurred vision, cataracts, retinopathy, oculogyric crisis
 GI: dry mouth, anorexia, constipation, diarrhea, nausea, vomiting, dyspepsia
 GU: urine retention, menstrual irregularities, priapism
 Hematologic: leukopenia, leucocytosis
 Hepatic: jaundice
 Metabolic: hyperglycemia, hypoglycaemia, hyponatremia
 Skin: rash, diaphoresis
 Other: gynecomastia

Nursing Considerations:

 Monitor patient for tardive dyskinesia, which may occur after prolonged use.
 Watch for signs and symptoms of NMS (mental status changes, muscle rigidity, hyperthermia,
autonomic disturbance) which is rare but commonly fatal.
 Monitor ECG when drug is given in high doses.
 Don’t withdraw drug abruptly unless required by severe adverse reactions.
 Complete fall risk assessments at start of antipsychotic treatment and recurrently.
 Esophageal dysmotility and aspiration can occur. Use cautiously at risk for aspiraton.
 Don’t confuse Haldod with Halcion or Halog.

Patient’s Teaching:

 Caution patient or caregiver of patient taking an opioid with benzodiazepine, CNS depressant, or
alcohol to seek immediate medical attention for dizziness, light-headedness, extreme sleepiness,
slowed or difficult breathing, or unresponsiveness.
 Advise patient to report all adverse reactions.
 Warn patient to avoid activities that require alertness and good coordination until effects of
drug are known.
 Advise patient that drug may cause somnolence, orthostatic hypotension, and motor and
sensory instability, which may lead to falls.
 Warn patient to avoid alcohol during therapy.
 Tell patient to relieve dry mouth with sugarless gum or hard candy.
 Tell patient to report changes in medications to physicians and pharmacist.

References
Drugbank Online. (2005, June 13). Haloperidol. Retrieved from Drugbank Online:
https://go.drugbank.com/drugs/DB00502

Woods, A. (2023). Haloperidol. In Nursing 2023 Drug Handbook (pp. 702-705). Philadelphia: Wolters
Kluwer.