Indications & Dose:
Nausea and vomiting
Adult: 1–2 mg
Nausea and vomiting in palliative care
Adult: Initially 1.5 mg 1–2 times a day, increased if necessary to 5–10 mg daily in divided doses
Adult: 5–15 mg, to be administered over 24 hours
Adult: 2.5–10 mg/24 hours
Schizophrenia
Psychoses
Mania and hypomania
Organic brain damage (depending on symptoms)
Adult: Initially 2–20 mg once daily, alternatively initially 2–20 mg daily in divided doses; maintenance 1–3 mg 3 times a day, adjusted according to response, daily maximum to be given in divided doses, for debilitated patients, use elderly dose; maximum 20 mg per day
Elderly: Initially 1–10 mg once daily, alternatively initially 1–10 mg daily in divided doses; maintenance 1–3 mg 3 times a day, adjusted according to response, daily maximum to be given in divided doses; maximum 20 mg per day
Adult: Initially 2–5 mg, repeated if necessary, repeated dose given according to response and tolerability, for debilitated patients, use elderly dose; maximum 12 mg per day
Elderly: Initially 1–2.5 mg, repeated if necessary, repeated dose given according to response and tolerability; maximum 12 mg per day Agitation and restlessness in the elderly
Elderly: Initially 0.75–1.5 mg 2–3 times a day adjusted according to response, if necessary Management of mental or behavioural problems such as aggression, hyperactivity and selfmutilation in patients with intellectual disabilities and in patients with organic brain damage (depending on symptoms)
Gilles de la Tourette syndrome
Severe tics
Intractable hiccup
Adjunct to short-term management of moderate to severe psychomotor agitation, excitement and, violent or dangerously impulsive behaviour
Adult: Initially 1.5–3 mg 2–3 times a day, alternatively initially 3–5 mg 2–3 times a day, higher dose in severely affected or resistant patients; maintenance 0.5–1 mg 3 times a day, increased if necessary to 2–3 mg 3 times a day, once symptoms are controlled, gradually reduce dose to the lowest effective maintenance dose, for debilitated patients, use elderly dose
Elderly: Initially 0.75–1.5 mg 2–3 times a day, alternatively initially 1.5–2.5 mg 2–3 times a day, higher dose in severely affected or resistant patients; maintenance 0.5–1 mg 3 times a day, increased if necessary to 2–3 mg 3 times a day, once symptoms are controlled, gradually reduce dose to the lowest effective maintenance dose
Restlessness and confusion in palliative care
Adult: 2 mg, then 2 mg every 2 hours if required
Adult: 2.5 mg, then 2.5 mg every 2 hours if required
Adult: 5–15 mg/24 hours
Contraindications:
Severe toxic CNS depression, comatose states from any cause, Parkinson’s disease
Side Effects:
Cautions:
Precautions:
Elderly, severe cardiac disorders, seizure disorder, hepatic dysfunction, child <3 yr, alcohol withdrawal, electroconvulsive therapy, abrupt withdrawal, glaucoma, COPD
Interaction:
Drugs
Anticholinergics: Inhibition of therapeutic effect of neuroleptics
Barbiturates: Potential reduction of serum neuroleptic concentrations
Bromocriptine: Inhibition of bromocriptineís ability to lower serum prolactin concentrations in patients with pituitary adenoma; theoretical inhibition of antipsychotic effects of neuroleptics
Carbamazepine: Decreased serum haloperidol concentrations
Guanethidine: Inhibition of antihypertensive effect of guanethidine
Levodopa: Inhibition of antiparkinsonian effects of levodopa
Lithium: Rare reports of severe neurotoxicity in patients receiving lithium and neuroleptics
Quinidine: Increases haldol concentrations; increased risk of toxicity.
Warnings:
Adverse Effects:
Lactations:
Pregnancy Has been used for hyperemesis gravidarum, chorea gravidarum, and manic-depressive illness during pregnancy; excreted into breast milk; effect on nursing infant unknown, but may be of concern
Special Precautions:
Counselling:
Side Effects Or Adverse Reactions:
CNS: Agitation, anxiety, catatonic-like behavioral states, confusion, depression, drowsiness, EPS (pseudoparkinsonism, akathisia, dystonia, tardive dyskinesia), euphoria, exacerbation of psychotic symptoms including hallucinations, headache, insomnia, lethargy, neuroleptic malignant syndrome, restlessness, seizures, vertigo
CV: ECG changes, hypertension, hypotension, tachycardia
EENT: Blurred vision, cataracts, dry eyes, glaucoma, retinopathy
GI: Anorexia, constipation, diarrhea, dry mouth, dyspepsia, hypersalivation, nausea, vomiting
GU: Priapism, urinary retention
HEME: Arganulocytosis, anemia, leukocytosis, minimal decreases in red blood cell counts, transient leukopenia.
METAB: Breast engorgement, gynecomastia, hyperglycemia, hyperprolactinemia, hypoglycemia, hyponatremia, impotence, increased libido, lactation, mastalgia, menstrual irregularities
RESP: Bronchospasm, increased depth of respiration, laryngospasm
SKIN: Diaphoresis, isolated cases of photosensitivity, loss of hair, maculopapular and acneiform skin reactions.
Patient And Carer Advice:
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