Interference with the binding of dopamine at D2 receptors

Pharmacologic Category

Antipsychotic Agent, Typical

Dosing: Adult

Psychosis:

Oral: 0.5-5 mg 2-3 times/day; usual maximum: 30 mg/day

I.M. (as lactate): 2-5 mg every 4-8 hours as needed

I.M. (as decanoate): Initial: 10-20 times the daily oral dose administered at 4-week intervals. Maintenance dose: 10-15 times initial oral dose; used to stabilize psychiatric symptoms

Delirium in the intensive care unit (unlabeled use, unlabeled route; Jacobi, 2002):

I.V.: Initial: 2-10 mg depending on degree of agitation; if inadequate response, may repeat bolus dose (with sequential doubling of initial bolus dose) every 15-30 minutes until calm achieved, then administer 25% of the last bolus dose every 6 hours; monitor ECG and QTc interval. After the patient is controlled, haloperidol therapy should be tapered over several days. Note: QTc prolongation may occur with cumulative doses ≥35 mg and torsade de pointes has been reported with single doses of ≥20 mg. The optimal dose and regimen of haloperidol for the treatment of severe agitation and/or delirium has not been established.

Continuous I.V. infusion (100 mg/100 mL D5W): Rates of 3-25 mg/hour have been used

Rapid tranquilization of severely-agitated patient (unlabeled use; administer every 30-60 minutes):

Oral: 5-10 mg

I.M. (as lactate): 5 mg

Average total dose (oral or I.M.) for tranquilization: 10-20 mg

Postoperative nausea and vomiting (PONV) (unlabeled use): I.M., I.V.: 0.5-2 mg (Gan, 2007)

Dosing: Pediatric

(For additional information see "Haloperidol: Pediatric drug information" )

Sedation/psychotic disorders: Oral:

Children 3-12 years (15-40 kg): Initial: 0.05 mg/kg/day or 0.25-0.5 mg/day given in 2-3 divided doses; increase by 0.25-0.5 mg every 5-7 days; maximum: 0.15 mg/kg/day

Usual maintenance:

Agitation or hyperkinesia: 0.01-0.03 mg/kg/day once daily

Nonpsychotic disorders: 0.05-0.075 mg/kg/day in 2-3 divided doses

Psychotic disorders: 0.05-0.15 mg/kg/day in 2-3 divided doses

Children 6-12 years: Sedation/psychotic disorders: I.M. (as lactate): 1-3 mg/dose every 4-8 hours to a maximum of 0.15 mg/kg/day; change over to oral therapy as soon as able.

Dosing: Geriatric

Nonpsychotic patient, dementia behavior (unlabeled use): Initial: Oral: 0.25-0.5 mg 1-2 times/day; increase dose at 4- to 7-day intervals by 0.25-0.5 mg/day. Increase dosing intervals (twice daily, 3 times/day, etc) as necessary to control response or side effects.

Dosing: Renal Impairment

Hemodialysis/peritoneal dialysis: Supplemental dose is not necessary