G-Haloperidol

• Approved Indications:
• Schizophrenia: Treatment of acute and chronic psychotic disorders.
• Acute Psychosis and Agitation: Including manic or mixed episodes of bipolar disorder and delirium.
• Tourette’s Syndrome: Management of motor and vocal tics.
• Huntington’s Disease: Control of chorea and associated psychotic symptoms.
• Severe Behavioral Disorders: In children (off-label use).
• Nausea and Vomiting: In palliative care settings (off-label).

রেজিস্টার্ড চিকিৎসকের নির্দেশনা অনুযায়ী ঔষধ সেবন করুন।

• Adults:
• Oral: Initial dose 0.5–2 mg two to three times daily. Maintenance dose 3–15 mg/day in divided doses.
• Intramuscular (IM): For acute agitation, 2–5 mg every 4 to 8 hours as needed, maximum 20 mg/day.
• Intravenous (IV): Reserved for emergencies under close monitoring; dose individualized.
• Pediatrics:
• Use with caution; typical doses 0.05–0.15 mg/kg/day divided; specialist supervision required.
• Elderly:
• Initiate at lower doses (e.g., 0.5 mg twice daily) and titrate carefully.
• Special Populations:
• No specific dose adjustments in renal or hepatic impairment; monitor clinical response.
• Administration Notes:
• Oral tablets should be swallowed whole with water.
• IM injections are used for rapid control of severe agitation.
• Avoid abrupt cessation; taper gradually to avoid withdrawal.

রেজিস্টার্ড চিকিৎসকের নির্দেশনা অনুযায়ী ঔষধ সেবন করুন।

Haloperidol is a typical antipsychotic of the butyrophenone class that acts primarily by blocking dopamine D2 receptors in the brain’s mesolimbic and mesocortical pathways. This reduces excessive dopaminergic activity associated with psychosis. Additionally, it antagonizes alpha-1 adrenergic and sigma receptors, contributing to its sedative and antipsychotic properties. Dopamine receptor blockade in the nigrostriatal and tuberoinfundibular pathways causes extrapyramidal symptoms and increased prolactin secretion, respectively. Through these actions, haloperidol controls psychotic symptoms, agitation, and tics.

• Absorption: Well absorbed orally; bioavailability 60–70%.
• Distribution: Widely distributed; ~90% plasma protein bound.
• Metabolism: Hepatic metabolism via CYP3A4 and CYP2D6 producing inactive metabolites.
• Elimination: Excreted primarily in urine (~50%) and feces (~30%) as metabolites.
• Half-life: 14–26 hours, variable among individuals.
• Onset of Action: Oral – 30 to 60 minutes; IM – 20 minutes; peak effect within hours.

• Pregnancy: FDA Category C. Animal studies suggest potential risks; human data limited. Use only if benefits justify risks.
• Lactation: Excreted in breast milk; potential infant effects unknown. Breastfeeding not recommended during therapy.
• Data: Limited safety data; caution advised.

• Primary Class: Typical Antipsychotic
• Subclass: Butyrophenone derivative

• Hypersensitivity to haloperidol or excipients.
• Parkinson’s disease or severe CNS depression.
• Comatose states.
• Known QT prolongation or arrhythmias (unless benefits outweigh risks).

• Increased mortality in elderly patients with dementia-related psychosis.
• Risk of QT prolongation and torsades de pointes; ECG monitoring advised.
• Extrapyramidal symptoms, tardive dyskinesia, and neuroleptic malignant syndrome possible.
• Orthostatic hypotension, sedation, anticholinergic effects may occur.
• May lower seizure threshold; use cautiously in epilepsy.
• Avoid abrupt withdrawal to prevent withdrawal symptoms and relapse.
• Monitor prolactin-related effects.

• Common:
• Extrapyramidal symptoms: dystonia, parkinsonism, akathisia.
• Sedation, somnolence.
• Orthostatic hypotension.
• Dry mouth, blurred vision, constipation.
• Serious/Rare:
• Neuroleptic malignant syndrome.
• Tardive dyskinesia.
• QT prolongation, cardiac arrhythmias.
• Hyperprolactinemia.
• Seizures.
• Agranulocytosis (rare).

• CYP450: Metabolized by CYP3A4 and CYP2D6; inhibitors (e.g., ketoconazole, fluoxetine) may increase levels.
• Additive CNS depression with alcohol, benzodiazepines, opioids.
• Increased arrhythmia risk with other QT-prolonging drugs.
• Dopaminergic agents may reduce efficacy.
• Anticholinergics may alter effects.

• Emphasis on avoiding use in elderly dementia patients due to mortality risk.
• Monitoring QT interval and electrolytes recommended.
• Cautious dose titration to minimize tardive dyskinesia.
• Early recognition of neuroleptic malignant syndrome advised.

• Store at 20°C to 25°C (68°F to 77°F).
• Protect from moisture, heat, and light.
• Keep container tightly closed.
• Do not freeze.
• Store oral solution upright to prevent leakage.
• Dispose expired products properly.