Drug Notebook

FDA Alerts

Special Alerts:

[Posted 06/16/2008] FDA notified healthcare professionals that both conventional and atypical antipsychotics are associated with an increased risk of mortality in elderly patients treated for dementia-related psychosis. In April 2005, FDA notified healthcare professionals that patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death. Since issuing that notification, FDA has reviewed additional information that indicates the risk is also associated with conventional antipsychotics. Antipsychotics are not indicated for the treatment of dementia-related psychosis. The prescribing information for all antipsychotic drugs will now include the same information about this risk in a BOXED WARNING and the WARNINGS section. For more information visit the FDA website at: http://www.fda.gov/medwatch/safety/2008/safety08.htm#Antipsychotics, http://www.fda.gov/cder/drug/InfoSheets/HCP/antipsychotics_conventional.htm and http://www.fda.gov/bbs/topics/NEWS/2008/NEW01851.html.

[Posted 09/17/2007] Johnson and Johnson and FDA informed healthcare professionals that the WARNINGS section of the prescribing information for haloperidol has been revised to include a new Cardiovascular subsection regarding cases of sudden death, QT prolongation and Torsades de Pointes(TdP) in patients treated with haloperidol, especially when given intravenously, or at doses higher than recommended. Although injectable haloperidol is only approved by the FDA for intramuscular injection, there is considerable evidence that the intravenous administration of haloperidol is a relatively common off-label clinical practice.

There are at least 28 case reports of QT prolongation and TdP, some with fatal outcome in the context of off-label intravenous haloperidol. Healthcare professionals should consider this new risk information when making individual treatment decisions for their patients. For more information visit the FDA website at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#Haloperidol and http://www.fda.gov/cder/drug/InfoSheets/HCP/haloperidol.htm.

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haloperidol
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(hal oh PER i doll)

Advice to Patients

Pending revision, the material in this section should be considered in light of more recently available information in the MEDWATCH notification at the beginning of this monograph.

  • Potential for drug to impair mental altertness or physical coordination; use caution when driving or operating machinery.
  • Importance of avoiding alcohol during therapy due to risk of additive effects and hypotension.
  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses.
  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.
  • Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Haloperidol
RoutesDosage FormsStrengthsBrand NamesManufacturer
OralTablets0.5 mg*
1 mg*
2 mg*
5 mg*
10 mg*
20 mg*
* available generically
Haloperidol Decanoate
RoutesDosage FormsStrengthsBrand NamesManufacturer
ParenteralInjection, for IM use only50 mg (of haloperidol) per mL*

Haldol® Decanoate (with benzyl alcohol 1.2% in sesame oil)

Ortho-McNeil, (also promoted by Scios Nova)

Haloperidol Decanoate Injection (with benzyl alcohol 1.2% in sesame oil)

American Pharmaceutical Partners, Apotex, Bedford, Sicor
100 mg (of haloperidol) per mL*

Haldol® Decanoate (with benzyl alcohol 1.2% in sesame oil)

Ortho-McNeil, (also promoted by Scios Nova)

Haloperidol Decanoate Injection (with benzyl alcohol 1.2% in sesame oil)

American Pharmaceutical Partners, Apotex, Bedford, Sicor
* available generically
Haloperidol Lactate
RoutesDosage FormsStrengthsBrand NamesManufacturer
OralSolution2 mg (of haloperidol) per mL*

Haloperidol Concentrate (with parabens and propylene glycol)

Pharmaceutical Associates, Silarx, Teva, UDL
ParenteralInjection5 mg (of haloperidol) per mL*

Haldol® (with parabens)

Ortho-McNeil
* available generically

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

Haldol Decanoate 100MG/ML Solution MCNEIL5/$378.99 or 15/$1133.9
Haloperidol 0.5MG Tablets MYLAN90/$17 or 180/$22
Haloperidol 1MG Tablets MYLAN90/$19.99 or 180/$27.97
Haloperidol 10MG Tablets SANDOZ60/$72.26 or 180/$202.57
Haloperidol 2MG Tablets MYLAN90/$18.99 or 270/$39.96
Haloperidol 20MG Tablets SANDOZ60/$124.07 or 180/$342.41
Haloperidol 5MG Tablets SANDOZ90/$25.99 or 270/$55.97
Haloperidol Decanoate 100MG/ML Solution APOTEX USA5/$184.99 or 15/$551.94

AHFS Drug Information. © Copyright, 1959-2008, Selected Revisions July 2008. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

† Use is not currently included in the labeling approved by the US Food and Drug Administration.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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