Haloperidol interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

  What to do: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

  4 sources

  1. Warrington SJ, Ankier SI, Turner P "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology 15 (1986): 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc. (1990):
  3. "Product Information. Fycompa (perampanel)." Eisai Inc (2012):
  4. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):

Conditions

Conditions in which Haloperidol needs care, as documented in this source.

• Alcoholic Intoxication

  Major

  The use of neuroleptic agents is contraindicated in patients with acute alcohol intoxication exhibiting depressed vital signs. The central nervous system depressant effects of neuroleptic agents may be additive with those of alcohol. Severe respiratory depression and respiratory arrest may occur. Therapy with neuroleptic agents should be administered cautiously in patients who might be prone to acute alcohol intake.

  10 sources

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  2. "Product Information. Navane (thiothixene)." Roerig Division (2001):
  3. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  4. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  5. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  6. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  7. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  8. "Product Information. Orap (pimozide)." Gate Pharmaceuticals

  Show all 10 sourcesShow fewer sources

  9. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  10. "Product Information. Loxitane C (loxapine)." Apothecon Inc (2022):

• Cardiovascular Diseases

  Major

  Neuroleptic agents may cause hypotension (including orthostatic hypotension), reflex tachycardia, increased pulse rate, syncope and dizziness, particularly during initiation of therapy or rapid escalation of dosage. Tolerance to the hypotensive effects often develops after a few doses to a few weeks. Rarely, fatal cardiac arrest has occurred secondary to severe hypotension. Other reported adverse cardiovascular effects include hypertension, edema, arrhythmias, thrombophlebitis, myocarditis, angina, myocardial infarction, congestive heart failure, and ECG abnormalities such as PR and QT interval prolongation, diffuse T-wave flattening, and ST segment depression. Therapy with neuroleptic agents should be administered cautiously in patients with severe cardiovascular disease, pheochromocytoma, a predisposition to hypotension, or conditions that could be exacerbated by hypotension such as a history of myocardial infarction, angina, or ischemic stroke. Close monitoring of cardiovascular status, including ECG changes, is recommended at all dosages. If parenteral therapy is given, patients should be in a supine position during administration and for at least 30 to 60 minutes afterwards. Patients who experience orthostatic hypotension should be cautioned not to rise too abruptly. Occasionally, when severe, hypotension may require treatment with vasoconstrictive agents such as norepinephrine or phenylephrine. Epinephrine should not be used, however, since neuroleptic agents can reverse its vasopressor effects and cause a further lowering of blood pressure.

  28 sources

  1. Huyse F, van Schijndel RS "Haloperidol and cardiac arrest." Lancet 2 (1988): 568-9
  2. McCance-Katz EF "New onset Raynaud's phenomenon in a schizophrenic patient ." J Clin Psychiatry 52 (1991): 89-90
  3. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  4. "Product Information. Navane (thiothixene)." Roerig Division (2001):
  5. Tueth M "Side effects of clozipine (Clozaril) requiring emergency treatment." Am J Emerg Med 11 (1993): 312-3
  6. Lieberman JA, Safferman AZ "Clinical profile of clozapine: adverse reactions and agranulocytosis." Psychiatr Q 63 (1992): 51-70
  7. Heel RC, Brogden RN, Speight TM, Avery GS "Loxapine: a review of its pharmacological properties and therapeutic efficacy as an antipsychotic agent." Drugs 15 (1978): 198-217
  8. Wilt JL, Minnema AM, Johnson RF, Rosenblum AM "Torsade de pointes associated with the use of intravenous haloperidol." Ann Intern Med 119 (1993): 391-4

  Show all 28 sourcesShow fewer sources

  9. Metzger E, Friedman R "Prolongation of the corrected QT and torsades de pointes cardiac arrhythmia associated with intravenous haloperidol in the medically ill." J Clin Psychopharmacol 13 (1993): 128-32
  10. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  11. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  12. Kerwin R "Adverse reaction reporting and new antipsychotics." Lancet 342 (1993): 1440
  13. Gupta S "Paradoxical hypertension associated with clozapine." Am J Psychiatry 151 (1994): 148
  14. Centorrino F, Baldessarini RJ, Kando JC, Frankenburg FR, Volpicelli SA, Flood JG "Clozapine and metabolites - concentrations in serum and clinical findings during treatment of chronically psychotic patients." J Clin Psychopharmacol 14 (1994): 119-25
  15. Marinkovic D, Timotijevic I, Babinski T, Totic S, Paunovic VR "The side-effects of clozapine: a four year follow-up study." Prog Neuropsychopharmacol Biol Psychiatry 18 (1994): 537-44
  16. Testani M "Clozapine-induced orthostatic hypotension treated with fludrocortisone." J Clin Psychiatry 55 (1994): 497-8
  17. Aronowitz JS, Umbricht DSG, Safferman AZ "Clozapine and new-onset ECG abnormalities." Psychosomatics 36 (1995): 82-3
  18. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  19. Baldassano CF, Ghaemi SN "Generalized edema with risperidone: divalproex sodium treatment." J Clin Psychiatry 57 (1996): 422
  20. Ravin DS, Levenson JW "Fatal cardiac event following initiation of risperidone therapy." Ann Pharmacother 31 (1997): 867-70
  21. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  22. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  23. O'Brien JM, Rockwood RP, Suh KI "Haloperidol-induced torsade de pointes." Ann Pharmacother 33 (1999): 1046-9
  24. Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange (1999):
  25. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  26. "Product Information. Loxitane C (loxapine)." Apothecon Inc (2022):
  27. Hatta K, Takahashi T, Nakamura H, Yamashiro H, Asukai N, Matsuzaki I, Yonezawa Y "The association between intravenous haloperidol and prolonged QT interval." J Clin Psychopharmacol 21 (2001): 257-61
  28. La Grenade L, Graham D, Trontell A "Myocarditis and cardiomyopathy associated with clozapine use in the United States." N Engl J Med 345 (2001): 224-5

• Central Nervous System Diseases

  Major

  The use of most miscellaneous antipsychotics is contraindicated in patients with severe central nervous system depression or comatose states from any cause (e.g., lesion, disease, drug or alcohol induced).

  4 sources

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  2. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  3. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  4. "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA (2015):

• Dementia

  Major

  Older patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death; although the causes were varied, most of the deaths appeared to be either cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia) in nature. A causal relationship with antipsychotic use has not been established. In controlled trials in older patients with dementia-related psychosis, patients randomized to risperidone, aripiprazole, and olanzapine had higher incidence of cerebrovascular adverse events (e.g., stroke, transient ischemic attack), including fatalities, compared to patients treated with placebo. These agents are not approved for the treatment of patients with dementia-related psychosis.

  14 sources

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):

  Show all 14 sourcesShow fewer sources

  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  13. "Product Information. Nuplazid (pimavanserin)." Accelis Pharma (2016):
  14. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):

• Dementia

  Major

  Elderly patients with dementia- related psychosis treated with antipsychotic drugs are at increased risk of death. Most of these drugs are not approved for the treatment of patients with dementia- related psychosis.

  3 sources

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  2. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  3. "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA (2015):

• Epilepsy

  Major

  Antipsychotics can lower the seizure threshold and trigger seizures in a dose-dependent manner. Seizures have been reported in patients receiving antipsychotic therapy and may occur in epileptic patients even with maintenance of routine anticonvulsant treatment. Therapy with antipsychotics should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism. High dosages should be avoided if possible.

  7 sources

  1. Markowitz J, Brown R "Seizures with neuroleptics and antidepressants." Gen Hosp Psychiatry 9 (1987): 135-41
  2. Lowry MR, Dunner FJ "Seizures during tricyclic therapy." Am J Psychiatry 137 (1980): 1461-2
  3. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  4. "Product Information. Eskalith (lithium)." SmithKline Beecham (2002):
  5. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  6. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  7. "Product Information. Loxitane C (loxapine)." Apothecon Inc (2022):

• Hyperthyroidism

  Major

  The use of neuroleptic agents in the presence of thyrotoxicosis has been associated with severe neurotoxicity that includes rigidity and inability to walk or talk. Therapy with haloperidol should be administered cautiously in patients with thyrotoxicosis or hyperthyroidism.

  1 source

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):

• Neuroleptic Malignant Syndrome

  Major

  Neuroleptic Malignant Syndrome (NMS), a potentially fatal symptom complex, has been reported in association with the use of antipsychotic drugs. The diagnostic evaluation is complicated and the management requires immediate discontinuation of the antipsychotic therapy and intensive symptomatic treatment and medical monitoring. If a patient that has recovered from NMS requires antipsychotic drug treatment again, the reintroduction of therapy should be carefully considered as NMS recurrences have been reported.

  5 sources

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  2. "Product Information. Eskalith (lithium)." SmithKline Beecham (2002):
  3. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  4. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  5. "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA (2015):

• Neuroleptic Malignant Syndrome

  Major

  The central dopaminergic blocking effects of neuroleptic agents may precipitate or aggravate a potentially fatal symptom complex known as neuroleptic malignant syndrome (NMS). NMS is observed most frequently when high-potency agents like haloperidol are administered intramuscularly, but may occur with any neuroleptic agent given for any length of time. Clinical manifestations of NMS include hyperpyrexia, muscle rigidity, altered mental status and autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac arrhythmias). Additional signs may include elevated creatine phosphokinase, myoglobinuria, and acute renal failure. Neuroleptic agents should not be given to patients with active NMS and should be immediately discontinued if currently being administered in such patients. In patients with a history of NMS, introduction or reintroduction of neuroleptic agents should be carefully considered, since NMS may recur.

  46 sources

  1. Hermesh H, Sirota P, Eviatar J "Recurrent neuroleptic malignant syndrome due to haloperidol and amantadine." Biol Psychiatry 25 (1989): 962-5
  2. Ryken TC, Merrell AN "Haloperidol-induced neuroleptic malignant syndrome in a 67-year-old woman with parkinsonism." West J Med 151 (1989): 326-8
  3. Levitt AJ, Midha R, Craven JL "Neuroleptic malignant syndrome with intravenous haloperidol." Can J Psychiatry 35 (1990): 789
  4. Aisen PS, Lawlor BA "Neuroleptic malignant syndrome induced by low-dose haloperidol." Am J Psychiatry 149 (1992): 844
  5. Caroff SN "The neuroleptic malignant syndrome." J Clin Psychiatry 41 (1980): 79-83
  6. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  7. "Product Information. Navane (thiothixene)." Roerig Division (2001):
  8. Miller DD, Sharafuddin MJ, Kathol RG "A case of clozapine-induced neuroleptic malignant syndrome." J Clin Psychiatry 52 (1991): 99-101

  Show all 46 sourcesShow fewer sources

  9. DasGupta K, Young A "Clozapine-induced neuroleptic malignant syndrome." J Clin Psychiatry 52 (1991): 105-7
  10. Anderson ES, Powers PS "Neuroleptic malignant syndrome associated with clozapine use." J Clin Psychiatry 52 (1991): 102-4
  11. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  12. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  13. Nemecek D "Atropism may precipitate neuroleptic malignant syndrome during treatment with clozapine." Am J Psychiatry 150 (1993): 1561
  14. Ewert AL, Kloek J, Wells B, Phelps S "Neuroleptic malignant syndrome associated with loxapine" J Clin Psychiatry 44 (1983): 37-8
  15. Chong LS, Abbott PM "Neuroleptic malignant syndrome secondary to loxapine." Br J Psychiatry 159 (1991): 572-3
  16. Padgett R, Lipman E "Use of neuroleptics after an episode of neuroleptic malignant syndrome" Can J Psychiatry 34 (1989): 323-5
  17. Webster P, Wijeratne C "Risperidone-induced neuroleptic malignant syndrome." Lancet 344 (1994): 1228-9
  18. Campellone JV, Mccluskey LF, Greenspan D "Fatal outcome from neuroleptic malignant syndrome associated with clozapine." Neuropsychiatry Neuropsychol Behav Neurol 8 (1995): 70-3
  19. Raitasuo V, Vataja R, Elomaa E "Risperidone-induced neuroleptic malignant syndrome in young patient." Lancet 344 (1994): 1705
  20. Dave M "Two cases of risperidone-induced neuroleptic malignant syndrome." Am J Psychiatry 152 (1995): 1233-4
  21. Singer S, Richards C, Boland RJ "Two cases of risperidone-induced neuroleptic malignant syndrome." Am J Psychiatry 152 (1995): 1234
  22. Najara JE, Enikeev ID "Risperidone and neuroleptic malignant syndrome: a case report." J Clin Psychiatry 56 (1995): 534-5
  23. Tarsy D "Risperidone and neuroleptic malignant syndrome." JAMA 275 (1996): 446
  24. Kern JL, Cernek PK "Delayed risperidone-induced malignant syndrome." Ann Pharmacother 30 (1996): 300
  25. Sharma R, Trappler B, Ng YK, Leeman CP "Risperidone-induced neutroleptic malignant syndrome." Ann Pharmacother 30 (1996): 775-8
  26. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  27. Gleason PP, Conigliaro RL "Neuroleptic malignant syndrome with risperidone." Pharmacotherapy 17 (1997): 617-21
  28. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  29. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  30. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  31. Moltz DA, Coeytaux RR "Case report: Possible neuroleptic malignant syndrome associated with olanzapine." J Clin Psychopharmacol 18 (1998): 485-6
  32. Burkhard PR, Vingerhoets FJG "Olanzapine induced neuroleptic malignant syndrome." Arch Gen Psychiat 56 (1999): 101-2
  33. Johnson V, Bruxner G "Neuroleptic malignant syndrome associated with olanzapine." Aust N Z J Psychiat 32 (1998): 884-6
  34. Margolese HC, Chouinard G "Olanzapine-induced neuroleptic malignant syndrome with mental retardation." Am J Psychiat 156 (1999): 1115-6
  35. Levenson JL "Neuroleptic malignant syndrome after the initiation of olanzapine." J Clin Psychopharmacol 19 (1999): 477-8
  36. Nyfort-Hansen K, Alderman CP "Possible neuroleptic malignant syndrome associated with olanzapine." Ann Pharmacother 34 (2000): 667
  37. SierraBiddle D, Herran A, DiezAja S, GonzalezMata JM, Vidal E, DiezManrique F, VazquezBarquero JL "Neuroleptic malignant syndrome and olanzapine." J Clin Psychopharmacol 20 (2000): 704-5
  38. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  39. "Product Information. Loxitane C (loxapine)." Apothecon Inc (2022):
  40. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  41. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  42. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):
  43. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  44. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  45. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  46. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):

• Parkinsonian Disorders

  Major

  The use of neuroleptic agents is associated with pseudo- parkinsonian symptoms such as akinesia, bradykinesia, tremors, pill- rolling motion, cogwheel rigidity, and postural abnormalities including stooped posture and shuffling gait. The onset is usually 1 to 2 weeks following initiation of therapy or an increase in dosage. Older neuroleptic agents such as haloperidol are more likely to induce these effects. The manufacturers of haloperidol consider its use to be contraindicated in patients with Parkinson's disease.

  6 sources

  1. Moleman P, Janzen G, von Bargen BA, et al. "Relationship between age and incidence of parkinsonism in psychiatric patients treated with haloperidol." Am J Psychiatry 143 (1986): 232-4
  2. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  3. Bransgrove LL, Kelly MW "Movement disorders in patients treated with long-acting injectable antipsychotic drugs." Am J Hosp Pharm 51 (1994): 895-9
  4. Sheppard C, Merlis S "Drug-induced extrapyramidal symptoms: their incidence and treatment." Am J Psychiatry 123 (1967): 886-9
  5. Boston Collaborative Drug Surveillance Program "Drug-induced extrapyramidal symptoms." JAMA 224 (1973): 889-91
  6. Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange (1999):

• Respiratory Insufficiency

  Major

  The use of neuroleptic agents is contraindicated in comatose patients and patients with severe central nervous system depression. Neuroleptic agents may potentiate the CNS and respiratory depression in these patients.

  7 sources

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  2. "Product Information. Navane (thiothixene)." Roerig Division (2001):
  3. Vetter PH, Proppe DG "Clozapine-induced coma." J Nerv Ment Dis 180 (1992): 58-9
  4. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  5. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  6. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  7. "Product Information. Loxitane C (loxapine)." Apothecon Inc (2022):

• Alcoholism

  Moderate

  The use of alcohol with haloperidol should be avoided due to possible additive effects and hypotension.

  1 source

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):

• Dehydration

  Moderate

  Neuroleptic agents may cause hypotension (including orthostatic hypotension) and associated reflex tachycardia, syncope or dizziness, particularly during initiation of therapy or rapid escalation of dosage. Tolerance to the hypotensive effects often develops after a few doses to a few months. Rarely, fatal cardiac arrest has occurred secondary to severe hypotension. Therapy with neuroleptic agents should be administered cautiously in patients with conditions that would predispose them to hypotension, such as hypovolemia or dehydration (e.g., due to severe diarrhea or vomiting). In addition, neuroleptic agents can interfere with the body's ability to regulate core body temperature, occasionally producing hyperthermia during strenuous exercise, exposure to hot weather, and concomitant treatment with anticholinergic medications. Patients who are dehydrated may be particularly susceptible.

  3 sources

  1. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  2. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  3. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):

• Hyperprolactinemia

  Moderate

  Antipsychotic drugs can elevate serum prolactin concentrations, and this elevation persists during chronic administration. This should be considered if therapy will be prescribed in patients with previously detected breast cancer as one-third of human breast cancers are prolactin-dependent in vitro. Associated disturbances such as galactorrhea, amenorrhea, gynecomastia, and impotence have been reported. Appropriate laboratory testing and follow-up is advised.

  5 sources

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  2. "Product Information. Eskalith (lithium)." SmithKline Beecham (2002):
  3. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  4. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  5. "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA (2015):

• Hyperprolactinemia

  Moderate

  The chronic use of neuroleptic agents can cause persistent elevations in prolactin levels due to antagonism of dopamine D2 receptors. Based on in vitro data, approximately one-third of human breast cancers are thought to be prolactin-dependent. The clinical significance of this observation with respect to long-term neuroleptic therapy is unknown. Chronic administration of neuroleptic drugs has been associated with mammary tumorigenesis in rodent studies but not in human clinical or epidemiologic studies. Until further data are available, therapy with neuroleptic agents should be administered cautiously in patients with a previously detected breast cancer. Caution is also advised in patients with preexisting hyperprolactinemia. Hyperprolactinemia may suppress hypothalamic gonadotrophin releasing hormone (GnRH), resulting in reduced pituitary gonadotropin secretion. This, in turn, may inhibit reproductive function by impairing gonadal steroidogenesis in both female and male patients. Galactorrhea, amenorrhea, gynecomastia, and impotence have been reported in patients receiving prolactin-elevating compounds; however, the clinical significance of elevated serum prolactin levels is unknown for most patients. Long-standing hyperprolactinemia when associated with hypogonadism may lead to decreased bone density in both female and male patients.

  16 sources

  1. Meco G, Falaschi P, Casacchia M, et al. "Neuroendocrine effects of haloperidol decanoate in patients with chronic schizophrenia." Adv Biochem Psychopharmacol 40 (1985): 89-93
  2. Ash PR, Bouma D "Exaggerated hyperprolactinemia in response to thiothixene ." Arch Neurol 38 (1981): 534-5
  3. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  4. "Product Information. Navane (thiothixene)." Roerig Division (2001):
  5. Huang ML, Van Peer A, Woestenborghs R, De Coster R, Heykants J, Jansen AA, Zylicz Z, Visscher HW, Jonkman JH "Pharmacokinetics of the novel antipsychotic agent risperidone and the prolactin response in healthy subjects." Clin Pharmacol Ther 54 (1993): 257-68
  6. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  7. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  8. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham (2001):

  Show all 16 sourcesShow fewer sources

  9. Dickson RA, Dalby JT, Williams R, Edwards AL "Risperidone-induced prolactin elevations in premenopausal women with schizophrenia." Am J Psychiatry 152 (1995): 1102-3
  10. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  11. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  12. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  13. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  14. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  15. "Product Information. Loxitane C (loxapine)." Apothecon Inc (2022):
  16. Bai YM, Ciu HJ, Guo ZZ "Risperidone-induced hyperprolactinemia in an elderly woman." Am J Psychiatry 159 (2002): 2112

• Liver Diseases

  Moderate

  Haloperidol appears to be primarily converted in the liver to several metabolites, one of which is believed to be pharmacologically active. The metabolites and approximately 1% of the parent drug are excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects due to drug and metabolite accumulation. Therapy with haloperidol should be administered cautiously in such patients. Lower initial dosages and slower titration may be appropriate.

  3 sources

  1. Lam YW, Chang W-H, Jann MW, Chen H "Interindividual variabilities in haloperidol interconversion and the reduced haloperidol/haloperidol ratio." Neuropsychopharmacology 7 (1992): 33-9
  2. Jann MW, Lam YW, Chang WH "Reversible metabolism of haloperidol and reduced haloperidol in Chinese schizophrenic patients." Psychopharmacology (Berl) 101 (1990): 107-11
  3. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):

• Long QT Syndrome

  Moderate

  Cases of sudden death, QT interval prolongation and ventricular arrhythmias including Torsade de Pointes have been reported in patients using haloperidol. Although cases have been reported even in the absence of predisposing factors, special caution is advised in treating patients with other QT- prolonging conditions (including electrolyte imbalance such as hypokalemia and hypomagnesemia), using QT- prolonging drugs, with underlying cardiac abnormalities, hypothyroidism and familial long QT syndrome. Consider periodic EKG assessment on these patients. Treatment should be discontinued and a cardiac evaluation should be considered if a patient develops signs or symptoms of ventricular arrhythmia.

  1 source

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):

• Neutropenia

  Moderate

  The use of antipsychotics has been associated with events of leukopenia, neutropenia and agranulocytosis. Possible risk factors include preexisting low white blood cell count, and history of drug induced leukopenia/neutropenia. Patients with these risk factors should have complete blood count monitored frequently during the first few months of therapy. Patients should also be monitored for any signs or symptoms of infection. Treatment should be discontinued in any patient who develops a sore throat, fever, stomatitis, or other signs of infection along with a low WBC count or severe neutropenia (ANC < 1000/mm3).

  5 sources

  1. "Product Information. Haldol (haloperidol)." McNeil Pharmaceutical (2002):
  2. "Product Information. Eskalith (lithium)." SmithKline Beecham (2002):
  3. "Product Information. Moban (molindone)." Gate Pharmaceuticals (2001):
  4. "Product Information. Orap (pimozide)." Gate Pharmaceuticals
  5. "Product Information. Adasuve (loxapine)." Teva Pharmaceuticals USA (2015):

• Seizures

  Moderate

  Antipsychotic and neuroleptic drugs can lower the seizure threshold and trigger seizures in a dose-dependent manner. This risk is greatest in patients with a history of seizures or with conditions that lower the seizure threshold. Therapy with these drugs should be administered cautiously in patients with a history of seizures or other predisposing factors, such as head trauma, CNS abnormalities, and alcoholism.

  13 sources

  1. "Product Information. Clozaril (clozapine)." Novartis Pharmaceuticals (2001):
  2. "Product Information. Risperdal (risperidone)." Janssen Pharmaceuticals (2001):
  3. "Product Information. Zyprexa (olanzapine)." Lilly, Eli and Company (2001):
  4. "Product Information. Seroquel (quetiapine)." Astra-Zeneca Pharmaceuticals (2001):
  5. "Product Information. Geodon (ziprasidone)." Pfizer U.S. Pharmaceuticals (2001):
  6. "Product Information. Abilify (aripiprazole)." Bristol-Myers Squibb (2002):
  7. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2007):
  8. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2009):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2009):
  10. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2010):
  11. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2015):
  12. "Product Information. Vraylar (cariprazine)." Actavis Pharma, Inc. (2015):
  13. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):

• Tardive Dyskinesia

  Moderate

  Tardive dyskinesia (TD) has occurred in patients treated with antipsychotic drugs; the syndrome consists of potentially irreversible, involuntary, dyskinetic movements. The risk appears highest in older patients (particularly older women) but it is not possible to predict which patients are likely to develop TD; whether antipsychotic drugs differ in their potential to cause TD is unknown. The risk of TD and the likelihood that it will become irreversible increase with the duration of therapy and the total cumulative dose. The syndrome can develop after relatively brief treatment periods, even at low dosages; it may also occur after discontinuation of therapy. TD may remit (partially or completely) upon discontinuation of antipsychotic therapy, although antipsychotic therapy itself may suppress (or partially suppress) signs/symptoms of TD, possibly masking the underlying process; the effect of symptomatic suppression on the long-term course of TD is unknown. In patients with preexisting drug-induced TD, initiating or increasing the dosage of antipsychotic therapy may temporarily mask the symptoms of TD but could eventually worsen the condition. In patients requiring chronic therapy, the lowest dose and shortest duration of therapy producing a satisfactory clinical response are recommended; the need for continued therapy should be reassessed periodically. If signs/symptoms of TD occur during antipsychotic therapy, discontinuation of the offending agent should be considered; however, some patients may require treatment despite the presence of TD.

  18 sources

  1. "Product Information. Abilify (ARIPiprazole)." Otsuka American Pharmaceuticals Inc (2020):
  2. "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc (2021):
  3. "Product Information. Vraylar (cariprazine)." Allergan Inc (2019):
  4. "Product Information. Latuda (lurasidone)." Sunovion Pharmaceuticals Inc (2019):
  5. "Product Information. Seroquel (QUEtiapine)." Astra-Zeneca Pharmaceuticals (2022):
  6. "Product Information. Caplyta (lumateperone)." Intra-Cellular Therapies, Inc. (2022):
  7. "Product Information. Haldol (haloperidol)." Janssen Pharmaceuticals (2020):
  8. "Product Information. Thiothixene (thiothixene)." Amneal Pharmaceuticals LLC (2022):

  Show all 18 sourcesShow fewer sources

  9. "Product Information. Clozaril (cloZAPine)." HLS Therapeutics Inc (2021):
  10. "Product Information. RisperDAL (risperiDONE)." Janssen Pharmaceuticals (2021):
  11. "Product Information. ZyPREXA (OLANZapine)." Lilly, Eli and Company (2020):
  12. "Product Information. Moban (molindone)." Endo Laboratories LLC (2017):
  13. "Product Information. Pimozide (pimozide)." Par Pharmaceutical Inc (2017):
  14. "Product Information. Geodon (ziprasidone)." Pfizer Inc. (2022):
  15. "Product Information. Loxapine Succinate (loxapine)." Actavis U.S. (Amide Pharmaceutical Inc) (2016):
  16. "Product Information. Invega (paliperidone)." Janssen Pharmaceuticals (2022):
  17. "Product Information. Fanapt (iloperidone)." Vanda Pharmaceuticals Inc (2017):
  18. "Product Information. Saphris (asenapine)." Schering-Plough Corporation (2017):

Therapeutic duplication

Drug classes that overlap with Haloperidol, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• antipsychotics

  The recommended maximum number of medicines in the 'antipsychotics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antipsychotics' category.

  Example product in the source data (US market): Fluoxetine/olanzapine

• antipsychotics

  The recommended maximum number of medicines in the 'antipsychotics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antipsychotics' category.

  Example product in the source data (US market): Olanzapine/samidorphan

• antipsychotics

  The recommended maximum number of medicines in the 'antipsychotics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'antipsychotics' category.

  Example product in the source data (US market): Amitriptyline/perphenazine