The boxed warning:
This medication isn’t FDA-approved for dementia-related psychosis. In older adults over 65 years of age, haloperidol raises the risk of death if taken for dementia-related psychosis.
Haloperidol is considered a conventional (typical) or first-generation antipsychotic (FGA). It’s thought to work by blocking certain dopamine receptors (binding sites) in specific parts of the brain. This inhibits the activity of dopamine, a naturally-occurring chemical in the brain.
Due to discontinuation, prescription tablets are only available for purchase in the haloperidol generic variation. The previously corresponding brand names, Haldol and Haldol Solutab, are no longer available.
Moreover, while the key ingredient, haloperidol, is also available for medical consumption in a liquid solution or as an injection, those routes of administration feature specifically either haloperidol lactate, haloperidol intensol, or haloperidol decanoate.
It’s important to know that the above-listed ingredients differ in chemical makeup from the standard haloperidol ingredient this article will feature.
What Is Haloperidol Used For?
The FDA approved Haloperidol as a prescription medication option for psychosis (e.g., hallucinations, delusions), which is a common symptom of schizophrenia. Haloperidol is also an option to help control symptoms of TS in children and adults. It might also be used in children with behavioral and hyperactivity problems when non-antipsychotics or psychotherapy aren’t effective.
Brand Name(s): N/A
Drug Availability: Prescription
Therapeutic Classification: Typical or FGA
Controlled Substance: N/A
Administration Route: Oral
Active Ingredient: Haloperidol
Dosage Form(s): Tablets
Mental health conditions are common in the United States (U.S.). Every year, mental health conditions affect 1 in 5 adults and 1 in 6 children between the ages of 6 to 17.
Schizophrenia is a mental health condition that affects an estimated 1.5 million people in the U.S. Schizophrenia symptoms may include:
Abnormal thoughtsDecreased expression of emotionsDelusionsDifficulties with making decisionsHallucinationsImpaired movementsLittle or low motivationProblems with memory or concentration (focus)Relationship troubles
Behavioral and hyperactivity problems are common mental health conditions in children. In fact, these conditions affect millions of children between the ages of 3 to 17.
TS is another medical condition that affects children. Children with TS tend to start experiencing symptoms between 5 and 10 years old. While symptoms might go away with age, some people may continue to have symptoms into adulthood.
TS is a medical condition of the nervous system. It’s unsure how common TS is, but it’s estimated that TS affects 1 out of every 162 children. This condition, however, might be underdiagnosed.
Symptoms of TS may include uncontrollable and repetitive movements or noises. TS may also happen at the same time with other medical conditions, such as obsessive-compulsive disorder (OCD), anxiety, or attention-deficit/hyperactivity disorder (ADHD).
How to Take Haloperidol
Take Haloperidol by mouth once to three times daily. This medication can be taken with or without food.
If your child is between 3 to 12 years old, haloperidol’s specific dosage and directions will depend on their weight.
Storage
When you receive haloperidol tablets from the pharmacy, keep them at room temperature between 68 to 77 degrees F.
Protect haloperidol tablets from light, and medications generally shouldn’t be stored in the bathroom. Also, keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet.
Try to avoid pouring unused and expired drugs down the drain or in the toilet. Visit the FDA’s website to know where and how to discard all unused and expired drugs. You can also find disposal boxes in your area. Ask your healthcare provider if you have any questions about the best ways to dispose of your medications.
If you plan to travel with haloperidol, get familiar with your final destination’s regulations. Checking with the U.S. embassy or consulate might be a helpful resource. In general, however, make a copy of your haloperidol prescription. It’s also a good idea to keep your medication in its original container from your pharmacy with your name on the label.
If you have any questions about traveling with your medicine, be sure to ask your healthcare provider.
Off-Label Uses
You may see healthcare providers prescribe haloperidol for some of the following off-label uses:
Bipolar: Experts support haloperidol to relieve manic or mixed episodes in people with bipolar when first-choice options didn’t help. Experts also support haloperidol as a potential option for hypomania.
Chemotherapy-induced nausea and vomiting (CINV): Many people receiving chemotherapy (chemo) experience nausea and vomiting (NV), especially with moderate to high-risk chemo drugs. Since haloperidol does have some anti-nausea activity, it is a potential treatment option for CINV.
Hyperactive delirium: People with delirium may experience confusion and impaired awareness. There are different types of delirium. If you have hyperactive delirium, there might also be symptoms of restlessness and agitation.
Experts don’t typically recommend antipsychotics—like haloperidol—for delirium in an intensive care unit (ICU) setting. Instead, nondrug measures should be tried first. Experts, however, might be open to short-term use of antipsychotics in an ICU setting if there are distressing symptoms, such as anxiety and agitation.
NV in people receiving palliative care for an advanced or terminal medical condition: Haloperidol showed some effectiveness in relieving NV for people receiving palliative care.
Postoperative nausea and vomiting (PONV) prevention for people at moderate to high risk: Experts support haloperidol as a medication option to prevent PONV.
What are the Side Effects of Haloperidol?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
Common Side Effects
Common side effects with haloperidol may include:
Blurry vision Constipation Dizziness Drowsiness Dry mouth Postural (positional) low blood pressure Rapid heartbeat Restlessness
Severe Side Effects
The FDA has issued a boxed warning for haloperidol. Boxed warnings are the agency’s strongest warnings for serious and potentially life-threatening risks.
The boxed warning: This medication isn’t FDA-approved for dementia-related psychosis. In older adults over 65, haloperidol raises the risk of death if taken for dementia-related psychosis.
Get medical help right away if you experience the following serious side effects with haloperidol:
Severe allergic reaction: If you have a severe allergic reaction to haloperidol, symptoms may include itchiness, swelling, and breathing difficulties. Abnormal heart rhythm: Haloperidol raises your risk of an abnormal heart rhythm. If you’re experiencing an abnormal heart rhythm, symptoms may include feeling dizzy or faint and having a rapid or pounding heartbeat. Abnormal white blood cell (WBC) amount: Haloperidol may lead to low WBC levels. This might raise your risk of infections. Be on the lookout for symptoms of an infection. Body temperature regulation problems: Haloperidol may cause body temperature regulation problems. As a result, you might have a higher risk of overheating and dehydration. Death: Haloperidol may raise the risk of death due to heart-related effects or infections in older adults over 65 with dementia-related psychosis. Hyperprolactinemia: Haloperidol might raise your prolactin hormone levels. High prolactin levels may result in symptoms of enlarged breasts, absence of menstrual periods, or milky discharge from nipples. Some people may also experience problems with erections or orgasms. Hyperprolactinemia can also trigger other consequential side effects in females and can potentially cause gynecomastia in males. Movement impairment: Haloperidol might cause some loss in muscle control. Before driving or using heavy machinery, see how haloperidol will affect you. Neuroleptic malignant syndrome (NMS): Antipsychotics—like haloperidol—might cause a rare but life-threatening condition called NMS. Symptoms of NMS may include excessive sweating, fever, and stiff (rigid) muscles. Some people may also experience confusion and blood pressure changes. Postural (positional) hypotension: While low blood pressure is a common side effect of haloperidol, it can be excessive and severe. Symptoms of extremely low blood pressure may include feeling dizzy and faint. These symptoms may raise your risk of falls, leading to a higher likelihood of bone fractures (breaks). Tardive dyskinesia (TD): Haloperidol might increase your likelihood of having TD. People with TD have uncontrollable muscle movements of the face and tongue.
Call 911 if your symptoms feel life-threatening.
Long-Term Side Effects
Possible long-term side effects with haloperidol may include:
Heart-related effects: Haloperidol is linked to heart-related effects, such as heart failure. The heart may also suddenly stop beating. These haloperidol effects—including certain infections—may raise the risk of death in older adults over 65 with dementia-related psychosis. Hyperprolactinemia: High prolactin hormone levels over time may result in low bone density. With haloperidol’s other side effects of drowsiness, sleepiness, low blood pressure, and muscle movement impairment, you’re also more likely to fall. Your low bone density and high risk of falls will increase your likelihood of bone fractures (breaks). TD: TD is a potentially severe side effect of abnormal muscle movement. In some people, TD is irreversible.
Dosage: How Much Haloperidol Should I Take?
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
Modifications
The following modifications (changes) should be kept in mind when using haloperidol:
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage forms (solution or tablets): For nervous, emotional, or mental conditions: Adults and children 13 years of age and older—At first, 0. 5 to 5 milligrams (mg) 2 or 3 times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 100 mg per day. Older adults—At first, 0. 5 to 2 mg 2 or 3 times a day. Your doctor may increase your dose if needed. However, the dose is usually not more than 100 mg per day. Children 3 to 12 years of age and weighs 15 to 40 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. Children younger than 3 years of age—Use and dose must be determined by the doctor. For Tourette’s disorder: Children 3 to 12 years of age and weighs 15 to 40 kilograms (kg)—Dose is based on body weight and must be determined by your doctor. The dose is usually 0. 05 to 0. 075 milligram (mg) per kilogram (kg) of body weight per day. Children younger than 3 years of age—Use and dose must be determined by the doctor.
Severe allergic reaction: Avoid using haloperidol if you have a known allergy to it or any of its ingredients. Ask your healthcare provider for a complete list of the ingredients if you’re unsure.
Pregnancy: Pregnant people taking antipsychotics during the third trimester may have newborns that experience withdrawal side effects, such as abnormal muscle movements, muscle tone, or tremors. Other side effects may also include agitation, feeding problems, breathing problems, and excessive drowsiness or sleepiness. Some newborns may quickly recover, but others might need more time in the hospital.
There are also reports of limb (e.g., arm, leg) development problems in the unborn fetus when haloperidol was taken with other medications during the first trimester. Since this connection can’t be ruled out, pregnant people should only take haloperidol when the benefits outweigh the risks.
Discuss with your healthcare provider if you plan to become pregnant or are pregnant. They will help you weigh the benefits and risks of haloperidol during your pregnancy.
Breastfeeding: Limited information suggests that up to 10 milligrams of haloperidol in the breastfeeding person results in low amounts of medication in breastmilk that don’t negatively affect the nursing infant.
When haloperidol is used alone while nursing, it doesn’t seem to be connected to negative childhood developmental effects. Combining haloperidol with other antipsychotic medications, however, might have negative effects on the child.
Some experts recommend avoiding haloperidol while breastfeeding, but haloperidol might be safe if used cautiously while nursing. Your healthcare provider will monitor your baby for drowsiness, side effects, and developmental milestones if you’re taking haloperidol—especially with other antipsychotics—while nursing.
Talk with your healthcare provider if you plan to breastfeed. They will help you weigh the benefits and risks of haloperidol while nursing. They can also discuss the different ways to feed your baby.
Older adults over 65: Clinical studies haven’t included a large enough number of people in this age group to see whether they respond differently from younger adults. TD, however, tends to happen more often in older adults assigned female at birth. TD is a severe side effect of abnormal muscle movements. There’s also a higher risk of death in older adults with dementia-related psychosis.
In general, older adults with several medical conditions or taking several medications should use caution.
Children: There is limited safety and effectiveness information about haloperidol in children.
Bipolar: If you’re currently experiencing mania from bipolar, haloperidol might quickly switch you to depression symptoms. For this reason, your healthcare provider will likely closely monitor you to ensure that your bipolar is adequately treated.
Heart-related conditions: Haloperidol may lower your blood pressure and worsen angina (chest pain). For this reason, your healthcare provider may want to closely monitor you if you have heart-related conditions.
History of low WBC: Haloperidol might result in low WBC levels. If you had a history of low WBC counts from a medical condition (e.g., HIV) or medication (e.g., clozapine antipsychotic), you might be at a higher risk of having this side effect. Therefore, your healthcare provider will closely monitor your WBC levels—especially during the first few months of treatment with haloperidol.
Seizures: Haloperidol may raise your risk of seizures. If you have a history of seizures, your healthcare provider will closely monitor your seizure condition.
Thyrotoxicosis: Thyrotoxicosis is a serious condition of too much thyroid hormone. Haloperidol in people experiencing thyrotoxicosis may result in severe neurotoxicity (damage or negative effects to the nervous system). Symptoms of neurotoxicity may include rigid muscles with an inability to walk or talk.
Missed Dose
If you accidentally forgot your haloperidol dose, take it as soon as you remember. If it’s already close to your next scheduled dose, then skip the missed dose and take the following dose at your next scheduled dosing time. Don’t try to double up to make up for the missed dose.
Try to find ways that work for you to help yourself remember to routinely keep your appointments and take your medication. If you miss too many doses, haloperidol might be less effective.
In fact, missing too many doses might result in withdrawal side effects, which may include abnormal muscle movements.
Overdose: What Happens If I Take Too Much Haloperidol?
The symptoms of a suspected overdose of haloperidol may include:
Cardiac arrhythmia (abnormal heart rhythm) Abnormal muscle movements Blood pressure changes Excessive sleepiness Loss of consciousness Rigid or weak muscles Slow breathing rate Tremors
If you think you’re experiencing an overdose or life-threatening symptoms, seek immediate medical attention.
Precautions
What Are Reasons I Shouldn’t Take Haloperidol?
Before taking haloperidol, talk with your healthcare provider if any of the following applies to you:
If someone collapses or isn’t breathing after taking haloperidol, call 911 immediately.
Do not stop taking this medicine without checking first with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping completely. This will allow your body time to adjust and help avoid a worsening of your medical condition.
This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.
This medicine may cause some people to become dizzy, drowsy, or may cause trouble with thinking or controlling body movements, which may lead to falls, fractures or other injuries. Even if you take haloperidol at bedtime, you may feel drowsy or less alert on arising. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or not alert.
Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.
This medicine will often make you sweat less, causing your body temperature to increase. Use extra care not to become overheated during exercise or hot weather while you are taking this medicine, since overheating may result in heat stroke. Also, hot baths or saunas may make you feel dizzy or faint while you are using this medicine.
Haloperidol may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin taking this medicine:
Stay out of direct sunlight, especially between the hours of 10:00 a. m. and 3:00 p. m. , if possible. Wear protective clothing, including a hat or sunglasses. Apply a sun block product that has a sun protection factor (SPF) of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor. Apply a sun block lipstick that has an SPF of at least 15 to protect your lips. Do not use a sunlamp or tanning bed or booth.
If you have a severe reaction from the sun, check with your doctor.
Haloperidol may cause dry mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.
Contact your doctor as soon as possible if you have chest pain or discomfort, a fast heartbeat, trouble breathing, or fever and chills. These can be symptoms of a very serious problem with your heart.
This medicine may cause tardive dyskinesia (a movement disorder). Check with your doctor right away if you have any of the following symptoms while taking this medicine: lip smacking or puckering, puffing of the cheeks, rapid or worm-like movements of the tongue, uncontrolled chewing movements, or uncontrolled movements of the arms and legs.
Check with your doctor right away if you have any of the following symptoms while using this medicine: convulsions, difficulty with breathing, a fast heartbeat, a high fever, high or low blood pressure, increased sweating, loss of bladder control, severe muscle stiffness, unusually pale skin, or tiredness. These could be symptoms of a serious condition called neuroleptic malignant syndrome (NMS).
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Severe allergic reaction: If you have a severe allergic reaction to haloperidol or any of its components (ingredients), it’s not a viable option for you.
Coma: Loss of consciousness is a possible symptom of overdose with haloperidol. For this reason, this medication shouldn’t be used in someone who is currently experiencing a coma.
Parkinson’s disease (PD): Haloperidol might worsen movement problems because haloperidol may work against PD medications. Taking these medications together may also raise your risk of glaucoma (high eye pressure). For these reasons, haloperidol should be avoided in people with PD.
Pregnancy: Pregnant people taking antipsychotics during the third trimester may have newborns that experience withdrawal side effects, such as abnormal muscle movements, muscle tone, or tremors. Other side effects may also include agitation, feeding problems, breathing problems, and excessive drowsiness or sleepiness. Some newborns may quickly recover, but others might need more time in the hospital.
There are reports of limb (e.g., arm, leg) development problems in the unborn fetus when haloperidol was taken with other medications during the first trimester. Since this connection can’t be ruled out, pregnant people should only take haloperidol when the benefits outweigh the risks. Discuss with your healthcare provider about the benefits and risks of haloperidol during pregnancy.
Breastfeeding: Limited information suggests that up to 10 milligrams of haloperidol in the breastfeeding person results in low amounts of medication in breastmilk that don’t negatively affect the nursing infant.
When haloperidol is used alone while nursing, it doesn’t seem to be connected to negative childhood developmental effects. However, combining haloperidol with other antipsychotic medications might have negative effects on the child.
Some experts recommend avoiding haloperidol while breastfeeding, but haloperidol might be safe if used cautiously while nursing. Your healthcare provider will monitor your baby for drowsiness side effects and developmental milestones if you’re taking haloperidol—especially with other antipsychotics—while nursing. Reach out to your healthcare provider to discuss the benefits and harms of haloperidol while breastfeeding.
Older adults over 65: Clinical studies haven’t included a large enough number of people in this age group to see whether they respond differently from younger adults. TD, however, tends to happen more often in older adults assigned female at birth. TD is a severe side effect of abnormal muscle movements. There’s also a higher risk of death in older adults with dementia-related psychosis. In general, older adults should use caution.
Children: There is limited safety and effectiveness information about haloperidol in children.
What Other Medications May Interact With Haloperidol?
Use caution when taking haloperidol with the following medications:
Anticholinergic medications: In general, anticholinergic medications block the activity of a naturally occurring chemical in your body called acetylcholine. Examples of anticholinergic medications may include benztropine for PD and oxybutynin for overactive bladder. Combining these medications with haloperidol may raise your risk of glaucoma.
Other anticholinergic medications, such as diphenhydramine and trihexyphenidyl, are regularly used alongside Haloperidol to prevent or treat the abnormal muscle movements or rigidity that can occur from Haloperidol therapy. However, these medications can also increase the risk of glaucoma. As such, sometimes anticholinergic medications will be prescribed alongside Haloperidol to help relieve muscle- and movement-related side effects.
Antidepressants: Antidepressants may raise haloperidol levels, increasing your chances of side effects. Prozac (fluoxetine) is an example of an antidepressant that interacts with haloperidol.
Antiseizure medications: Antiseizure medications may decrease haloperidol levels, reducing haloperidol’s effectiveness. Examples of these antiseizure medications may include Dilantin (phenytoin) and Tegretol (carbamazepine).
Blood pressure medications: Haloperidol may lower your blood pressure. This may have additive effects with other antihypertensive medications, such as Microzide (hydrochlorothiazide).
Central nervous system (CNS) depressants: The CNS consists of the brain and spinal cord. CNS depressants have a slowing effect on these parts of the nervous system. Examples may include opioid pain medications and alcohol. These medications with haloperidol may worsen the slowing effects on the CNS.
Ketoconazole: The ketoconazole antifungal may result in a build-up of haloperidol, raising the likelihood of side effects.
Medications with the side effect of abnormal heart rhythm: Haloperidol may raise your risk of abnormal heart rhythm. This risk is further increased with other medications that have this similar side effects. Examples of these medications may include other antipsychotics—like Fanapt (iloperidone)—or heart medications—like Multaq (dronedarone).
PD medications: Haloperidol might worsen movement problems because haloperidol may work against PD medications. Examples of PD medications include Sinemet (levodopa/carbidopa) and Requip (ropinirole).
Rifampin: Rifampin is a medication used for tuberculosis (TB). It may also decrease haloperidol levels in your body, reducing its effectiveness.
For more detailed information about medication interactions with haloperidol, talk with your healthcare provider.
And be sure to talk with your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC), nonprescription products, vitamins, herbs, or plant-based medicines.
What Medications Are Similar?
Haloperidol is a typical (conventional) or first-generation antipsychotic (FGA).
Other similar antipsychotics may include:
ChlorpromazineFluphenazineLoxapineMolindonePerphenazinePimozideThioridazineThiothixeneTrifluoperazine
The following is some interesting information about some of these antipsychotics:
Haloperidol is better at relieving positive schizophrenia symptoms, such as hallucinations and delusions. People are generally more likely to discontinue haloperidol for various reasons. Haloperidol is linked to less weight gain. Haloperidol is linked to higher prolactin levels. Haloperidol, chlorpromazine, and thioridazine tend to have higher reports of anticholinergic side effects, which may include constipation, dry mouth, and urination (peeing) difficulties. Other side effects may also include confusion, memory problems, and vision changes. Haloperidol and pimozide are treatment options for TS. In fact, the FDA approved them for TS in children. Haloperidol, chlorpromazine, loxapine, perphenazine, and thiothixene are FDA-approved FGAs for schizophrenia in children. Haloperidol is an FDA-approved FGA for short-term use in children with hyperactivity problems. Chlorpromazine and haloperidol are two FDA-approved FGAs for behavioral problems in children. Chlorpromazine is an FDA-approved FGA for bipolar in children.
While all of these are antipsychotics, you may see healthcare providers using multiple antipsychotics together for mental health conditions, such as schizophrenia.
How Can I Stay Healthy While Taking Haloperidol?
If you’re taking haloperidol, chances are schizophrenia, TS, or behavioral and hyperactivity problems have been negatively affecting your quality of life. You may have tried different approaches or treatments.
TS and hyperactivity or behavioral problems may happen at the same time. For this reason, more than one medication might be necessary to address multiple conditions.
If you’re taking haloperidol for TS, the need for medication may change over time. As for hyperactivity and behavioral problems, healthcare providers might use antipsychotics on a short-term basis.
Instead, reach out right away to your healthcare provider. They will advise you on the next steps. If stopping haloperidol is necessary, they will likely discuss how to slowly and safely stop this medication.
While living with any of these conditions does have its challenges, there are ways to help improve your quality of life. Refer below for some general suggestions to help manage schizophrenia:
Take medications as recommended by your healthcare provider. Consider therapy and psychosocial support to help you with managing symptoms and daily challenges at school and work. These treatments and support may also help develop life-management and social skills. They may also help you manage stress and notice any warning signs of a possible relapse of your schizophrenia symptoms. Share your diagnosis with your loved ones when you’re ready. This is a difficult step. The sooner you let them know, however, they can find education and support programs to learn more about schizophrenia and find ways to give you the support you need.
The following are more general tips to help you manage TS and hyperactivity or behavioral problems:
Take medications as recommended by your healthcare provider. Consider behavioral treatment to help reduce tics and manage other conditions that may happen together with TS. For example, children with TS may also have OCD, anxiety, or ADHD. Consider behavioral therapy training for parents to strengthen parent-and-children relationships and find effective ways to respond to your child’s behavior.
