Interacting drugs - summary

             
Haloperidol +

Liltium
 increase in lithium blood levels and may produce neuroleptic  
  malignant syndrome.

Haloperidol + betablockers/betablokers+ haloperidol
  pharmacologic effects (hypotensive episodes ) of both drugs may be increased

Guanethidine
 haloperidol antagonises the hypotensive effect of guanethidine

CNS depressant
  effects enhanced by alcohol and other CNS depressants.

Tricyclic antidepressants
 Increases adverse effects of tricyclic antidepressants

Metoclopramide,/ prochlorperazine + anticholinergics
 Adverse effects worsened

Orphenadrine
  worsening of schizophrenic symptoms decreased haloperidol levels and development of
   tardive dyskinesia may occur

Carbamzepine/ rifampicin
  Haloperidol serum levels and efficacy may be decreased  by Carbamazepine/Rifampicin

+ Haloperidol

Nefazodone  + Haloperidol
  Haloperidol apparent clearance decreased with no  significant increase
in peak plasma concentration  or time to peak

Oxybutynin    + Haloperidol 
 worsening of schizophrenic symptoms, decreased serum concentration of
 haloperidol, development of tardive dyskinesesia

Antipsychotic agents group - Include-

Chlorpromazine, Promazine, Thioflupromazine,Mesoridazine, Thioridazine ,Acetophenazine Perphenazine,Prochlorperazine, Fluphenazine, Trifluoperazine, Chlorprothixene, Thiothixene Haloperidol,Pimozide,Molindone,Loxapine,Clozapine ,Olanzapine,Quetiapine , Ziprasidone, Paliperidone, Risperidone, Aripiprazole

Neuroleptic malignant syndrome(coma/confusion,rigidity, sweating, constipation/retension, depolarising block), predisposed by lithium. Tardive, dyskinesia. Extrapyrimidal reactions.

Anxiety, drowsiness, depression, hallucinations, anorexia, Transcient tachycardia, postural hypotension, leucopenia. Lowered seizure threshold. Anticholenergic side effects.

Coma,CNS depression,parkinsonism,lactation.Children.

Special precautions:

Neonates,children,elderly,hepatic failure.

Approved by (DCI) Drug Controller  GENERAL -  India  For Marketing                                                                                   (Ref- IDMA Publication)

Indications:

Psychotic disorders.

Dosage::

Adults- 2mg 2 or 3 times a day, severe conditions, 3 to 5mg 2 or 3 times daily.

Children-(3 to 12 years)- 0.5mg/day,do not use in children below 3 years.

Extrapyramidal effects-

Drugs causing adverse reactions- ( 388 )

1. Butyrophenone- haloperidol

2. Phenothiazine

3. Tricyclic antidepressants

4. Levodopa

5. Reserpine

6. Metoclopramide

HALOPERIDOL-

1.Allergies- tell your doctor if you have ever had any unusual or allergic reaction to haloperidol.  Also tell your doctor if youare allergic to any other substances, such as foods, presrvatives or dyes.
   
2.Pregnancy - haloperidol have shown reduced fertility, delayed delivery, cleft palate, and an increase in number
   ofstillbirths and newborn deaths.

3. Breast feeding-  not recommended  

4 Children - side effects especially muscle spasms of the neck and back and twisting movements of the body,   trembling fingers and hands and inabilitry to move the eyes are more likely to occur

5. Elderly- constipation,dizziness, or fainting ,drowsiness,dryness of the mouth , trembling of the hands and fingers  and symptoms of tardive dyskinesia  or other uncontrolled movements of the mouth of the mouth, tongue, jaw    are sepecially likely to occur in elderly.  

10. Other medicines -

    Let your doctor know what other medicines you are taking, so that he can advice you accordingly.
   
    Amoxapine or
    Metclopromide or
    Metyrosine or
    other antipsychotic medicines or
    Pemoline or 
    Pimozide or
    Promethazine or
    Rauwoulfia alkaloids or
    Trimeprazine - taking these medicines with haloperidol may increae the frequency and severity of certain    side effects.     
    
    CNS depresants- that cause drowsiness or
    Tricyclic antideprsants - taking these mediociones togetherr with haloperidol may result in increased CNS   and other depressant efects,and increase chance of low blood pressure -hypotension

    Ephinephrine - severe low blood pressure or irregular heartbeat may occur

    Levodopa - haloperidol may interfere with the effects of tis medicine
    Lithium- although lithium and haloperidol are sometime used together their use must be closely monitored  by your doctor who may change the amount of medicine you need to take
     
10. Other medical problems -

   Tell your doctor if you have any other medical problems especially -

    Alcohol abuse - risk of herat stroke may be increased
    Difficult urination or
    Glaucoma or
    Heart or blood vessel disease or
    Lung disease or
    Parkinsons disease -haloperidol may make the condition worse
    Epilepsy -the risk of seizures may be increased
    Kidney disease -higher blood levels of haloperidol may occur increasing the chance ofside effects

     Overactive thyroid- serious unwanted effects may occur

11. Missed dose -
    If you miss a dose of this medicine, take it as soon as possible. however, if it is almost time
      for the next dose, skip the missed dose. Do not double doses.

12. Storage -
     Keep out of reach of children. Store away from heat or direct sunlight. Do not store
      the capsule in bathroom, near the kitchen sink, or in other damp places.

13. Outdated medicines -
   Do not keep outdated medicine or medicine no longer needed. Be sure that any
     discarded medicine is out of reach of children.

14.AVOID CONCURRENT USE WITH ERYTHROMYCIN

 

Antipsychotic agents group -
     Include- Chlorpromazine, Promazine, Thioflupromazine,Mesoridazine, Thioridazine ,Acetophenazine
                    Perphenazine,Prochlorperazine, Fluphenazine, Trifluoperazine,  Chlorprothixene, Thiothixene
                    Haloperidol,Pimozide,Molindone,Loxapine,Clozapine ,Olanzapine,Quetiapine ,
                    Ziprasidone, Paliperidone, Risperidone, Aripiprazole      
Refer Chlorpromazine

Pharmacokinetics:
An antipsychotic agent with pharmacolgical effect similar to piperazine phenothiazines

None.

Use contraindicated. Observe caution