Section 03 · Monograph
Haloperidol
Reviewed Nov 2026FDA label
HaldolTypical antipsychotic (butyrophenone)
- Forms
- Tab: 0.5, 1, 2, 5, 10, 20mg
- Dose
- Tourette's: adults 0.5-2mg BID-TID (moderate) up to 3-5mg BID-TID (severe) | Children 3-12y (15-40kg): 0.05-0.075mg/kg/day divided, start 0.5mg/day, increase 0.5mg every 5-7 days
- MOA
- D2 receptor blockade
Black Box Warning
- Increased mortality in elderly patients with dementia-related psychosis
Indications
- SchizophreniaFDA-labeled
- Control of tics and vocal utterances of Tourette's disorder in children and adultsFDA-labeled
Mechanism of Action
- Butyrophenone antipsychotic with potent dopamine D2 receptor blockade
Full Dosing
Adult / usual
- Tourette's, adults: moderate symptoms 0.5-2mg two to three times daily; severe or resistant 3-5mg two to three times daily; individualize and use the lowest effective dose
- Doses above about 6mg/day are rarely more effective for tics; taper gradually when discontinuing
Pediatric
- Children 3-12 years (15-40kg): 0.05-0.075mg/kg/day in 2-3 divided doses; start 0.5mg/day and increase by 0.5mg every 5-7 days
Contraindications
- Severe toxic CNS depression or comatose states
- Parkinson's disease
- Known hypersensitivity to haloperidol
Drug Interactions
- QT-prolonging drugs increase arrhythmia risk
- CYP3A4/2D6 inhibitors raise levels; carbamazepine, phenytoin and rifampin lower levels
- Anticholinergics and other CNS depressants: additive effects
Adverse Effects
- Extrapyramidal symptoms (dystonia, parkinsonism, akathisia)
- Tardive dyskinesia and neuroleptic malignant syndrome
- QT prolongation and torsades de pointes
- Sedation, hyperprolactinemia
Monitoring Parameters
- Extrapyramidal signs and tardive dyskinesia (AIMS)
- ECG/QTc and electrolytes
- WBC (rare agranulocytosis) and prolactin-related symptoms
Pregnancy & Lactation
- Third-trimester exposure may cause neonatal extrapyramidal and withdrawal symptoms
- Excreted in milk; weigh risk and benefit