Domperidone
Contraindicated
Database
Increased risk of QT prolongation and Torsades de Pointes (TdP)
Concomitant use is contraindicated. Avoid co-administration.
Drug reference
Haloperidol
First-generation (typical) antipsychotic (butyrophenone) · Antipsychotic
Also known as Haloperidol decanoate, Haldol, Serenace
START
Acute: 2-5 mg PO/IM; Chronic: 2-5 mg/day; Elderly/delirium: 0.5 mg; check baseline ECG (QTc), electrolytes
TYPICAL MAX
30 mg/day oral; 100 mg/day acute parenteral (exceptional circumstances)
STOP IF
QTc >500 ms, signs of NMS (fever, rigidity, autonomic instability), severe EPS, agranulocytosis
WATCH
QTc at baseline and with dose changes, electrolytes (K+, Mg2+, Ca2+), EPS (AIMS, SAS), prolactin if symptomatic, CBC if long-term
CDSCO approvedSchedule HJan AushadhiATC N05AD01
KDIGO 2024 + manufacturer label
- ONSET
- 30min · IM: 20-40 min; PO: 2-4 hours
- PEAK
- 45min · IM peak
- t½
- 1d · 25 hours (oral); 3 weeks (depot)
- DURATION
- 12h · 12-hour coverage (oral)
EXCRETION
Renal (30-50%, metabolites)
route + CYP
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Use only if benefits outweigh risks; neonatal EPS and withdrawal reported; third trimester exposure risk
FDA category + note
Top interactionssee all 12 →
- DomperidoneContraindicatedDatabase
- Qt Prolonging DrugsContraindicatedDatabaseKimi deep-research + Cla
- DiazepamSevereTextbook-citedKDT 7e · p950
- AbarelixSevereDatabaseDDInter
Available in India
248 branded formulations and 18 fixed-dose combinations. Look up specific brands in the Drugs workspace.
Jan Aushadhi — generic available at GoI pharmacies
Mechanism
Potent antagonist at dopamine D2 receptors in mesolimbic pathway (antipsychotic effect), nigrostriatal pathway (extrapyramidal side effects), and tuberoinfundibular pathway (hyperprolactinemia). Also has antagonist activity at alpha-1 adrenergic receptors and weak anticholinergic effects.
Indications
Schizophrenia and other psychotic disorders (acute and maintenance)Acute mania / bipolar disorder (adjunctive)Delirium (agitation management)Tourette syndromeHuntington's choreaSevere behavioral problems in children (short-term)
Dosing
- Adult
- Acute psychosis: 2-10 mg IM/IV, may repeat every 30-60 min (max 100 mg/day acute); Oral: 2-20 mg/day in divided doses. Maintenance: 5-20 mg/day. Delirium: 0.5-2 mg PO/IM/IV q2-4h PRN
- Pediatric
- 3-12 years (Tourette/behavioral): 0.025-0.05 mg/kg/day in 2-3 divided doses
- Renal adjustment
- No specific adjustment; start low and titrate slowly
- Hepatic adjustment
- Reduce dose; haloperidol is hepatically metabolized
- Geriatric
- Start 0.5 mg once or twice daily; increased sensitivity to EPS and sedation; delirium: 0.25-0.5 mg PRN
- Max dose
- 100 mg/day (acute parenteral); 30 mg/day (oral chronic)
Pharmacokinetics
Onset
PO: 2-4 hours; IM: 20-40 minutes; IV: rapid
Peak effect
PO: 2-6 hours; IM: 30-45 minutes
Duration
PO: 8-12 hours; IM depot: 4 weeks
Half-life
PO: 12-38 hours; IM depot: 3 weeks (due to slow absorption from muscle)
Bioavailability
PO: 60-70%; IM: 100%
Protein binding
90%
Metabolism
Hepatic CYP3A4 and CYP2D6 (extensive); glucuronidation and reduction
Excretion
Renal (30-50%, as metabolites); fecal (15-30%)
Contraindications
- Parkinson's disease
- Lewy body dementia
- Severe CNS depression / coma
- QT prolongation or congenital long QT syndrome
- Concomitant QT-prolonging medications
- Hypersensitivity to haloperidol
- Basal ganglia lesions
Side effects
Common
Extrapyramidal symptoms (EPS): akathisia, dystonia, parkinsonismSedationDry mouthConstipationBlurred visionOrthostatic hypotensionHyperprolactinemia (galactorrhea, amenorrhea, sexual dysfunction)Weight gain
Serious
- Neuroleptic malignant syndrome (NMS)
- Tardive dyskinesia (potentially irreversible)
- QT prolongation and torsades de pointes
- Severe extrapyramidal reactions
- Agranulocytosis (rare)
- Hepatotoxicity (rare)
- Seizure threshold lowering
Pregnancy & lactation
Pregnancy
Use only if benefits outweigh risks; neonatal EPS and withdrawal reported; third trimester exposure risk
Lactation
Excreted in breast milk; small amounts; monitor infant for sedation and EPS
Drug interactions
Qt Prolonging Drugs
Contraindicated
Database
Additive QT prolongation; high risk of torsades de pointes
Avoid combination; monitor QTc if unavoidable
Source: Kimi deep-research + Cla
Diazepam
Severe
Textbook-cited
Excessive sedation, respiratory depression, motor impairment.
Avoid concurrent use
Source: KDT 7e · p950
Abarelix
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Abiraterone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Adenosine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Alimemazine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Amitriptyline
Severe
Database
Drug interaction classified as: metabolism.
Source: DDInter
Amoxapine
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Anagrelide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Apalutamide
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Apomorphine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Related guidelines
Hypertensive disorders of pregnancy
FOGSI · Obstetrics & Gynaecology · 2019
Substance use disorders
NIMHANS · Psychiatry · 2022
Primary headache disorders
NICE · Neurology · 2021
Hypertensive disorders of pregnancy
ACOG · Obstetrics & Gynaecology · 2020
Acute coronary syndrome in chronic kidney disease
CSI · Cardiology · 2020
Ask House about Haloperidol
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-19 · House clinical team·Cockpit curated: 2026-05-19