Given these considerations, antipsychotic drugs should be prescribed in a manner that is most likely to minimize the occurrence of tardive dyskinesia. Chronic antipsychotic treatment should generally be reserved for patients who suffer from a chronic illness that 1) is known to respond to antipsychotic drugs, and 2) for whom alternative, equally effective, but potentially less harmful treatments are not available or appropriate. In patients who do require chronic treatment, the smallest dose and the shortest duration of treatment producing a satisfactory clinical response should be sought. The need for continued treatment should be reassessed periodically.
The dose of Haloperidol Decanoate Injection, 50 mg per mL or Haloperidol Decanoate Injection, 100 mg per mL should be expressed in terms of its haloperidol content. The starting dose of haloperidol decanoate should be based on the patient's age, clinical history, physical condition, and response to previous antipsychotic therapy. The preferred approach to determining the minimum effective dose is to begin with lower initial doses and to adjust the dose upward as needed. For patients previously maintained on low doses of antipsychotics (. up to the equivalent of 10 mg/day oral haloperidol), it is recommended that the initial dose of haloperidol decanoate be 10 to 15 times the previous daily dose in oral haloperidol equivalents; limited clinical experience suggests that lower initial doses may be adequate.
Drug has few CV adverse effects and may be preferred in patients with cardiac disease.
Dose of 2 mg is therapeutic equivalent of 100 mg chlorpromazine.
When changing from tablets to decanoate injection, patient should initially receive 10 to 20 times the oral dose once monthly (not more than 100 mg).
Assess patient periodically for extrapyramidal reactions and tardive dyskinesia.
Don’t withdraw drug abruptly except when required, because abrupt withdrawal may cause severe adverse reaction. Taper dosage over several weeks.
Safety and efficacy of drug injection in children haven’t been established, and oral drug isn’t recommended for children younger than age 3.
Drug is especially useful for agitation related to senile dementia. Tardive dyskinesia may occur more often, especially in elderly women.
Elderly patients usually need lower initial doses and a more gradual dosage adjustment.