Haloperidol Lactate

H

Class: Butyrophenones
Note: This monograph also contains information on Haloperidol, Haloperidol Decanoate
VA Class: CN709
CAS Number: 52-86-8
Brands: Haldol

Special Alerts:

[Posted 02/22/2011] ISSUE: FDA notified healthcare professionals that the Pregnancy section of drug labels for the entire class of antipsychotic drugs has been updated. The new drug labels now contain more and consistent information about the potential risk for abnormal muscle movements (extrapyramidal signs or EPS) and withdrawal symptoms in newborns whose mothers were treated with these drugs during the third trimester of pregnancy.

The symptoms of EPS and withdrawal in newborns may include agitation, abnormally increased or decreased muscle tone, tremor, sleepiness, severe difficulty breathing, and difficulty in feeding. In some newborns, the symptoms subside within hours or days and do not require specific treatment; other newborns may require longer hospital stays.

BACKGROUND: Antipsychotic drugs are used to treat symptoms of psychiatric disorders such as schizophrenia and bipolar disorder.

RECOMMENDATION: Healthcare professionals should be aware of the effects of antipsychotic medications on newborns when the medications are used during pregnancy. Patients should not stop taking these medications if they become pregnant without talking to their healthcare professional, as abruptly stopping antipsychotic medications can cause significant complications for treatment. For more information visit the FDA website at: and .

Increased Mortality in Geriatric Patients with Dementia-related Psychosis

Geriatric patients with dementia-related psychosis treated with antipsychotic agents are at an increased risk of death.177 178 179 180 181 182 183 184 g

Analyses of 17 placebo-controlled trials (modal duration: 10 weeks) in geriatric patients mainly receiving atypical antipsychotic agents revealed an approximate 1.6- to 1.7-fold increase in mortality compared with that in patients receiving placebo.177 178 179 180 184 g Over a typical 10-week trial, the rate of death in drug-treated patients was about 4.5% compared with about 2.6% in those receiving placebo.177 178 179 180 184 g Causes of death were varied, but most appeared to be cardiovascular (e.g., heart failure, sudden death) or infectious (e.g., pneumonia).177 178 179 180 184 g

Observational studies suggest that conventional or first-generation antipsychotic agents also may increase mortality.177 178 179 180 181 182 183 g The extent to which these findings may be attributed to the antipsychotic agent as opposed to certain patient characteristics remains unclear.177 178 179 182 183 g

Antipsychotic agents, including haloperidol, are not approved for the treatment of dementia-related psychosis.177 178 179 180 181 g (See Increased Mortality in Geriatric Patients with Dementia-related Psychosis under Cautions.)

Introduction

Butyrophenone derivative;a b c d e conventional (prototypical, first-generation) antipsychotic agent.185

Uses for Haloperidol Lactate Psychotic Disorders

Symptomatic management of psychotic disorders (e.g., schizophrenia).a b d 185

Antipsychotic agents are used for all phases of schizophrenia, including acute psychotic episodes and accompanying violent behavior as well for long-term stabilization and to minimize risk of relapse.185

Patients who do not respond to or tolerate one drug may be successfully treated with an agent from a different class or with a different adverse effect profile.136 137 138 185

APA considers certain atypical (second-generation) antipsychotic agents first-line for the acute phase of schizophrenia, principally because of the decreased risk of adverse extrapyramidal effects and tardive dyskinesia, with the understanding that the relative advantages, disadvantages, and cost-effectiveness of atypical antipsychotic agents compared with first-generation antipsychotic agents remain controversial.185

Conventional antipsychotic agents may be considered first-line in patients with acute psychotic episodes who have been treated successfully in the past with, or who prefer, conventional agents.185

Long-acting haloperidol decanoate ester used principally for prolonged antipsychotic therapy (e.g., chronic schizophrenic disorder).100 101 105 106 108 110 111 112 185 Parenteral antipsychotic therapy with a long-acting preparation may be particularly useful in patients with a history of poor compliance.105 106 108 110 111 112 185 However, should not be used in the acute management of severely agitated patients.100 101

Tourette’s Syndrome

Control of tics and vocal utterances of Tourette’s syndrome (Gilles de la Tourette’s syndrome).b d e

May be used concomitantly with a stimulant for tic disorders (e.g., Tourette’s syndrome) and comorbid attention deficit hyperactivity disorder† (ADHD) in children in whom stimulants alone cannot control tics.147 148

Disruptive Behavior Disorder and ADHD

Treatment of severe behavioral problems in children marked by combativeness and/or explosive hyperexcitable behavior (out of proportion to immediate provocations).b d e

Short-term treatment in children with hyperactivity associated with excessive motor activity and accompanying conduct disorders that are manifested as impulsive behavior, difficulty sustaining attention, aggression, mood lability, and/or poor frustration tolerance.b d e

Manufacturers recommend reserving for severe behavioral problems or ADHD, only after failure of psychotherapy or drug therapy other than antipsychotics.d e Some experts recommend use only for comorbid tics in children with ADHD.148

Delirium

Management of delirium†.121 130 172

Antipsychotic agents often considered drugs of choice for delirium†.121 172 Haloperidol generally is considered the antipsychotic of choice for most patients with delirium† because of its relatively low risk of anticholinergic activity and of sedative and hypotensive effects.121 130 132 170

Various antipsychotic agents may be given orally, IM, or IV, but IV† administration is considered most effective in emergency situations or where oral access is limited.121 IV administration also may be associated with less severe extrapyramidal effects.121 123 130

Consider risk of QT-interval prolongation, possibly leading to atypical ventricular tachycardia (torsades de pointes), ventricular fibrillation, and sudden death, if haloperidol is used IV† for delirium.121 124 125 126 130 131 132 133 134 169 Institute appropriate monitoring (e.g., ECG).121 124 125 126 130 131 132 133 134 162 163 164 (See Delirium under Dosage and Administration and see QT-interval Prolongation and Sudden Death under Cautions.)

Nausea and Vomiting

Has been used in the prevention and control of severe nausea and vomiting† (e.g., cancer chemotherapy-induced emesis).a Appears to be as effective as phenothiazines in preventing cancer chemotherapy-induced emesis; additional studies required.a

Haloperidol Lactate Dosage and Administration Administration

Administer haloperidol orally as tablets.102 103

Administer haloperidol lactate orally as solution concentrate or IM;102 103 also has been administered by IV injection†121 123 124 125 127 128 129 130 131 133 134 135 or infusion†.121 129

Administer haloperidol decanoate IM; do not administer IV.100 101

Avoid skin contact with haloperidol lactate oral solution and injection, since contact dermatitis has occurred rarely.a

Oral Administration

Haloperidol or haloperidol lactate: Administer orally 2 or 3 times daily.102 103

IM Administration

Haloperidol decanoate: Administer by deep IM injection into the gluteal region using a 21-gauge needle, usually at monthly intervals;100 101 maximum volume should not exceed 3 mL per IM injection site.100 101 102 103

Haloperidol lactate: Administer IM at intervals based on patient response; may administer as often as every hour, although 4-to 8-hour intervals may be satisfactory.100 101 102 103

IM administration of haloperidol decanoate or lactate in children is not recommended by the manufacturers.b c

IV Administration

For solution and drug compatibility information, see Compatibility under Stability.

Haloperidol lactate: Has been administered by IV injection†121 123 124 125 127 128 129 130 131 133 134 135 or infusion†.121 129

ECG monitoring is recommended whenever haloperidol is administered IV.121 125 129 130 132 133 162 163 164 (See Delirium under Dosage and Administration and see QT-interval Prolongation and Sudden Death under Cautions.)

Dosage

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.

Available as the base, decanoate (decanoic acid ester), and lactate salt; dosage is expressed in terms of haloperidol.100 101 102 103

There is considerable interindividual variation in optimum dosage requirements; carefully adjust dosage according to individual requirements and response, using the lowest possible effective dosage.b c d e

Because of risk of adverse reactions associated with cumulative effects of butyrophenones, periodically evaluate patients with a history of long-term therapy with haloperidol and/or other antipsychotic agents to determine whether maintenance dosage can be decreased or drug therapy discontinued.a

Pediatric Patients Psychotic Disorders Oral

Children 3–12 years of age (weighing 15–40 kg): Initially, 0.5 mg daily given in 2 or 3 divided doses.d e Subsequent dosage may be increased by 0.5 mg daily at 5- to 7-day intervals, depending on the patient’s tolerance and therapeutic response; usual dosage range is 0.05–0.15 mg/kg daily given in 2 or 3 divided doses.d e

Severely disturbed psychotic children may require higher dosages.d e

During prolonged maintenance therapy, keep dosage at the lowest possible effective level; once an adequate response has been achieved, gradually reduce dosage and make subsequent adjustments according to patient response and tolerance.d e

Tourette’s Syndrome Oral

Children 3–12 years of age (weighing 15–40 kg): Initially, 0.5 mg daily given in 2 or 3 divided doses.d e Subsequent dosage may be increased by 0.5 mg daily at 5- to 7-day intervals, depending on the patient’s tolerance and therapeutic response; usual dosage range is 0.05–0.075 mg/kg daily given in 2 or 3 divided doses.d e

Once an adequate response is achieved, gradually reduce dosage and make subsequent adjustments according to patient response and tolerance.d e

Disruptive Behavior Disorder and ADHD Oral

Children 3–12 years of age (weighing 15–40 kg): Initially, 0.5 mg daily given in 2 or 3 divided doses.d e Subsequent dosage may be increased by 0.5 mg daily at 5- to 7-day intervals, depending on the patient’s tolerance and therapeutic response; usual dosage range is 0.05–0.075 mg/kg daily given in 2 or 3 divided doses.d e

Nonpsychotic or hyperactive behavioral problems in children may be acute, and short-term administration may be adequate.d e

Maximum effective dosage for management of behavioral problems in children not established, but there is little evidence that improvement in behavior is further enhanced at dosages >6 mg daily.d e

Adults Psychotic Disorders Moderate Symptomatology Oral

Initially, 0.5–2 mg 2 or 3 times daily.d e Carefully adjust subsequent dosage according to the patient’s tolerance and therapeutic response.d e During prolonged maintenance therapy, keep dosage at lowest effective level.d e

Severe Symptomatology Oral

Initially, 3–5 mg 2 or 3 times daily.d e

To achieve prompt control, higher dosages may be required in some patients.d e Patients who remain severely disturbed or inadequately controlled may require dosage adjustment.d e

Dosages up to 100 mg daily may be required in some severely psychotic patients.d e

Occasionally, dosages >100 mg daily have been used for the management of severely resistant disorders in adults; however, safety of prolonged administration of such dosages has not been demonstrated.d e

Chronic/Resistant Disorders Oral

Initially, 3–5 mg 2 or 3 times daily.d e

Patients who remain severely disturbed or inadequately controlled may require dosage adjustment.d e

Dosages up to 100 mg daily may be required in some severely psychotic patients.d e

Occasionally, dosages >100 mg daily have been used for the management of severely resistant disorders in adults; however, safety of prolonged administration of such dosages has not been demonstrated.d e

IM (Haloperidol Decanoate)

May consider for patients requiring prolonged antipsychotic therapy (e.g., patients with chronic schizophrenic disorder).100 101 105 106 108 110 111 112 185

Initially, stabilize patient’s condition with an antipsychotic agent prior to attempting conversion to haloperidol decanoate.c If patient is receiving an antipsychotic agent other than haloperidol, initial conversion to oral haloperidol is recommended to minimize risk of an unexpected adverse reaction that might not be readily reversible following use of the decanoate.100 101 c

Base initial IM decanoate dose on patient’s clinical history, physical condition, and response to previous antipsychotic therapy.100 101 110

A precise formula for converting oral haloperidol dosage to IM haloperidol decanoate not established, but an initial IM dose 10–20 times the previous daily oral haloperidol dose, not >100 mg (regardless of previous antipsychotic dosage requirements) is suggested, although limited clinical experience suggests that a lower initial dosage of the decanoate may be adequate.c (See Table: Haloperidol Decanoate Dosage Recommendations under Dosage and Administration.)

If conversion requires an initial haloperidol decanoate dosage >100 mg, administer in 2 injections (i.e., administer a maximum initial dose of 100 mg followed by the balance in 3–7 days); however, some clinicians have converted therapy to decanoate using a higher initial dose.c

Haloperidol Decanoate Dosage Recommendationsc

Patient Population

Initial Therapy

Monthly Maintenance Therapy

Patients stabilized on low daily oral dosages (up to 10 mg daily), or geriatric or debilitated patients

10–15 times daily oral dosage

10–15 times previous daily oral dosage

Patients receiving high-dose oral therapy, at risk for relapse, or tolerant to oral haloperidol

20 times daily oral dosage

10–15 times previous daily oral dosage

Usually, administer at monthly intervals (i.e., every 4 weeks), but individual response may dictate need for adjusting dosing interval as well as the dose.100 101 108 109 110 111

Observe closely during dosage titration to minimize risk of overdosage or emergence of psychotic manifestations prior to next dose; if supplemental antipsychotic therapy is necessary during periods of dosage titration or for control of acute exacerbations of psychotic manifestations, use a short-acting haloperidol preparation.100 101 110

Experience with haloperidol decanoate dosages >450 mg monthly is limited.100 101

Acute Agitation IM (Haloperidol Lactate)

Initially, 2–5 mg as a single dose for prompt control in patients with moderately severe to very severe symptoms.b Depending on patient response, may repeat dose as often as every hour; however, administration every 4–8 hours may be adequate to control symptoms in some patients.102 103

Conversion from IM to Oral Therapy Oral

Oral: Replace short-acting parenteral therapy with haloperidol lactate with oral therapy as soon as possible; depending on patient’s clinical status, give first oral dose within 12–24 hours after administration of last parenteral dose.b

Use total parenteral dosage during preceding 24 hours for initial approximation of total daily oral dosage required; since this dosage is only an initial estimate, closely monitor patients being switched to oral therapy, particularly for efficacy, sedation, and adverse effects, for first several days following initiation of oral therapy.b

Increase or decrease subsequent oral dosage according to patient tolerance and therapeutic response, using lowest possible effective dosage.b

Tourette’s Syndrome Moderate Symptomatology Oral

Initially, 0.5–2 mg 2 or 3 times daily.d e Carefully adjust subsequent dosage according to patient’s tolerance and therapeutic response.d e

During prolonged maintenance therapy, keep dosage at lowest effective level.d e

Severe Symptomatology and/or Chronic/Resistant Disorder Oral

Initially, 3–5 mg 2 or 3 times daily.d e

Patients who remain inadequately controlled may require dosage adjustment.d e

Dosages up to 100 mg daily may be required in some patients to achieve optimal response.d e

Occasionally, dosages >100 mg daily have been used for management of severely resistant disorders in adults; however, safety of prolonged administration of such dosages has not been demonstrated.d e

Delirium† IV (Haloperidol Lactate)

Optimum dosage not established.121 However, initiation of IV† haloperidol (as the lactate) with dosages of 1–2 mg every 2–4 hours has been suggested; 121 127 severely agitated adults may require titration to higher dosages.121 124 125 127

Although single IV doses up to 50 mg or total daily dosages of 500 mg have been reported,121 125 127 128 132 must consider risk of adverse effects, particularly prolongation of the QT interval and torsades de pointes.125 130 132 162

Some evidence suggests that risk of torsades de pointes increases at total daily dosages of 35–50 mg or more.125 132 162

In patients requiring multiple IV injections of the drug to control delirium (e.g., more than eight 10-mg doses in 24 hours or >10 mg/hour for >5 consecutive hours), may consider continuous IV infusion†;121 129 in such patients, an initial 10-mg dose followed by an infusion of 5–10 mg/hour has been suggested.121 129 If agitation persists, can consider repeating 10-mg IV doses at 30-minute intervals, accompanied by a 5-mg/hour increase in the infusion rate.129

Determine ECG at baseline and periodically or continuously thereafter, paying special attention to possible prolongation of the QT interval; reduce dosage or discontinue drug if clinically important QT prolongation (e.g., 15–25% or more over baseline) occurs or the QTc interval exceeds 450 msec.121 125 129 130 132 133 162 163 164 (See QT-interval Prolongation and Sudden Death under Cautions.)

Prescribing Limits Pediatric Patients Oral

Maximum effective dosage not established, but there is little evidence that improvement in behavior is further enhanced at dosages >6 mg daily.d e

IM

Safety and efficacy not established in children.b c

Adults Oral

Safety of prolonged administration of dosages >100 mg not demonstrated.d e

IM

Experience with haloperidol decanoate dosages >450 mg monthly is limited.100 101

Special Populations Hepatic Impairment

No specific dosage recommendations.a g

Renal Impairment

No specific dosage recommendations.a g

Geriatric/Debilitated Patients

In geriatric or debilitated patients, lower dosages may be required than those in younger adults; optimal response is usually obtained with more gradual dosage adjustments.b (See Geriatric Use under Cautions.)

Initially, 0.5–2 mg orally 2 or 3 times daily; increase dosage more gradually in debilitated, emaciated, or geriatric patients than in younger adults.d e

Lower IV† dosages (e.g., 0.25–0.5 mg every 4 hours as haloperidol lactate) have been suggested for geriatric patients with delirium.121

Cautions for Haloperidol Lactate Contraindications

Severe toxic CNS depression or comatose states from any cause.b c d e

Parkinsonian syndrome.a b c d e

Hypersensitivity to haloperidol.b c d e

Warnings/Precautions Warnings

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.

Increased Mortality in Geriatric Patients with Dementia-related Psychosis

Geriatric patients with dementia-related psychosis treated with antipsychotic agents are at an increased risk of death.177 178 179 180 181 182 183 184 g

Antipsychotic agents, including haloperidol, are not approved for the treatment of dementia-related psychosis.177 178 179 180 181 g (See Boxed Warning and see Geriatric Use under Cautions.)

QT-interval Prolongation and Sudden Death

Sudden death, QT-interval prolongation, and torsades de pointes reported in patients receiving haloperidol.124 125 126 129 130 132 133 162 163 164 167 168 169 170 171

Use of higher than recommended doses of any haloperidol formulation and IV† administration of the drug appear to be associated with an increased risk of QT-interval prolongation and torsades de pointes.124 125 129 130 132 133 162 163 164 167 168 170 171

Although these effects have been reported in the absence of predisposing factors, use haloperidol with particular caution in patients with other conditions that prolong the QT interval, including electrolyte imbalance (particularly hypokalemia and hypomagnesemia), underlying cardiac abnormalities, hypothyroidism, and familial long QT syndrome, as well as in those concurrently receiving other drugs known to prolong the QT interval.130 132 133 162 163 164 170 (See Drugs that Prolong QT Interval under Interactions.)

Monitor ECG whenever haloperidol is administered IV.125 130 162 163 164 (See Delirium under Dosage and Administration.) Prolongation of the QTc interval to >450 msec or to >15–25% over that in previous ECGs may warrant telemetry, cardiology consultation, and dose reduction or discontinuance.121 130 132 133

Monitor serum magnesium and potassium at baseline and periodically in critically ill patients,121 132 133 especially those with baseline QTc interval ?440 msec, those receiving other drugs known to increase the QT interval, and those who have electrolyte disorders.121

Tardive Dyskinesia

Tardive dyskinesia, a syndrome of potentially irreversible, involuntary, dyskinetic movements, may develop in patients receiving antipsychotic agents, including haloperidol.b c d e g

Use of higher dosages or longer periods of treatment may increase risk of developing the syndrome.f g

Reserve long-term treatment for patients with chronic illness known to be responsive to antipsychotic agents and for which alternative, equally effective, but potentially less toxic therapy is not available or appropriate.g

APA recommends assessing patients receiving first-generation antipsychotic agents for abnormal involuntary movements every 6 months; for patients at increased risk for tardive dyskinesia, assess every 3 months.185

Consider drug discontinuance if signs and symptoms of tardive dyskinesia develop.b c d e f g Some patients may require treatment despite the presence of the syndrome.f g

Neuroleptic Malignant Syndrome

Neuroleptic malignant syndrome (NMS), a potentially fatal syndrome characterized by hyperpyrexia, muscle rigidity, altered mental status, and autonomic instability, has been reported with antipsychotic agents, including haloperidol.100 102 103 b f g

Immediately discontinue therapy and initiate supportive and symptomatic therapy if NMS occurs.g Careful monitoring recommended if therapy is reinstituted following recovery; the risk that NMS can recur must be considered.f g

Hyperpyrexia and heat stroke not associated with NMS also reported.b c d e

Fetal/Neonatal Morbidity and Mortality

Cases of limb malformations in offspring of women given haloperidol concurrently with other potentially teratogenic drugs during first trimester of pregnancy reported; causal relationship not established.a b Teratogenic and fetotoxic in animals.a b

Use during pregnancy or in women likely to become pregnant only when potential benefits justify possible risks to fetus.a b

Concomitant Therapy with Lithium

Acute encephalopathic syndrome reported occasionally in patients receiving lithium and an antipsychotic agent concurrently, especially when high serum lithium concentrations were present.a b Observe patients receiving combined therapy for evidence of neurologic effects; promptly discontinue if manifestations appear.a b

Respiratory Effects

Bronchopneumonia, sometimes fatal, reported with use of antipsychotic agents, including haloperidol.a b Consider that lethargy and decreased thirst, resulting from central inhibition, may cause dehydration, hemoconcentration, and reduced pulmonary ventilation; if such manifestations occur, particularly in geriatric patients, promptly institute appropriate therapy.a b

Ocular Effects

Ocular changes reported in patients receiving chemically related drugs, although not reported with haloperidol.a b

Sensitivity Reactions Hypersensitivity

Skin reactions (i.e., maculopapular, acneiform) and isolated cases of photosensitivity reported;b c d e contact dermatitis reported rarely with skin contact to haloperidol lactate oral solution and injection.a

Use with caution in patients with known allergies or with a history of allergic reactions to drugs.a

General Precautions Hypotension and Angina

Possible transient hypotension and/or precipitation of angina; use with caution in patients with severe cardiovascular disorders163 164 165 166

If hypotension occurs, may use metaraminol, norepinephrine, or phenylephrine; do not use epinephrine since haloperidol causes a reversal of epinephrine’s vasopressor effects and a further lowering of BP.163 164 165 166

Seizures

Possible risk of seizures; may lower seizure threshold.100 101 103 b c d e Use with caution in patients with a history of seizures or EEG abnormalities or in those receiving anticonvulsant agents.100 101 103 Maintain adequate anticonvulsant therapy.a b

CNS Depression

Possible impairment of ability to perform activities requiring mental alertness or physical coordination (e.g., operating machinery, driving a motor vehicle).a b

Possible additive effects or potentiated action when used with other CNS depressants.a b c d e (See Specific Drugs under Interactions.)

Extrapyramidal Symptoms

Extrapyramidal symptoms occur frequently; if concomitant therapy with an antiparkinsonian drug is necessary to manage extrapyramidal symptoms, it may be necessary to continue the antiparkinsonian drug for a period of time after haloperidol discontinuance to prevent emergence of these symptoms.a b

Thyrotoxicosis

Severe neurotoxicity (e.g., rigidity, inability to walk or talk) may occur in patients with thyrotoxicosis who are also receiving antipsychotic agents, including haloperidol.a b

Bipolar Disorder

If used to control mania in patients with bipolar disorder, there may be a rapid mood swing to depression.a b

Abrupt Withdrawal

Possible transient dyskinetic signs after abrupt withdrawal in some patients receiving maintenance therapy; in some cases, dyskinetic movements are indistinguishable from tardive dyskinesia except for duration.b It is not known whether gradual withdrawal will reduce occurrence of withdrawal-emergent neurological signs; pending further evidence, withdraw gradually.b

Endocrine Effects

Elevated prolactin concentrations possible; may persist during long-term therapy.a b c d e g

Although disturbances such as galactorrhea, amenorrhea, gynecomastia, and impotence have been reported, clinical importance of elevated prolactin concentrations for most patients has not been established.a g

Use with caution in patients with previously diagnosed breast cancer, since in vitro tests indicate that about one-third of such tumors are prolactin dependent.a g

Metabolic Effects

Decreased serum cholesterol concentrations reported in patients receiving chemically related agents.b c d e

Myelosuppression

Leukopenia, neutropenia, and agranulocytosis (sometimes fatal) reported in patients receiving antipsychotic agents, including haloperidol.e

Possible risk factors for leukopenia/neutropenia include preexisting low WBC count and history of drug-induced leukopenia or neutropenia.e Monitor CBC frequently during the first few months of therapy in such patients; discontinue drug at the first sign of a decline in WBC count in the absence of other causative factors.e

Monitor patients with neutropenia carefully for signs or symptoms of infection (e.g., fever); treat promptly if such signs or symptoms occur.e

Discontinue haloperidol if severe neutropenia (ANC <1000/mm3) occurs; monitor WBC until recovery occurs.e

Specific Populations Pregnancy

Pending revision, the material in this section should be considered in light of more recently available information in the MedWatch notification at the beginning of this monograph.

Haloperidol Lactate

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