HALD SR 200MG is a long-acting intramuscular (IM) antipsychotic injection containing Haloperidol Decanoate, used for maintenance therapy in schizophrenia and other psychotic disorders in patients who require prolonged treatment.
Composition
-
Active Ingredient:Â Haloperidol Decanoate 200 mg/mLÂ (in sesame oil base).
-
Vehicle: Sesame oil, benzyl alcohol (preservative).
Mechanism of Action
-
Potent dopamine (D2) receptor antagonist in the CNS.
-
Also blocks serotonin (5-HT2), alpha-adrenergic, and histamine (H1) receptors to a lesser extent.
-
Long-acting depot formulation: Slowly releases haloperidol over 3–4 weeks.
Dosage & Administration
Initial Dose (Stabilized Patients):
-
10–15x the equivalent daily oral dose (e.g., if oral dose = 10 mg/day → 100–150 mg IM).
-
Max initial dose:Â 200 mg IM.
Maintenance Dose:
-
50–200 mg IM every 4 weeks (adjust based on response).
Administration:
-
Deep IM injection (gluteal muscle preferred).
-
Do not administer IV or subcutaneously (risk of oil embolism).
Switching from Oral to Depot:
-
Overlap oral haloperidol for 4–8 weeks to ensure stability.
Uses (Indications)
✅ Maintenance therapy for schizophrenia (non-adherent patients).
✅ Chronic psychotic disorders (e.g., paranoid schizophrenia).
✅ Tourette’s syndrome (alternative when oral therapy fails).
Storage & Stability
-
Store at 15–30°C, protect from light.
-
Do not freeze (oil base may solidify).
-
Stable for up to 3 months after first use if stored properly.
Key Recommendations
✔ Monitor for EPS (extrapyramidal symptoms): Dystonia, akathisia, tardive dyskinesia.
✔ Assess QT prolongation risk (ECG monitoring in high-risk patients).
✔ Avoid abrupt withdrawal (risk of relapse).
✔ Use lowest effective dose (elderly patients are more sensitive).
Important Notes
âš Â Black Box Warning:
-
Increased mortality in elderly dementia patients (not approved for dementia-related psychosis).
-
QT prolongation & torsades de pointes (avoid in cardiac disease).
âš Â Contraindications:
-
Parkinson’s disease, Lewy body dementia (worsens motor symptoms).
-
Severe CNS depression, coma.
⚠ Pregnancy (Category C): Risk of neonatal EPS; use only if benefits justify risks.
Side Effects
Common (≥10%) | Serious (<1%) |
---|---|
– EPS (dystonia, tremors) | – Neuroleptic malignant syndrome (NMS) |
– Sedation | – Severe QT prolongation |
– Dry mouth | – Tardive dyskinesia (irreversible) |
– Weight gain | – Seizures |
Drug Interactions
Interacting Drug | Effect | Management |
---|---|---|
CYP3A4 inhibitors (ketoconazole) | ↑ Haloperidol levels | Monitor for toxicity |
CYP2D6 inhibitors (fluoxetine) | ↑ Haloperidol levels | Reduce dose |
QT-prolonging drugs (amiodarone) | ↑ Arrhythmia risk | Avoid combo |
CNS depressants (benzodiazepines) | ↑ Sedation | Caution |
Comparison with Other Depot Antipsychotics
Feature | HALD SR (Haloperidol) | Risperidone Consta | Fluphenazine Decanoate |
---|---|---|---|
Dosing Interval | Every 4 weeks | Every 2 weeks | Every 2–4 weeks |
EPS Risk | High | Moderate | High |
QT Risk | High | Low | Moderate |
Cost | Low | High | Moderate |
Conclusion
HALD SR 200MG is a cost-effective depot antipsychotic for chronic schizophrenia, but requires careful monitoring for EPS and cardiac effects.
Reviews
There are no reviews yet.