Psychiatry is a special field of medicine that requires certain medications to help a diagnosed patient cope with emerging problems. One of the tools used in practice is Haloperidol (drops). Instructions for the use of this drug, explaining why and how it is prescribed, will be considered in the article.
How is the drug produced?
Haloperidol was developed by Janssen Pharmaceutica in 1957. Those firms that manufacture drugs, release the same drug only in tablets or in the form of a solution for injection of prolonged action. A solution of Haloperidol in drops is produced by one company Ratiopharm GmbH, in 2010 absorbed by the multinational corporation Teva Pharmaceutical Industries Ltd. (Teva). Drops are a clear liquid, packaged in 30 mg vials. In 1 ml drops contains 2 mg of the active substance haloperidol. As auxiliary components in the drops are present:
- methyl parahydroxybenzoate, used in the food, pharmaceutical and cosmetic industries, as a preservative with some antibacterial properties;
- lactic acid, which plays a significant role in tissue metabolism, in the functioning of the nervous system and brain,
- propyl parahydroxybenzoate is another preservative;
- purified water used in the amount necessary for a specific concentration of the solution.
Which pharmaceutical group does the medicine belong to?
The drug "Haloperidol" (drops), a photo of which can be seen on medical sites, refers to the drugs of the antipsychotic (antipsychotic) group as defined by the State Register of the Ministry of Health of the Russian Federation.
How does the active component work?
The medicine "Haloperidol" in drops in its composition contains one active substance. It is a derivative of the complex organic compound butyrophenone. The instructions for use with Haloperidol (in drops) describe the active substance and some points regarding its mechanism of action. Haloperidol is a powerful antipsychotic whose action is based on blocking dopamine receptors, which play an important functional role in the functioning of the central nervous system. Another functional feature of this substance is a moderate sedative effect associated with the inhibition of α-adrenergic receptors in the limbic and mesocortical structures of the brain. The drug also affects the D2 receptors of the hypothalamus, which affects lowering body temperature and activating the production of prolactin, which causes galactorrhea, not only in women but also in men.
The pathway of a substance in the human body
One of the sought-after remedies in psychiatric practice is Haloperidol in drops. The dosage of the drug calculated by the manufacturer takes into account the pharmacokinetics of the active substance. Once in the human body, the drug is actively absorbed, up to 60% of the substance is absorbed by the tissues. The assimilated amount of the drug has 92% biological activity. It is well bound by blood proteins, successfully penetrates histohematological barriers. The peculiarity of the metabolism of haloperidol is its ability to the so-called "first pass", however, this substance does not have pharmacologically active metabolites. Its maximum concentration in the blood is reached in 3 hours, and the half-life from the body is on average one day. Haloperidol is excreted from the body through the liver with urine and feces. If there is a need for hemodialysis, it should be borne in mind that due to the large volume of distribution, as well as the low concentration in the blood, only a small amount of the substance can be removed from the body in this way.
In what cases is the medicine prescribed in drops?
The main area of application of Haloperidol drops is a psychiatric practice, although sometimes it can be prescribed to eliminate vomiting, for example, during the treatment of cancer. The main indications for the use of this medicinal antipsychotic will be the following diseases and conditions:
- delusions, hallucinations, delirious syndromes, catatonic syndromes, disorders of thinking, disorders of consciousness against the background of acute psychotic syndromes;
- psychosis of endogenous and exogenous etiology in the chronic stage;
- psychomotor agitation ;
- vomiting
- stuttering.
Contains all the necessary information about the drug "Haloperidol" (drops) in the instructions for use. The drug receives good reviews both from patients and from doctors who successfully use it as a prophylactic and to suppress symptoms in psychoses and psychotic syndromes of various origins.
Possible contraindications
Information about contraindications is contained in the instructions for use with Haloperidol (drops). Reviews that have a negative connotation are based on this side of the drug’s functionality. "Haloperidol" can not be prescribed for conditions and diseases such as:
- coma of various origins;
- diseases of the central nervous system, accompanied by musculoskeletal symptoms;
- xenobiotic intoxication followed by severe inhibition of central nervous system function;
- individual sensitivity to the components of the drug or derivatives of butiferon.
Haloperidol should not be taken by children under 3 years of age. The same restriction applies to pregnant and breast-feeding women, since this substance penetrates the placental barrier and into breast milk.
Medicinal drops "Haloperidol" can be used with extreme caution and only for absolute medical reasons should be prescribed in the following cases:
- alcohol intoxication;
- arrhythmias;
- bradycardia;
- vegetovascular dystonia;
- prostatic hyperplasia;
- hyperthyroidism;
- hypokalemia;
- severe arterial hypotension;
- depression of endogenous origin;
- orthostatic dysregulation;
- diseases of the hematopoietic system;
- angle-closure glaucoma;
- malignant antipsychotic syndrome (history);
- changes in the electrocardiogram with lengthening of the QT interval;
- clinical heart disorders;
- tumors dependent on the hormone prolactin (e.g., mammary glands);
- organic brain damage;
- poisoning with an analgesic group of opioids, sleeping pills and psychotropic substances;
- renal and / or liver failure;
- thyrotoxicosis;
- epilepsy.
If the use of Haloperidol is the only possible treatment option for certain conditions, then it is prescribed with extreme caution to patients with neurological symptoms of damage to the subcortical structures of the brain and a low threshold for convulsive readiness. In this case, a large epileptic seizure (convulsions such as "grandmal") can be observed. For such patients, the use of this drug is indicated only against the background of continued administration of anticonvulsants.
If the patient is diagnosed with depression and treatment of the concomitant disease Haloperidol is necessary, then antidepressants are taken in combination.
If the patient has a disease of the endocrine system and is treated with thyroxine, then the appointment of "Haloperidol" is contraindicated. If the use of this drug is necessary, then antithyroid therapy should be carried out in case of an increase in the number of undesirable effects.
If something went wrong
For many patients, the use of a drug such as Haloperidol in drops is indicated. In reviews of it, development of side effects is often mentioned. In this regard, the medicine is often perceived negatively by patients. During studies of the drug, as well as observations of patients taking it, it was noted that a therapeutic dose of 1-2 mg per day does not have long, pronounced side effects. If they arise, they are of a rapidly passing (transient) nature. Adverse reactions from taking "Haloperidol" include:
- From the nervous system: akathisia, anxiety, insomnia, agitation, hallucinations, headache, dizziness, depression, lethargy, psychosis, anxiety, drowsiness, fear, euphoria, epilepsy. With a long course, the appearance of extrapyramidal disorders, late dystonia, malignant antipsychotic syndrome is possible. They are expressed in smacking, wrinkling of the lips, swelling of the cheeks, fast and worm-like movements of the tongue, uncontrolled chewing movements, uncontrolled movements of the neck, trunk, arms and legs, rapid blinking, unusual expression of the face or body, shortness of breath or shortness of breath, hyperthermia, increase or decrease HELL, increased sweating, urinary incontinence, muscle stiffness, epileptic seizures, loss of consciousness.
- On the part of the cardiovascular system, an inadequate reaction to taking the drug, especially in large doses, is manifested by arrhythmia, decreased blood pressure, orthostatic hypotension, tachycardia, ECG changes, manifested in lengthening of the QT interval, flutter and ventricular fibrillation.
- The respiratory system can respond to taking the drug with pathological changes in the rhythm of breathing, shortness of breath, inflammatory lung diseases.
- For the digestive system, hyposalivation (decreased salivation), dry mucous membranes of the oral cavity, decreased appetite, nausea, vomiting, diarrhea, constipation, impaired liver function, and jaundice may become characteristic of the digestive system.
- Hematopoietic organs can show a negative reaction in the form of agranulocytosis, monocytosis, transient leukopenia or leukocytosis, erythropenia.
- The genitourinary system can respond with pain in the mammary glands, gynecomastia, hyperprolactinemia, urinary retention (especially with prostatic hyperplasia), menstrual irregularities, the appearance of peripheral edema, decreased potency, increased libido, priapism (painful erection without sexual arousal).
As a side effect of the drug, the patient may experience alopecia, cataracts, retinopathy, skin irritations, weight gain, photosensitivity.
The appearance of any abnormal sensations and health conditions, well-being require either dose adjustment or drug withdrawal. Only a doctor can solve the question of changing the treatment regimen.
Dosage and dosage
It is important for those patients who are shown antipsychotics to know how to take "Haloperidol" in drops. The answer to this question should be given by the doctor when prescribing the drug for medical reasons. The dosage regimen is slightly different for different age groups and takes into account concomitant diseases or conditions of the patient. For the drug "Haloperidol" (in drops), the instructions for use recall that 10 drops of the solution contain 1 mg of the active substance. The amount of substance prescribed by the doctor should be divided by 1, 2 or 3 times. If the dose required for treatment and determined by a specialist is greater than that indicated in the standard instructions, then it can be divided into 4-5 doses. It should be remembered that this antipsychotic is taken with food, measuring the required number of drops with a pipette. The product can be diluted with drinks or added to food. Those patients who do not suffer from diabetes mellitus or high blood sugar can use lump sugar to take the drug.
For patients of childhood (from 3 to 18 years), a progressive change in the dosage of the drug is used in the treatment, taking into account the amount of active component per 1 kg of the child’s body weight. Start with 0.025 mg. Then, if necessary, the dosage is adjusted to 0.05 mg (per 1 kilogram of the patient’s body weight). In case of acute need, the doctor may increase this dose to 0.2 mg / kg for adequate treatment.
For the treatment of adult patients, a progressive dosage change is also used. They start with a daily amount of medicine of 0.5-1.5 mg 2-3 times a day, then the dosage is increased to 2-4 mg for each of 2-3 doses of the drug per day. If treatment is carried out in a specialized medical institution under the supervision of specialists and is prescribed for the relief of acute symptoms, the dose can be increased to 15 mg of the active substance. It should be remembered that the maximum allowable amount of haloperidol, which can be taken per day, should not exceed 100 mg. Clinicians have found that for therapeutic purposes, the medicine is used at 10-15 mg per day. If the patient suffers from chronic schizophrenia, then the dose increases to 40 mg. With often recurring exacerbations, with resistance to traditional treatment, the amount of haloperidol increases to 60 mg per day.
In maintenance therapy for outpatient treatment, a daily dosage of 0.5-5 mg is most often recommended, taking into account the anamnesis, the condition of the patient, the course of the disease, and concomitant diseases. The patient is monitored by the doctor systematically.
A single dose of the drug "Haloperidol" (in drops) for the elderly, as well as patients weakened physically should not be higher than 1.5 mg. In this case, the maximum daily amount of the active substance should not be more than 5 mg.
It should be remembered that for the drug "Haloperidol" (drops), the instructions for use with regard to dosing are recommendatory in nature. The correct and adequate dosage, the regimen for the use of the medicine is prescribed by the doctor treating the patient.
Overdose and drug poisoning
The question of how long you can take "Haloperidol" in drops is also decided by the attending physician. Prolonged inadequate use of this drug can cause overdose and poisoning, they appear as follows:
- aspiration
- excitation;
- hyperthermia;
- hypothermia;
- glossopharyngeal syndrome;
- delirium;
- dyskinetic disorders;
- dystonic disorders;
- urinary retention;
- coma;
- respiratory failure;
- intestinal paresis;
- pneumonia;
- cardiovascular failure
- decrease or increase in blood pressure;
- confusion of consciousness;
- drowsiness;
- epileptic seizures.
In case of an overdose, symptomatic therapy is used, which should take into account the following aspects:
- vomiting may not be possible due to the antiemetic effect of this drug;
- gastric lavage will help relieve detoxification of the body only in case of early diagnosis of poisoning or overdose due to the fact that the drug has a high degree of absorption;
- dialysis and forced diuresis are ineffective;
- with symptomatic therapy of poisoning or an overdose of haloperidol, analeptic drugs can not be used, since there is a high risk of epileptic seizures;
- for relief of extrapyramidal symptoms, it is necessary to use antiparkinsonian drugs such as biperiden, introducing it intravenously, such therapy can be carried out for a sufficiently long time;
- if the patient is in a coma, then intubation is indicated, which is carried out using short-acting muscle relaxants to relieve spasm of the pharyngeal muscles.
Cases of haloperidol overdose or poisoning with this drug should undergo clinical symptomatic treatment with constant monitoring of blood pressure and heart activity. It should be borne in mind that developed respiratory depression may require mechanical ventilation.
"Haloperidol" and other drugs, analogues
Like the Haloperidol drug itself (drops), analogues of this drug should be prescribed for use taking into account the drugs taken by the patient for the treatment of concomitant diseases. These include the following drugs: Haloper, Senorm. In addition, drugs manufactured by other manufacturers in the form of tablets, injection solution: “Haloperidol-Acre”, “Haloperidol-PAR”, “Haloperidol-ratiopharm”, etc. are considered analogues.
Antihypertensive drugs, as well as m-anticholinergic drugs activate their action when taken together with Haloperidolum. But the effect of anticonvulsants: bromocriptine, dopamine, norepinephrine, phenylephrine, epinephrine, ephedrine, on the contrary, decreases. An antipsychotic becomes more toxic if taken along with tricyclic antidepressants and MAO inhibitors by reducing the metabolism of these drugs.
Haloperidol should never be taken together with alcohol-containing substances, including drugs, analgesics of the opioid group, barbiturates, tricyclic antidepressants, and other sleeping pills due to a sharp decrease in blood pressure and depression of the central nervous system.
Where and how to buy medicine?
The drug "Haloperidol" (in drops) reviews is more positive, they are left by more than one generation of patients and practitioners. It should be remembered that this drug can be used in the treatment strictly for medical reasons and on prescription. In the pharmacy network, it is sold exclusively on a special prescription form, the free sale of this medicine is prohibited. This feature of treatment with Haloperidol (drops) confirms the instructions for use. The cost of the medicine is small - about 50 rubles per 1 bottle of 30 ml. After opening the package, the medicine must be used within six months, then it must be disposed of.
Some features
As with other antipsychotics, instructions for use tell about the features of treatment with Haloperidolum (drops). With increasing dosing of the drug for patients of childhood or old age, as well as for debilitated patients, the adjustment of its intake should be carried out no more than 1 time in 3-5 days.
Any self-medication with other drugs during the course of taking this medicine is strictly prohibited. A doctor's consultation on all substances taken is simply necessary.
The period of treatment with Haloperidol should be monitored by a doctor, the patient's condition needs to be monitored.
Before you stop taking the drug, it is necessary to gradually reduce the dose of the active substance, both daily and simultaneous. This must be done in order to avoid the so-called "withdrawal syndrome."
During the treatment with this drug, extreme caution must be exercised when driving vehicles and engaging in other activities that require a quick psychomotor reaction and an increased concentration of attention.
The use of "Haloperidol" in drops is a popular therapeutic measure in the treatment of many diseases of psychiatric practice, despite numerous contraindications and a high likelihood of side effects, the medication should be prescribed only by the attending physician.