Haloperidol Richter

We present your attention to the annotation to the medication. Haloperidol Richter is a neuroleptic and an antipsychotic agent capable of blocking the central α-adrenergic and dopamine receptors. 

[1]

Indications of the haloperidol Richter

The medication is prescribed:

• with acute and chronic course of mental disorders, taking place against the background of general overexcitation, hallucinatory and delusional conditions (patients with schizophrenia, affective state, psychosomatic disorders);
• at inadequate behavior, paranoia, schizoid personality changes (including in children), for the therapy of autism;
• with hereditary chorea, nervous tics;
• with persistent long hiccups of neurological etiology;
• with persistent attacks of vomiting (with the inability to eliminate by usual means);
• in preparation for surgery.

[2], [3]

Release form

Haloperidol is made in the form of injectable solution or tablets.

 The injection solution is colorless or slightly yellow in color, without signs of turbidity or sediment. It is produced in ampoules of 1 ml (contains 5 mg of active ingredient), 5 pcs in a pack of cardboard.

 Tablet form: light tablets of 1.5 mg or 5 mg, flattened, rounded, with a notch for dosing, with the logo "| | |" on one of the surfaces.

 In addition to the active ingredient, there are a number of additional ingredients that are represented by starch, silica, magnesium stearate, talc and lactose. The package contains 25 tablets.

[4], [5], [6], [7]

Pharmacodynamics

Medication: Haloperidol Richter is a psycholeptic, a butyrofenone derivative. It has a bright antipsychotic and antiemetic effect. This ability of the drug is explained by the possibility of blocking central dopamine and α-adrenergic receptors in the brain. Blocking of hypothalamic receptors leads to a decrease in overall temperature indices, to an increase in the production of prolactin. Antiemetic effect is associated with oppression of dopamine receptors in the trigger region of vomiting centers. A significant antipsychotic effect is favorably accompanied by a mild soothing effect.

 Haloperidol Richter is able to potentiate the action of barbiturates, narcotic analgesics, anesthetics, as well as some other drugs that can in some way inhibit the activity of the central nervous system. 

[8], [9]

Pharmacokinetics

Absorption of the drug occurs by passive transport of substances, in a non-ionized form, mainly directly from the small intestine. The bioavailability of the drug is estimated at about 65%. At internal reception the limiting concentration in a blood flow is observed after 2-6 hours, at an injection introduction - during 20 minutes.

 The therapeutic effect is detected even at a drug level in plasma from 20 to 25 mg / l. The binding to plasma proteins is about 92%.

 Metabolism of the drug occurs in the liver, while the metabolite does not have pharmacological activity.

 The half-life from the plasma during ingestion occurs throughout the day, and when injected - for 21 hours. Most of the metabolite is excreted through the intestine (up to 60%), the rest - through the urinary system. Without problems overcomes both blood-brain and placental barriers, and also is found in breast milk. 

[10], [11], [12], [13], [14]

Dosing and administration

METHODS OF APPLICATION AND DOSES Haloperidol is determined by the doctor depending on the phase of the pathology and on the patient's individual response to the medication. We give the average dosage of the drug, most often used in medicine.

 To stabilize the psychomotor reactions at the beginning of the treatment, I / m injections of the drug from 2.5 to 5 mg three times a day are used. The maximum daily dosage is 60 mg. With a stable sedative effect, injection of the drug is replaced by oral administration.

 Elderly patients can take from 0.5 to 1.5 mg of haloperidol, which is 0.1-0.3 ml of r-ra for injection. The maximum daily allowance is 5 mg.

 Children, from the age of 3 years, use from 0.025 to 0.05 mg of the drug per day, divided into two injections. The maximum allowed dosage is 0.15 mg per kilogram of child weight per day.

 Tablets Haloperidol Richter take for half an hour before meals. Drink followed by water or milk (to reduce the negative effects on the digestive tract). The initial daily dosage can be from one and a half to five milligrams, divided by 2 or 3 times. Dosage is gradually increased by an average of 2 mg to a persistent therapeutic effect. The limit of the drug per day is 100 mg.

 The average duration of the treatment course is from 2 to 3 months. Further, the preparation can be administered in maintenance amounts (after the exacerbation phase), while the dosage is reduced gradually over several weeks.

 For anti-emetic effect of haloperidol, the richter is taken orally from 1.5 to 2.5 mg.

[18], [19], [20], [21], [22], [23]

Use of the haloperidol Richter during pregnancy

Studies using haloperidol richter during pregnancy have not found a significant increase in the number of identified congenital anomalies of fetal development. Meanwhile, there are data on the occurrence of congenital anomalies when using haloperidol in combination with other drugs during pregnancy. For this reason, the appointment of haloperidol to pregnant women is permissible only in situations where the expected positive effect for the expectant mother is higher than the risk to the fetus.

The active substance of the drug is found in the composition of breast milk. Therefore, many prefer to temporarily abandon breastfeeding in cases where treatment is inevitable. There are known situations in which the extrapiramidal signs developed in a nursing child against the background of taking Haloperidol, a breastfeeding mother.

Contraindications

A number of contraindications to the use of haloperidol is known:

• depression of the central nervous system, coma;
• CNS diseases that occur in the background of extrapyramidal disorders (Parkinsonism);
• disorders of basal nuclei;
• children up to 3 years;
• depressive conditions;
• allergic hypersensitivity of the organism to the active or additional ingredients of the drug.

 Haloperidol is very carefully prescribed for cardiac decompensation, for arrhythmias, for severe kidney or liver damage, with a tendency to epilepsy, with increased thyroid function, with active prostatitis, and increased intraocular pressure.

[15]

Side effects of the haloperidol Richter

Standard dosages of the drug are transferred, as a rule, without problems. Elevated doses may be accompanied by side effects:

• extrapyramidal disorders (dystonia, rigidity of muscles, hypo- and hyperkinesis, athetosis, akathisia, etc.);
• anxiety, depressive syndrome, epileptic seizures;
• fatigue, sleep disturbances;
• disorders of cardiac activity, falling blood pressure, disturbances of cardiographic indices;
• allergy, skin rashes, disorders of the function of the sebaceous and sweat glands;
• Dyspeptic disorders, loss or weight gain, increased salivation;
• disorders of menstrual function, disorders of sexual desire, impotence;
• swelling of the extremities, worsening of the outflow of urine.

[16], [17],

Overdose

 Overdose Haloperidol Richter may be accompanied by the following reactions:

• muscle weakness, trembling in the limbs, a sense of fatigue;
• instability of blood pressure;
• with a large overdose, coma, respiratory dysfunction, heart rhythm disturbances, convulsions may develop;
• increase in temperature indicators as a sign of the development of neuroleptic syndrome.

 In case of overdose, the drug should be discontinued. If the medicine was taken orally, then the gastric lavage is performed, after which sorbent preparations are used (activated-charcoal pills, sorbes).

 If development of respiratory dysfunction is observed, the use of mechanical ventilation is possible. With a sharp drop in blood pressure, it may be necessary to support blood circulation by introducing plasma or albumin drugs, dopamine. It is inadmissible in such situations to use epinephrine!

 According to the indications, it is possible to resort to the appointment of antiparkinsonian medications (benzthropine mesylate). Drip diazepam, glucose, vitamin and nootropic drugs are used.

 Hemodialysis is not carried out because of its ineffectiveness. There is no special antidote preparation.

[24], [25], [26]

Interactions with other drugs

The drug Haloperidol Richter can interact with some other medications, which must be taken into account when using them in a complex manner.

 Haloperidol Richter is able to suppress the influence on the central nervous system of narcotic analgesic medications, hypnotics, antidepressants of the tricyclic structure (amitriptyline), anesthetics and ethyl alcohol.

 It was noted a decrease in the therapeutic effect with the combined use of haloperidol and antiparkinsonian agents.

 Haloperidol reduces the effect of adrenaline, and also helps lower blood pressure and the increase in heart rate when combined.

 Potentiates the effect of medications that lower blood pressure.

 When combined with anticonvulsants, their dosage should be increased, as the threshold of convulsive activity decreases.

 The effect of haloperidol is lowered by the influence of such drinks as tea or coffee.

 The effect of indirect coagulants may decrease, and the toxicity of antidepressants of the tricyclic structure and drugs that inhibit MAO may be increased.

 The combination with an atypical antidepressant bupropion increases the risk of an epileptic attack.

 The neurotoxic effect is enhanced with the simultaneous treatment with lithium preparations, and this effect is irreversible.

 The effect of bromocriptine is lowered.

 The antipsychotic effect of Haloperidol decreases, and its side effects are aggravated when combined with anticholinergic, antiparkinsonian and antihistamine medicines.

 It is not prescribed with thyroxine, since it increases the toxic effect of haloperidol.

 Use with anticholinergics can provoke the development of glaucoma. 

[27], [28], [29], [30],

Storage conditions

Haloperidol Richter in tableted form, or in the form of an injection solution is recommended to be stored at temperatures ranging from + 15 ° to + 30 ° C, in a place inaccessible to children. Keep the drug from exposure to sunlight and other bright lighting. 

[31], [32], [33], [34],

Shelf life

 Shelf life - up to 5 years from the date of production, which is indicated on the packing box.

 Haloperidol Richter is allowed to leave in the pharmacy network only if there is a prescription from the doctor. 

[35], [36]