| Schizophrenia in patients who have not responded to or cannot tolerate other antipsychotics (label). View labelExact | The label emphasizes determining the smallest effective dose for each patient due to QT risk and restricting use to schizophrenia after failure of other agents (label).
Adult schizophrenia dosing: label describes a usual starting dose of 50–100 mg three times daily with gradual titration as needed (label). | Low-potency phenothiazine first-generation antipsychotic (D2 antagonism) with prominent anticholinergic effects. Notable for dose-related QTc prolongation risk; labeling restricts use to schizophrenia after failure of other agents. | CYP2D6 | No | - Weight
- Sedation
- EPS
- Prolactin
- QTc
| - Baseline ECG and potassium; consider periodic ECG/potassium during titration (label).
- Avoid QT-prolonging combinations; re-check medication list after any new prescription.
- Sedation, orthostasis, and anticholinergic effects (falls and delirium risk).
- Movement symptoms and tardive dyskinesia screening.
- Palpitations, presyncope/syncope, or new dizziness prompt urgent reassessment (label/clinical).
| No | 2026-02-22 |
|---|
| Schizophrenia and other psychotic disorders; acute mania; nausea/vomiting; intractable hiccups (label-dependent). View labelExact | Dosing is individualized by indication and setting. The label emphasizes gradual titration until symptoms are controlled, then step-down to the lowest effective maintenance dose (label).
Psychotic disorders: label examples include outpatient starts such as 10 mg three or four times daily or 25 mg two or three times daily; more severe cases may be titrated upward in semi-weekly intervals (label). | Low-potency phenothiazine first-generation antipsychotic (D2 antagonism) with prominent antihistamine (H1) and anticholinergic effects; often associated with sedation and orthostatic hypotension. | Hepatic metabolism | No | - Weight
- Sedation
- EPS
- Prolactin
- QTc
| - Sedation and functional impairment (falls risk, driving safety).
- Orthostatic symptoms and blood pressure (especially early titration).
- Anticholinergic effects (bowel/urinary symptoms, delirium risk).
- Movement symptoms (akathisia, rigidity, tremor; tardive dyskinesia screening).
- Weight and cardiometabolic risk factors over time.
| No | 2026-02-22 |
|---|
| Schizophrenia; severe behavior disorders; Tourette's syndrome (tics/vocal utterances); adjunct in acute agitation. View labelExact | Schizophrenia (oral): initiate 1–5 mg two or three times daily; maintenance 5–20 mg/day divided; doses >30 mg/day increase EPS risk. | Potent dopamine D2 receptor antagonist; minimal anticholinergic. | CYP3A4, CYP2D6 | Steady-state mean 21 h | No | | - Extrapyramidal symptoms are monitored periodically; prophylaxis is generally reserved for clear need.
- QTc: ECG monitoring is often considered when risk factors or higher doses are present.
- LAI: Haloperidol decanoate every 4 weeks—product-specific conversion guidance is typically used.
- Regular AIMS screening for tardive dyskinesia (typically every 3–6 months; every 3 months in higher-risk groups or with dose increases).
- Prolactin-related symptoms (sexual dysfunction, amenorrhea, galactorrhea) and overall quality-of-life impact—consider switching if persistent.
- Orthostatic vitals and falls risk, especially in older adults and when combined with other CNS depressants or antihypertensives.
- Metabolic monitoring (weight/BMI, glucose, lipids) periodically as part of comprehensive schizophrenia care, even though metabolic risk is lower than many SGAs.
| q4wk | 2026-03-31 |
|---|
| Schizophrenia; acute mania or mixed episodes (bipolar I) as monotherapy or adjunct; irritability associated with autistic disorder. View labelExact | Schizophrenia (adults): start 1–2 mg/day; increase by 1–2 mg/day to 4–6 mg/day (doses >6 mg/day increase EPS). | Dopamine D2 and serotonin 5‑HT2A receptor antagonism; also alpha‑1 and H1 activity. | CYP2D6 | Single-dose mean 3 h; Steady-state mean 21 h | No | - Weight
- Sedation
- EPS
- Prolactin
| - Metabolic: weight/BMI, fasting glucose/HbA1c, and lipids (baseline and periodic).
- EPS: monitor akathisia/parkinsonism; periodic AIMS for tardive dyskinesia.
- Prolactin: monitor for symptoms (amenorrhea, galactorrhea, sexual dysfunction).
- Sedation: assess next-day impairment and fall risk, especially with other sedatives.
| q2wk; Monthly (q4wk); q4wk or q8wk (by dose) | 2025-12-28 |
|---|