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haloperidol decanoate

Long-acting injectable antipsychotic • Brands: HALDOL DECANOATE

Last reviewed: 2025-12-30

General information

Class: Long-acting injectable antipsychotic
Common US brands: HALDOL DECANOATE
Typical dose range: Confirm oral tolerability and response before depot conversion when feasible. Conversion is individualized; labeling commonly describes an initial monthly dose roughly 10–15× the total daily oral dose.
Long-acting injectable formulation available.
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-30

Dosing & forms

Forms/strengths: Long-acting depot injection: deep intramuscular injection, typically administered monthly (q4wk).
Frequency: Confirm oral tolerability and response before depot conversion when feasible. Conversion is individualized; labeling commonly describes an initial monthly dose roughly 10–15× the total daily oral dose.
Typical range: Confirm oral tolerability and response before depot conversion when feasible. Conversion is individualized; labeling commonly describes an initial monthly dose roughly 10–15× the total daily oral dose.

Mechanism (brief)

Long-acting injectable formulation of haloperidol (high-potency dopamine D2 antagonist) designed for monthly maintenance dosing in schizophrenia when scheduled injections support adherence.

Metabolism & Half‑life

Metabolism: CYP3A4, CYP2D6
Half‑life: Steady-state mean 504 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Long‑acting injectable (LAI)

Haloperidol decanoate

Interval: q4wk
Oral overlap: Consider short overlap during conversion
Site: Gluteal

Citations

Label DOI DOI DOI

Monitoring highlights

Movement disorder monitoring (akathisia, parkinsonism, tardive dyskinesia) including periodic AIMS-style exams.
ECG/QTc monitoring when clinically indicated (cardiac disease, electrolyte disturbances, QT-prolonging co-medications).
Prolactin-related symptom review (sexual dysfunction, menstrual changes, galactorrhea).
Injection site assessment and documentation (site rotation, local reactions).

Sources

HALDOL Decanoate (haloperidol decanoate) injection — Prescribing Information — DailyMed (2025)
Haloperidol tablets prescribing information — DailyMed (2025)
The American Psychiatric Association Practice Guideline for the Treatment of Patients With Schizophrenia — American Psychiatric Association (2020)
Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis — The Lancet (2013)
AGNP Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsycharmacology — Pharmacopsychiatry (2018)