FIRAZYR 30mg Price

Overview

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This medicine contains an important and useful components, as it consists of
Icatibantis available in the market in concentration

Name

Haloperidol

Precaution

Haloperidol is an antipsychotic medication primarily used to manage psychiatric disorders such as schizophrenia, acute psychosis, and as an adjunct for severe agitation or tics in Tourette’s syndrome. Caution should be used when prescribing haloperidol to patients with a history of cardiovascular conditions, including arrhythmias, as haloperidol can cause QT interval prolongation, which may increase the risk of arrhythmias. It is also contraindicated in patients with known hypersensitivity to haloperidol or other butyrophenones. Haloperidol should be used with caution in elderly patients, especially those with dementia-related psychosis, as there is an increased risk of death in this population. Patients should be monitored for extrapyramidal symptoms (EPS), such as tremors, rigidity, and bradykinesia, as well as for tardive dyskinesia (TD), a potentially irreversible condition involving involuntary muscle movements, which can develop with prolonged use. Patients with a history of seizures, alcohol dependence, or electrolyte imbalances (especially hypokalemia) should also be monitored closely during treatment. Haloperidol can cause sedation, so caution is needed when performing activities that require alertness, such as driving. Pregnant and breastfeeding women should only use haloperidol if the benefits outweigh the risks, as it may cause fetal harm or be excreted in breast milk.

Indication

Haloperidol is primarily indicated for the treatment of schizophrenia and other psychotic disorders, such as acute psychosis and manic episodes of bipolar disorder. It is also used to manage agitation and violent behavior in patients with acute psychiatric conditions. In addition, haloperidol is used in the treatment of tics and vocal utterances associated with Tourette’s syndrome. It can also be administered for the short-term management of severe nausea and vomiting, particularly when other treatments have failed. Haloperidol is sometimes used off-label for the management of delirium in critically ill patients or for severe agitation in conditions such as dementia, though it should be used cautiously in older adults due to the risk of serious side effects, including sedation and mortality. Its primary action is through dopamine receptor antagonism, which helps to reduce the positive symptoms of schizophrenia, such as delusions, hallucinations, and disorganized thinking.

Contra indication

Haloperidol is contraindicated in patients with a known hypersensitivity to the drug or other butyrophenone derivatives. It should not be used in patients with severe central nervous system (CNS) depression, such as coma, or in those with Parkinson’s disease, as it can exacerbate the motor symptoms of the condition. Haloperidol is also contraindicated in patients with a history of QT interval prolongation or who are at high risk for arrhythmias, as it can further increase the risk of life-threatening arrhythmias. Additionally, it should not be used in patients with severe hypokalemia or untreated electrolyte imbalances, as these conditions can increase the risk of cardiac arrhythmias when using haloperidol. In elderly patients with dementia-related psychosis, haloperidol has been associated with an increased risk of death, so it is contraindicated for this purpose. Pregnant women, particularly in the first trimester, should avoid haloperidol unless absolutely necessary, as the drug can have teratogenic effects. The medication should not be used in patients with a history of neuroleptic malignant syndrome (NMS), a potentially fatal condition associated with antipsychotic use.

Side Effect

Haloperidol is associated with several potential side effects, both common and serious. Common side effects include sedation, dizziness, dry mouth, constipation, and weight gain. Extrapyramidal symptoms (EPS) are among the most concerning side effects, especially with higher doses or prolonged treatment, and include symptoms such as tremors, rigidity, bradykinesia (slowness of movement), and akathisia (restlessness). Tardive dyskinesia (TD), characterized by involuntary movements, typically of the face and tongue, can develop after long-term use, and may be irreversible in some cases. Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening reaction to haloperidol and other antipsychotics, marked by fever, altered mental status, muscle rigidity, and autonomic dysregulation. Haloperidol can also cause hypotension, especially when used in high doses or in combination with other hypotensive agents. Other serious side effects include QT prolongation, which increases the risk of arrhythmias, and elevated prolactin levels, which can lead to gynecomastia, galactorrhea, and menstrual irregularities. In elderly patients, particularly those with dementia, haloperidol has been associated with an increased risk of death. For patients experiencing severe side effects such as signs of NMS or TD, discontinuation of the medication should be considered, and alternative treatments should be explored.

Pregnancy Category ID

3

Mode of Action

Haloperidol is a first-generation antipsychotic that exerts its therapeutic effects primarily through dopamine receptor antagonism. It binds to and inhibits dopamine D2 receptors in the brain, particularly in the mesolimbic and mesocortical pathways, which are involved in mood and behavior regulation. Dopamine blockade in these areas reduces the positive symptoms of schizophrenia, such as hallucinations, delusions, and disorganized thinking. Haloperidol also affects the nigrostriatal pathway, which controls motor function, and this is why extrapyramidal symptoms (EPS) can occur with its use. In addition to dopamine, haloperidol may also have some mild antagonistic effects on serotonin receptors, but it is much more selective for dopamine. The drug also has anticholinergic and antihistaminic properties, though these effects are less pronounced than in some other antipsychotics. Haloperidol’s ability to control psychosis is due to its strong dopamine blockade, but this same property contributes to the risk of motor side effects like tremors, rigidity, and tardive dyskinesia. The balance between efficacy and side effects in haloperidol treatment requires careful management.

Interaction

Haloperidol can interact with a variety of drugs, especially those affecting the central nervous system. Co-administration with other sedatives or CNS depressants (e.g., alcohol, benzodiazepines, opioids) can exacerbate sedation and respiratory depression, leading to potentially dangerous side effects. Haloperidol also has the potential to interact with medications that affect the QT interval, such as certain antiarrhythmics, macrolide antibiotics, and some antidepressants (e.g., tricyclic antidepressants), increasing the risk of arrhythmias. When used concurrently with drugs that lower the seizure threshold, such as antidepressants, antipsychotics, or lithium, the risk of seizures may increase. Haloperidol is metabolized in the liver via the cytochrome P450 enzyme system, specifically CYP3A4 and CYP2D6, so drugs that inhibit or induce these enzymes can alter the drug’s metabolism. Strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) can increase haloperidol levels, leading to an increased risk of side effects such as sedation, extrapyramidal symptoms (EPS), and QT prolongation. Conversely, CYP3A4 inducers (e.g., rifampin, carbamazepine) may decrease haloperidol levels, reducing its effectiveness. Patients should be closely monitored when starting or stopping drugs that affect the cytochrome P450 enzymes. Combining haloperidol with lithium may increase the risk of neuroleptic malignant syndrome (NMS), a rare but serious side effect of antipsychotic medications.

Pregnancy Category Note

Information not available

Adult Dose

The typical starting dose of haloperidol for adults depends on the condition being treated. For acute psychosis or schizophrenia, haloperidol is usually initiated at 2 to 5 mg daily, with the dose gradually increased depending on the response and tolerance. The dose can be titrated up to 10–15 mg per day for severe cases, although doses higher than this are rarely needed. For management of severe agitation or delirium, a single dose of haloperidol may be given intravenously or intramuscularly in a hospital setting, starting at 5 mg and adjusting as needed. The total daily dose is typically divided into one to three doses. For Tourette’s syndrome, haloperidol is usually started at a low dose of 0.5 to 1 mg, gradually increasing based on the patient’s response. The maximum dose for adults typically does not exceed 100 mg daily, although this is rare. Dosage adjustments may be required for elderly patients or those with renal or hepatic impairments, as these populations are more sensitive to the effects of haloperidol.

Child Dose

For children, haloperidol is typically used in the treatment of severe behavioral disturbances, tics, or Tourette’s syndrome. The initial dose for children generally starts at 0.25 to 0.5 mg per day, with gradual increases to a maximum dose of 3 to 5 mg per day for children under 12 years old, depending on the condition being treated. For children over 12, the adult dosing regimen may apply, though the starting dose should generally be lower, particularly for those with a history of seizures, CNS depression, or cardiac abnormalities. Close monitoring is required for any side effects, particularly extrapyramidal symptoms (EPS), as children are more susceptible to these side effects. It is essential to adjust the dose based on the child’s response and to avoid prolonged use due to the potential for tardive dyskinesia (TD) and other side effects.

Renal Dose

In patients with renal impairment, haloperidol should be used with caution, although no specific dose adjustment is typically necessary for mild renal impairment. However, for patients with moderate to severe renal dysfunction, haloperidol should be initiated at a lower dose, and the patient should be carefully monitored for signs of drug accumulation and increased side effects. In cases of renal failure, the drug’s clearance may be reduced, leading to prolonged half-life and an increased risk of adverse effects, particularly sedation and extrapyramidal symptoms (EPS). Dosing intervals may need to be extended to prevent toxicity. Since haloperidol is primarily metabolized in the liver, liver function should also be evaluated in patients with renal impairment to avoid complications.

Administration

Information not available