Last update: Jan. 15, 2020

Haloperidol

Low Risk for breastfeeding


Moderately safe. Probably compatible.
Mild risk possible. Follow up recommended.
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A selective monoaminergic antagonist indicated in the treatment of schizophrenia, manic episodes of bipolar disorder, persistent aggression in dementias such as Alzheimer's, severe tics (Gilles de la Tourette syndrome) and Huntington's chorea.
Oral administration in one to three daily doses.

It is excreted in breastmilk in very variable amounts that can become clinically significant (Yoshida 1998, Kuniyoshi 1985, Whaley 1981, Stewart 1980). Haloperidol has been found in urine (Whaley 1981) and high plasma concentrations (Yoshida 1998) of infants whose mothers were taking it.

Occasionally clinical or developmental problems have been observed in infants whose mothers were taking it.
- Three of fourteen infants whose mothers were taking haloperidol and chlorpromazine simultaneously had a decrease in developmental scores between 12 and 18 months (Rubin 2004, Yoshida 1998).
- A one-month-old infant whose mother was treated daily with 1.5 mg of risperidone 1.5 mg and 0.8 mg of haloperidol had no problems during the first month of life. Sedation and poor nutrition appeared when the dose of haloperidol was increased to 1.5 mg daily (Uguz 2019).

In contrast, no short-term (Whaley 1981) or long-term developmental problems were observed in breastfed infants up to 6 -12 months while the mother was taking haloperidol on its own or with other antipsychotics (Uguz 2016, Mendhekar 2011), which is why some authors consider its use to be probably safe during breastfeeding under medical supervision (Parikh 2014, Klinger 2013).

Haloperidol induces an increase in prolactin and can cause galactorrhea (Rosenbloom 2010, Goodnick 2002, Atmaca 2002, Crawford 1997).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

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Other names

Haloperidol in other languages or writings:

Group

Haloperidol belongs to this group or family:

Tradenames

Main tradenames from several countries containing Haloperidol in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 40 - 75 %
Molecular weight 376 daltons
Protein Binding 92 %
VD 20 l/Kg
pKa 8,66 -
Tmax 0,5 - 4 hours
T1/2 10 - 38 hours
M/P ratio 0,6 - 0,8 -
Theoretical Dose 0,0003 - 0,005 mg/Kg/d
Relative Dose 2 - 12 %

References

  1. Uguz F. Adverse Events in a Breastfed Infant Exposed to Risperidone and Haloperidol. Breastfeed Med. 2019 May 28. Abstract
  2. Uguz F. Breastfed Infants Exposed to Combined Antipsychotics: Two Case Reports. Am J Ther. 2015 Abstract
  3. Parikh T, Goyal D, Scarff JR, Lippmann S. Antipsychotic drugs and safety concerns for breast-feeding infants. South Med J. 2014 Abstract
  4. Klinger G, Stahl B, Fusar-Poli P, Merlob P. Antipsychotic drugs and breastfeeding. Pediatr Endocrinol Rev. 2013 Abstract
  5. Mendhekar DN, Andrade C. Uneventful use of haloperidol and trihehexyphenidyl during three consecutive pregnancies. Arch Womens Ment Health. 2011 Feb;14(1):83-4. Abstract
  6. Rosenbloom AL. Hyperprolactinemia with antipsychotic drugs in children and adolescents. Int J Pediatr Endocrinol. 2010;2010. pii: 159402. Abstract
  7. Rubin ET, Lee A, Ito S. When breastfeeding mothers need CNS-acting drugs. Can J Clin Pharmacol. 2004 Fall;11(2):e257-66. Epub 2004 Dec 8. Abstract
  8. Goodnick PJ, Rodriguez L, Santana O. Antipsychotics: impact on prolactin levels. Expert Opin Pharmacother. 2002 Oct;3(10):1381-91. Review. Abstract
  9. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Full text (link to original source) Full text (in our servers)
  10. Atmaca M, Kuloglu M, Tezcan E, Canatan H, Gecici O. Quetiapine is not associated with increase in prolactin secretion in contrast to haloperidol. Arch Med Res. 2002 Nov-Dec;33(6):562-5. Abstract
  11. Yoshida K, Smith B, Craggs M, Kumar R. Neuroleptic drugs in breast-milk: a study of pharmacokinetics and of possible adverse effects in breast-fed infants. Psychol Med. 1998 Abstract
  12. Crawford AM, Beasley CM Jr, Tollefson GD. The acute and long-term effect of olanzapine compared with placebo and haloperidol on serum prolactin concentrations. Schizophr Res. 1997 Jul 25;26(1):41-54. Abstract
  13. Lee JJ, Rubin AP. Breast feeding and anaesthesia. Anaesthesia. 1993 Jul;48(7):616-25. Review. Abstract Full text (link to original source) Full text (in our servers)
  14. Kuniyoshi M, Inanaga K. Haloperidol and biperiden plasma levels in a pregnant atypical psychotic woman and a neonate--a case report. Kurume Med J. 1985 Abstract Full text (link to original source) Full text (in our servers)
  15. Whalley LJ, Blain PG, Prime JK. Haloperidol secreted in breast milk. Br Med J (Clin Res Ed). 1981 Abstract
  16. Stewart RB, Karas B, Springer PK. Haloperidol excretion in human milk. Am J Psychiatry. 1980 Jul;137(7):849-50. No abstract available. Abstract

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