Last update Feb. 22, 2024

C21 H23 ClFNO2

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

A selective monoaminergic antagonist indicated in the treatment of schizophrenia, manic episodes of bipolar disorder, puerperal psychosis, 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 (RD 1-12%). (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).


See below the information of this related product:

Alternatives

  • Aripiprazole (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Olanzapine (Safe substance and/or breastfeeding is the best option.)
  • Quetiapine Fumarate (Safe substance and/or breastfeeding is the best option.)
  • Risperidone (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

C21 H23 ClFNO2 is Haloperidol in Molecular formula.

Is written in other languages:

Groups

C21 H23 ClFNO2 belongs to these groups or families:

Tradenames

Main tradenames from several countries containing C21 H23 ClFNO2 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
10 - 38 hours
M/P ratio 0.6 - 0.8 -
Theoretical Dose 0.0003 - 0.005 mg/Kg/d
Relative Dose 3.5 (1 - 12) %

References

  1. Uguz F. A New Safety Scoring System for the Use of Psychotropic Drugs During Lactation. Am J Ther. 2021 Jan-Feb 01;28(1):e118-e126. Abstract
  2. Uguz F. Adverse Events in a Breastfed Infant Exposed to Risperidone and Haloperidol. Breastfeed Med. 2019 May 28. Abstract
  3. Uguz F. Breastfed Infants Exposed to Combined Antipsychotics: Two Case Reports. Am J Ther. 2016;23(6):e1962-e1964. Abstract
  4. Parikh T, Goyal D, Scarff JR, Lippmann S. Antipsychotic drugs and safety concerns for breast-feeding infants. South Med J. 2014 Abstract
  5. Klinger G, Stahl B, Fusar-Poli P, Merlob P. Antipsychotic drugs and breastfeeding. Pediatr Endocrinol Rev. 2013 Mar-Apr;10(3):308-17. Review. Abstract
  6. 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
  7. Rosenbloom AL. Hyperprolactinemia with antipsychotic drugs in children and adolescents. Int J Pediatr Endocrinol. 2010;2010. pii: 159402. Abstract
  8. 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
  9. Goodnick PJ, Rodriguez L, Santana O. Antipsychotics: impact on prolactin levels. Expert Opin Pharmacother. 2002 Oct;3(10):1381-91. Review. Abstract
  10. 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 Abstract Full text (link to original source) Full text (in our servers)
  11. 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
  12. 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
  13. 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
  14. 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)
  15. 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)
  16. Whalley LJ, Blain PG, Prime JK. Haloperidol secreted in breast milk. Br Med J (Clin Res Ed). 1981 Abstract
  17. 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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