Table 13

Haloperidol buccal or sublingual

Haloperidol buccal or sublingual
What is it?Butyrophenone antipsychotic
Mechanism of actionD2, alpha-adrenergic and sigma receptor antagonist
Starting dose0.5 mg–1.5 mg 6–8 hourly
Time to onset of effectI hour if give PO (buccal/sublingual may be faster)17
FormulationOral solution
IndicationDelirium
Nausea and vomiting
Hiccups
Psychosis
Common adverse effectsExtra pyramidal effects, altered liver function tests, dizziness, sedation, visual disturbance, depression, hypotension16
ContraindicationsParkinson’s disease, Lewy body dementia, cardiac disorders, QTc prolongation, recent myocardial infarction, decompensated heart failure heart failure16
CautionDementia, stroke risk, epilepsy, renal and hepatic impairment, cardiac disease16
LicenceOff licence use of licensed product
BenefitsAlternative route of administration of an antipsychotic
RisksTime to effect unknown when used sublingually
CostPrice varies widely by product:
£4.45 for 100 mL of Haldol 2 mg/mL oral solution