[Ruthbud19]

Has anyone every given a dec shot over 100 mg. All of the medication info I have read states not to exceed a 100 mg dose. However, one of our physicians ordered a 300 mg dose. This concerns me since the patient has not been compliant for months. Any information would be greatly appreciated.

[wtbcrna]

Originally Posted by Ruthbud19

Has anyone every given a dec shot over 100 mg. All of the medication info I have read states not to exceed a 100 mg dose. However, one of our physicians ordered a 300 mg dose. This concerns me since the patient has not been compliant for months. Any information would be greatly appreciated.

Here is what I found on Up to Date (based on Lexi-Comp Drug database)

http://www.merck.com/mmpe/print/lexi...loperidol.html

Haloperidol: Drug information

DOSING: ADULTS

Psychosis:

Oral: 0.5-5 mg 2-3 times/day; usual maximum: 30 mg/day

I.M. (as lactate): 2-5 mg every 4-8 hours as needed

I.M. (as decanoate): Initial: 10-20 times the daily oral dose administered at 4-week intervals. Maintenance dose: 10-15 times initial oral dose; used to stabilize psychiatric symptoms

It seems like it would be in the therapeutic range, but that is extremely large dose. I would probably call the physician and see what their rationale is for giving such a large dose.

[EarthChild1130]

It is within the therapeutic dose, but then again oral Haldol at 30mg is quite a bit too. The most I've ever given of Haldol Dec is 175mg.

[Toph McGee]

How much Haldol is to much?

[EarthChild1130]

Here's a link from Drug Library...

http://www.druglib.com/druginfo/haldol/indications/

[Virginia PMH-NP]

This is high but not beyond the acceptable limit. At 20 mg a day of Haldol the conversion would be up to 400mg of Dec.

If the patient has been on Haldol in the past his history of use should indicate how much po haldol he had taken.

As the dose is absorbed slowly you do not need to be worried about overdosing.

If the patient is actively psychotic and has been non-compliant he may need this high dose at first to get his symptoms under control. This will avoid hospitalization which may really get the patient highly medicated because they have so little time to get a response.

Make sure to check after the third day for any dystonia. If not, the worse thing that will happen is he may be oversedated, this may not be a bad thing in the acute stages.

Checking any dose with the prescriber is always OK!
Always good to Ask.