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1st October 2018

The Emergency Sedation policies included in this section of TAM are past the review date but are currently being updated. Until the updated guidance is ratified, the current policies remain in place.

IMPORTANT INFORMATION : The licensed contra-indications and maximum daily doses of haloperidol have changed following EU harmonisation of the prescribing information.

  • The maximum cumulative dose of haloperidol over 24 hours (oral and/or IM combined)  in adults aged 18 years and above is now 20mg. The maximum cumulative dose in elderly patients is 5mg over 24 hours.
  • Use of haloperidol is now contra-indicated in combination with drugs that prolong the QTc interval. The use of haloperidol in such a combination renders treatment outside the product licence.

Given these changes the decision to administer haloperidol as per the existing Emergency Sedation policies should be taken on a case by case basis, and discussed with senior medical staff. It is important that a pre-treatment ECG is obtained prior to administering haloperidol to check for prolonged QTc. Ensure the rationale for treatment is clearly documented and reflected in the patient’s care plan.