Haloperidol Contraindications and Precautions

Cardiac Risks

The American Heart Association notes that haloperidol may cause prolongation of the QT interval, increasing the risk of ventricular arrhythmias and torsades de pointes 1, 2
The administration of haloperidol with other medications that prolong the QT interval requires special caution, as it may increase the risk of cardiac events 2
The QT interval prolongation is dose-dependent, with higher doses associated with greater risk 1
Patients with pre-existing cardiac disease or electrolyte imbalances are at increased risk of QT interval prolongation 1

The American Academy of Pediatrics reports that haloperidol may cause acute extrapyramidal symptoms, including distonia (involuntary muscle spasms) 2
Acute akathisia (subjective feeling of restlessness) and drug-induced parkinsonian syndrome are also potential side effects of haloperidol 2
Laryngeal dystonia, although rare, is a potentially life-threatening side effect that presents as a sensation of asphyxiation, difficulty breathing, or stridor 2

Patients with a history of seizures or conditions that lower the seizure threshold require special caution when taking haloperidol 3
Patients with hepatic or renal insufficiency may have altered metabolism of the drug, requiring dose adjustments 4

In patients with Parkinson's disease who require an antipsychotic, quetiapine or aripiprazol may be considered as alternatives to haloperidol, as they have a lower risk of extrapyramidal symptoms 5
In patients at risk of QT interval prolongation, antipsychotics with minimal impact on the QT interval, such as aripiprazol or olanzapine, may be preferred 2