Converting Haloperidol Decanoate to Oral Haloperidol

Conversion Methodology

• For patients who may be more sensitive, a conservative approach can be used with a 10-fold conversion factor (monthly dose ÷ 10 = daily oral dose) 1

Monitoring Requirements

• QTc monitoring is prudent, especially if oral doses exceed 5-10 mg daily, as recommended by clinical guidelines 2, 1

Special Populations

• Elderly or frail patients require lower conversion ratios, with a maximum daily oral dose not exceeding 5 mg 2, 1
• Elderly patients should start with 0.5-1 mg oral doses and titrate slowly 2

Alternative Consideration

• For acute management, such as delirium or acute agitation, standard dosing guidelines apply regardless of prior decanoate use, with doses starting at 0.5-2 mg as needed 3, 2, 1