BNF for Children 2011-2012

BNFC 2011–2012 4.2.1 Antipsychotic drugs 175Indication and doseSchizophrenia and other psychoses, mania,short-term adjunctive management of psychomotoragitation, excitement and violent ordangerously impulsive behaviour (under specialistsupervision). By mouthChild 12–18 years initially 0.5–3 mg 2–3 timesdaily or 3–5 mg 2–3 times daily in severely affectedor resistant disease; in resistant schizophrenia upto 30 mg daily may be needed; adjusted accordingto response to lowest effective maintenance dose(as low as 5–10 mg daily)Motor tics (including Tourette syndrome) (underspecialist supervision). By mouthChild 5–12 years 12.5–25 micrograms/kg twicedaily, adjusted according to response up to 10 mgdailyChild 12–18 years 1.5 mg 3 times daily, adjustedaccording to response up to 10 mg dailyNausea and vomiting in palliative care. By mouthChild 12–18 years 1.5 mg once daily at night,increased to 1.5 mg twice daily if necessary; max.5 mg twice daily. By continuous intravenous or subcutaneousinfusionChild 1 month–12 years 25–85 micrograms/kgover 24 hoursChild 12–18 years 1.5–5 mg over 24 hoursHaloperidol (Non-proprietary) ATablets, haloperidol 500 micrograms, net price 28-tabpack = 91p; 1.5 mg, 28-tab pack = £1.39; 5 mg, 28-tabpack = £2.15; 10 mg, 28-tab pack = £5.53; 20 mg, 28-tab pack = £14.07. Label: 2Injection, haloperidol 5 mg/mL, net price 1-mL amp= 49pDozic c (Rosemont) AOral liquid, sugar-free, haloperidol 1 mg/mL, netprice 100-mL pack = £6.86. Label: 2Haldol c (Janssen) ATablets, both scored, haloperidol 5 mg (blue), netprice 100-tab pack = £7.21; 10 mg (yellow), 100-tabpack = £14.08. Label: 2Oral liquid, sugar-free, haloperidol 2 mg/mL, netprice 100-mL pack (with pipette) = £4.45. Label: 2Injection, haloperidol 5 mg/mL, net price 1-mL amp= 37pSerenace c (IVAX) ACapsules, green, haloperidol 500 micrograms, netprice 30-cap pack = 98p. Label: 2Tablets, haloperidol 1.5 mg, net price 30-tab pack =£1.74; 5 mg (pink), 30-tab pack = £3.95; 10 mg (palepink), 30-tab pack = £6.76. Label: 2Oral liquid, sugar-free, haloperidol 2 mg/mL, netprice 500-mL pack = £34.48. Label: 2LEVOMEPROMAZINE(Methotrimeprazine)Cautions see notes above; diabetes; children receivinglarge initial doses should remain supineContra-indications see notes aboveHepatic impairment see notes aboveRenal impairment see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; occasionally raisederythrocyte sedimentation rate occurs; hyperglycaemiaalso reportedIndication and doseRestlessness and confusion in palliative care. By continuous subcutaneous infusionChild 1–12 years 0.35–3 mg/kg over 24 hoursChild 12–18 years 12.5–200 mg over 24 hoursNausea and vomiting in palliative care. By continuous intravenous or subcutaneousinfusionChild 1 month–12 years 100–400 micrograms/kg over 24 hoursChild 12–18 years 5–25 mg over 24 hoursAdministration for administration by subcutaneousinfusion dilute with a suitable volume of SodiumChloride 0.9%Nozinan c (Sanofi-Aventis) ATablets, scored, levomepromazine maleate 25 mg, netprice 84-tab pack = £20.26. Label: 2Injection, levomepromazine hydrochloride 25 mg/mL, net price 1-mL amp = £2.01PERICYAZINE(Periciazine)Cautions see notes aboveContra-indications see notes aboveHepatic impairment see notes aboveRenal impairment see notes abovePregnancy see notes aboveBreast-feeding see notes aboveSide-effects see notes above; more sedating; hypotensioncommon when treatment initiated; respiratorydepressionLicensed use tablets not licensed for use in childrenIndication and doseSchizophrenia, psychoses (severe mental orbehavioural disorders only) (under specialistsupervision). By mouthChild 1–12 years initially 500 micrograms dailyfor 10-kg child, increased by 1 mg for each additional5 kg to max. total daily dose of 10 mg; dosemay be gradually increased according to responsebut maintenance should not exceed twice initialdoseChild 12–18 years initially 25 mg 3 times dailyincreased at weekly intervals by steps of 25 mgaccording to response; usual max. 100 mg 3 timesdaily; total daily dose may alternatively be given in2 divided doses4 Central nervous system