Lowest Available Dose of Haloperidol
Haloperidol is available in a 0.5 mg oral tablet, which represents the lowest commercially available dose. 1
FDA-Approved Dosage Forms
The FDA label confirms that haloperidol oral formulations begin at 0.5 mg, with the recommended starting dose for moderate symptomatology in adults being 0.5 mg to 2 mg two or three times daily. 1
For geriatric or debilitated patients specifically, the FDA label recommends starting at 0.5 mg to 2 mg two or three times daily, establishing 0.5 mg as the appropriate lower threshold for this vulnerable population. 1
Clinical Context for Low-Dose Use
In geriatric delirium management, guidelines recommend starting with 0.25-0.5 mg for older or frail patients, though this may require splitting tablets or using liquid formulations since 0.25 mg is not available as a standard tablet. 2
The British Medical Journal guidelines support 0.5-1 mg orally as the starting dose for delirium, with this dose given at night and every 2 hours as needed. 3
For cancer patients who are older or frail, the Annals of Oncology recommends even lower doses of 0.25-0.5 mg, acknowledging that doses below the standard tablet strength may be necessary. 3
Pediatric Formulations
For children aged 3-12 years, the FDA label specifies that therapy should begin at the lowest dose possible (0.5 mg per day), with incremental increases of 0.5 mg at 5-7 day intervals if required. 1
Important Clinical Caveat
While 0.5 mg tablets represent the lowest manufactured strength, clinical practice in frail elderly patients may necessitate doses as low as 0.25 mg, which requires either tablet splitting or use of liquid concentrate formulations to achieve the desired dose. 2, 3