The intravenous route is not FDA approved and is generally not recommended except when no other alternatives are available. Intravenous administration appears to be associated with a higher risk of QT prolongation and torsade de pointes (TdP) than other forms of administration. The manufacturer recommends ECG monitoring for QT prolongation and arrhythmias if IV administration is required. A dose in the range of 1 to 5 mg IV has been suggested, with the dose being repeated at 30 to 60 minute intervals, if needed. A maximum IV dose has not been established. The lowest effective dose should be used in conjunction with conversion to oral therapy as soon as possible.
This topic addresses the use of LAI antipsychotics in the treatment of schizophrenia. The pharmacology, administration, comparative side effects and treatment of schizophrenia with standard (non-LAI) antipsychotics are discussed separately as is the management of antipsychotic side effects. The epidemiology, clinical manifestations, and diagnosis of schizophrenia are discussed separately. (See "Pharmacotherapy for schizophrenia: Acute and maintenance phase treatment" and "First-generation antipsychotic medications: Pharmacology, administration, and comparative side effects" and "Second-generation antipsychotic medications: Pharmacology, administration, and side effects" and "Pharmacotherapy for schizophrenia: Side effect management" and "Schizophrenia in adults: Clinical manifestations, course, assessment, and diagnosis" and "Schizophrenia in adults: Epidemiology and pathogenesis" .)
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