Rapid tranquilisation (i.m.)
To be prescribed only if clinically indicated and as a SINGLE dose
If there is insufficient information to guide the choice of medication for rapid tranquilisation, or the service user has not taken antipsychotic medication before, use lorazepam.
If there is evidence of cardiovascular disease, including prolonged QT interval, or no ECG has been carried out, avoid intramuscular haloperidol combined with promethazine and use intramuscular lorazepam or olanzapine instead.
The Prevention and Management of Violence and Aggression and Rapid Tranquilisation Policy and Guidance must be followed
Recommended dose 1 - 2 mg (0.5 - 1mg if >65 years or learning disability)
Ensure flumazenil available in case of benzodiazepine-induced respiratory depression
Repeat after 30 - 60 minutes if partial response
Maximum dose in 24 hours 4mg (2mg if >65 years or learning disability)
| Pack | Price |
|---|---|
| 10 ampoule |
Recommended dose 50 mg (25 mg if >65 years old or learning disability) in combination with haloperidol
Maximum dose 100mg in 24 hours (50mg if >65 years old or learning disability)
Repeat after 30 - 60 minutes if partial response
Recommended in people known to have dependency on benzodiazepines
| Pack | Price |
|---|---|
| 10 ampoule |
Recommended dose 5 mg (2.5mg if >65 years or learning disability) in combination with i.m. promethazine
Maximum dose in 24 hours 20mg (5mg if > 65 years or learning disability)
Ensure i.m. procyclidine available
Repeat after 60 minutes if partial response, continued use should be evaluated early in treatment
DO NOT USE if evidence of cardiovascular disease or if no recent normal ECG has been carried out (within a month)
| Pack | Price |
|---|---|
| 1 ampoule | |
| 10 ampoule | £35.00 |
| 5 ampoule |
Restricted to initiation by a consultant
Not recommended by NICE for rapid tranquilisation but approved for use by the trust
Recommended dose 5 - 10mg (2.5 - 5mg if > 65 years or learning disability
Minimum interval between doses 2 hours, maximum dose in 24 hours 20mg (10mg if >65 years old or learning disabilities)
Not to be given within 1 hour of intramuscular lorazepam
| Pack | Price |
|---|---|
| 1 vial |