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.
Inform patient that drug may cause dizziness or drowsiness. Advise patient to avoid hazardous tasks that require alertness until CNS response to drug is established.
Tell patient to avoid ingestion of alcohol and to seek medical approval before taking other drugs.
Instruct patient to promptly report rash or hives, anxiety, nervousness, anorexia (especially in underweight patients), suspicion of pregnancy, or intent to become pregnant.