The dose of Haldol Decanoate 50 or Haldol Decanoate 100 should be expressed in terms of its haloperidol content. The starting dose of haloperidol decanoate should be based on the patient's age, clinical history, physical condition, and response to previous antipsychotic therapy. The preferred approach to determining the minimum effective dose is to begin with lower initial doses and to adjust the dose upward as needed. For patients previously maintained on low doses of antipsychotics (. up to the equivalent of 10 mg/day oral haloperidol), it is recommended that the initial dose of haloperidol decanoate be 10–15 times the previous daily dose in oral haloperidol equivalents; limited clinical experience suggests that lower initial doses may be adequate.
Tardive Dyskinesia (TD) is a serious, sometimes permanent side effect reported with RISPERDAL CONSTA® and similar medications. TD includes uncontrollable movements of the face, tongue, and other parts of the body. The risk of developing TD and the chance that it will become permanent is thought to increase with the length of therapy and the overall dose taken by the patient. This condition can develop after a brief period of therapy at low doses, although this is much less common. There is no known treatment for TD, but it may go away partially or completely if therapy is stopped.
In a related issue, Risperdal sales practices resulted in a 2012 provisional settlement totaling $ billion.  The United States Department of Justice began investigating Risperdal sales practices in 2004, and in 2010 joined a whistleblowers suit alleging bribes paid to Omnicare , the largest company supplying pharmaceutical drugs to nursing homes.   The allegations include that Johnson & Johnson and Janssen were warned by the . Food and Drug Administration (FDA) not to promote Risperdal as effective and safe for elderly patients when in fact it is associated with early death, but they did so; and that they in fact bribed Omnicare pharmacists tens of millions of dollars to promote the drug to care home physicians for this unapproved use. A settlement was provisionally agreed with Johnson & Johnson of around $ billion for this and related allegations, with Omnicare having already settled for around $100 million.  Former head of sales and president of Janssen, Alex Gorsky , who the Dept of Justice say “was actively involved” in the fraud, nevertheless become the new CEO of Johnson & Johnson in 2012.