Levorphanol

Generic name: Levorphanol (oral)
Brand names: Levo-Dromoran
Dosage form: oral tablet (2 mg; 3 mg)
Drug class: Opioids (narcotic analgesics)

Usage of Levorphanol

Levorphanol is an opioid medicine that is used to treat moderate to severe pain.

Levorphanol may also be used for purposes not listed in this medication guide.

Levorphanol side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Levorphanol may cause serious side effects. Call your doctor at once if you have:

noisy breathing, sighing, shallow breathing, breathing that stops;

a slow heart rate or weak pulse;

a light-headed feeling, like you might pass out;

mood changes, unusual thoughts or behavior;

severe stomach pain, severe constipation;

high levels of serotonin in the body--agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, diarrhea; or

low cortisol levels-- nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

Serious breathing problems may be more likely in older adults and those who are debilitated or have wasting syndrome or chronic breathing disorders.

Common side effects of levorphanol may include:

nausea, vomiting, stomach pain;

constipation;

dizziness, drowsiness;

tiredness; or

headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Before taking Levorphanol

You should not use levorphanol if you are allergic to it, or if you have:

severe asthma or breathing problems; or

a stomach or bowel obstruction (including paralytic ileus).

Tell your doctor if you have ever had:

breathing problems, sleep apnea (breathing stops during sleep);

a head injury, or seizures;

drug or alcohol addiction;

liver or kidney disease;

urination problems; or

problems with your gallbladder, pancreas, or thyroid.

If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.

Ask a doctor before using opioid medicine if you are breastfeeding. Tell your doctor if you notice severe drowsiness or slow breathing in the nursing baby.

Levorphanol is not approved for use by anyone younger than 18 years old.

Relate drugs

How to use Levorphanol

Usual Adult Dose for Pain:

As First Opioid Analgesic: Initial dose: 1 to 2 mg orally every 6 to 8 hours as needed for pain-May increase dose up to 3 mg orally every 6 to 8 hours as needed; if around the clock dosing is used, allow 72 hours for patient to reach a new steady-state before dose adjustment Maximum doses: Higher doses may be appropriate in opioid tolerant patientsCONVERSION from other Opioids:-Due to inter-patient variability, a conservative approach is advised-Levorphanol is 4 to 8 times as potent as morphine and has a longer half-life-May consider initiating levorphanol at 1/15 to 1/12 the total daily dose of oral morphine and adjust to clinical response-Allow 72 hours for patient to reach a new steady-state before dose adjustment Comments:-Doses should be adjusted according to the severity of the pain, age, weight, and physical status, underlying disease, and use of concomitant medications. -Monitor closely for respiratory depression especially on initiation and with each dose increase. -Because of the risks of addiction, abuse, and misuse, even at recommended doses, this drug should be reserved for use in patients for whom alternative treatment options have not or are not expected to be tolerated or have not or are not expected to provide adequate analgesia. Use: For the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

Warnings

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.

Taking opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use opioid medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

What other drugs will affect Levorphanol

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, heart or blood pressure medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

other narcotic medications--opioid pain medicine or prescription cough medicine;

a sedative like Valium--Diazepam, alprazolam, lorazepam, Xanax, Klonopin, Ativan, and others;

drugs that make you sleepy or slow your breathing--a sleeping pill, muscle relaxer, medicine to treat mood disorders or mental illness; or

drugs that affect serotonin levels in your body--a stimulant, or medicine for depression, Parkinson's disease, migraine headaches, serious infections, or nausea and vomiting.

This list is not complete. Other drugs may affect levorphanol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Disclaimer

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