Levorphanol

Generic Name: levorphanol (lee-VOR-fa-nole)
Brand Name: Levo-Dromoran

Levorphanol is used for:

Treating or preventing moderate to severe pain. It may also be used before surgery for pain management and for other conditions as determined by your doctor.

Levorphanol is a narcotic analgesic. It works by acting in the brain and spinal cord to decrease the feeling of pain.

Do NOT use levorphanol if:

  • you are allergic to any ingredient in levorphanol or similar medicines (eg, morphine)
  • you are taking a monoamine oxidase (MAO) inhibitor (eg, phenelzine), a narcotic agonist/antagonist medicine (eg, pentazocine), or sodium oxybate (GHB)
  • you are having certain types of surgery (eg, biliary surgery)
  • you are having an asthma attack, have severe asthma, or have severe diarrhea due to antibiotic use

Contact your doctor or health care provider right away if any of these apply to you.

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Before using levorphanol:

Some medical conditions may interact with levorphanol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of prostate problems, seizures, heart problems or a recent heart attack, kidney problems, liver disease, an underactive thyroid, severe inflammatory bowel disease, lung problems, asthma, a head injury or increased pressure within the head, a brain tumor, trouble urinating, or low blood pressure
  • if you have a history of mental or mood problems or suicidal thoughts
  • if you will be having surgery on the stomach, intestines, liver, or gallbladder
  • if you consume large amounts of alcohol or have a history of substance abuse or dependence

Some MEDICINES MAY INTERACT with levorphanol. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Cimetidine, MAO inhibitors (eg, phenelzine), or sodium oxybate (GHB) because side effects of levorphanol may be increased
  • Naltrexone or narcotic agonist/antagonists (eg, pentazocine) because the effectiveness of levorphanol may be decreased
  • Antihistamines (eg, diphenhydramine), barbiturates (eg, phenobarbital), muscle relaxants (eg, methocarbamol), other narcotic pain medicines (eg, codeine), phenothiazines (eg, chlorpromazine), sleeping medicines (eg, zolpidem), or tricyclic antidepressants (eg, amitriptyline) because severe side effects, such as severe drowsiness, low blood pressure, or trouble breathing, may occur

This may not be a complete list of all interactions that may occur. Ask your health care provider if levorphanol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use levorphanol:

Use levorphanol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Levorphanol is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using levorphanol at home, carefully follow the injection procedures taught to you by your health care provider.
  • If levorphanol contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
  • Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
  • If you miss a dose of levorphanol and you are using it regularly, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use levorphanol.

Important safety information:

  • Levorphanol may cause drowsiness, dizziness, or lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to levorphanol. Using levorphanol alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
  • Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking levorphanol. Levorphanol will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
  • Levorphanol may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.
  • Risk of severe drowsiness, low blood pressure, and severe breathing problems may be increased with high doses or prolonged use. Do NOT exceed the recommended dose or use levorphanol for longer than prescribed without checking with your doctor.
  • Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using levorphanol.
  • Use levorphanol with caution in the ELDERLY because they may be more sensitive to its effects.
  • Levorphanol is not recommended for use in CHILDREN younger than 18 years of age. Safety and effectiveness in this age group have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: It is unknown if levorphanol can cause harm to the fetus. If you become pregnant while taking levorphanol, discuss with your doctor the benefits and risks of using levorphanol during pregnancy. It is unknown if levorphanol is excreted in breast milk. Do not breast-feed while taking levorphanol.

When used for long periods of time or at high doses, levorphanol may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if levorphanol stops working well. Do not take more than prescribed.

When used for long periods of time or at high doses, some people develop a need to continue taking levorphanol. This is known as DEPENDENCE or addiction.

If you suddenly stop taking levorphanol, you may experience WITHDRAWAL symptoms, including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

Possible side effects of levorphanol:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Altered mood and thoughts; constipation; dizziness; drowsiness; flushing; nausea; reaction or pain at the injection site; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); depression; difficulty urinating; fainting; fast, slow, or irregular heartbeat; itching; seizures.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include cold and clammy skin; deep sleep; dizziness; drowsiness; lightheadedness; loss of consciousness; slowed breathing; slowed heartbeat.

Proper storage of levorphanol:

Store at room temperature as directed on the prescription label. Keep levorphanol out of the reach of children and away from pets.

General information:

  • If you have any questions about levorphanol, please talk with your doctor, pharmacist, or other health care provider.
  • Levorphanol is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about levorphanol. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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