Levorphanol Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Light Sedation

Premedication for Anesthesia:
1 to 2 mg IM or subcutaneously, administered 60 to 90 minutes before surgery. Older or debilitated patients usually require less drug. Two mg of levorphanol is approximately equivalent to 10 to 15 mg of morphine or 100 mg of meperidine.

Usual Adult Dose for Pain

IV: 1 mg every 3 to 6 hours as needed.
IM or subcutaneous: 1 to 2 mg every 6 to 8 hours as needed.
Oral: 2 mg every 6 to 8 hours as needed.
May be increased to 3 mg every 6 to 8 hours.

Renal Dose Adjustments

The manufacturer recommends caution when dosing patients with renal disease.

Liver Dose Adjustments

Levorphanol should be administered with caution to patients with extensive liver disease who may be vulnerable to excessive sedation due to increased pharmacodynamic sensitivity or impaired metabolism of the drug.

Dose Adjustments

Dosage should be adjusted according to the severity of the pain; age, weight and physical status of the patient; the patient's underlying diseases; use of concomitant medications; and other factors. Higher doses may be appropriate in opioid tolerant patients. Lower doses may be appropriate for patients with renal or hepatic dysfunction.

Precautions

If a patient is to be placed on fixed-schedule dosing (round-the-clock) with this drug, care should be taken to allow adequate time after each dose change (approximately 72 hours) for the patient to reach a new steady-state before a subsequent dose adjustment to avoid excessive sedation due to drug accumulation.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Total Daily doses or more than 4 to 8 mg IV, 3 to 8 mg IM, or 6 to 12 mg orally are generally not recommended as starting doses in nonopioid tolerant patients. Levorphanol is 4 to 8 times as potent as morphine and has a longer half-life. When converting a patient from morphine to levorphanol, the total daily dose of oral levorphanol should begin at approximately 1/15 to 1/12 of the total daily dose of oral morphine.

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