levorphanol

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

What is levorphanol?

Levorphanol is an opioid pain medication. An opioid is sometimes called a narcotic.

Levorphanol is used to treat moderate to severe pain.

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

What is the most important information I should know about levorphanol?

You should not use levorphanol if you are allergic to it.

Do not use levorphanol if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

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Levorphanol may be habit-forming and should be used only by the person for whom it was prescribed. Keep the medication in a secure place where others cannot get to it.

Do not drink alcohol while you are using this medication. Dangerous side effects or death can occur when alcohol is combined with levorphanol. Check your food and medicine labels to be sure these products do not contain alcohol.

Never take levorphanol in larger amounts, or for longer than recommended by your doctor. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how levorphanol will affect you.

What should I discuss with my healthcare provider before taking levorphanol?

You should not use levorphanol if you are allergic to it.

Do not use levorphanol if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days. A dangerous drug interaction could occur, leading to serious side effects.

You should not use levorphanol unless you are already being treated with a similar opioid medicine and your body is tolerant to it. Opioid medicines include fentanyl (Actiq, Duragesic), hydromorphone (Dilaudid, Palladone), methadone (Methadose, Dolophine), morphine (Kadian, MS Contin, Oramorph), oxycodone (Oxycontin), oxymorphone (Opana), and many others. Talk with your doctor if you are not sure you are opioid-tolerant.

To make sure you can safely take levorphanol, tell your doctor if you have any of these other conditions:

  • asthma, COPD, sleep apnea, or other breathing disorder;

  • liver or kidney disease;

  • heart disease;

  • low blood pressure;

  • a history of head injury or brain tumor;

  • a thyroid disorder;

  • gallbladder disease;

  • enlarged prostate or urination problems;

  • an adrenal gland tumor or disorder (such as Addison's disease);

  • mental illness;

  • a history of alcoholism or drug addiction; or

  • if you recently drank large amounts of alcohol.

Levorphanol may be habit forming and should be used only by the person for whom it was prescribed. Never share levorphanol with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

FDA pregnancy category C. It is not known whether levorphanol will harm an unborn baby. Levorphanol may cause addiction or withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using levorphanol.

It is not known whether levorphanol passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using levorphanol.

Do not give this medication to anyone under 18 years old without medical advice.

Serious side effects may be more likely in older adults taking levorphanol.

How should I take levorphanol?

Take exactly as prescribed. Never take levorphanol in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Your doctor may occasionally change your dose to make sure you get the best results.

Take levorphanol with food or milk if it upsets your stomach.

Do not stop using levorphanol suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using levorphanol.

Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Levorphanol is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since levorphanol is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of levorphanol can be fatal.

Overdose symptoms may include severe forms of some of the side effects listed in this medication guide.

What should I avoid while taking levorphanol?

Do not drink alcohol while you are using this medication. Dangerous side effects or death can occur when alcohol is combined with levorphanol. Check your food and medicine labels to be sure these products do not contain alcohol.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how levorphanol will affect you.

Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Levorphanol side effects

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

Call your doctor at once if you have a serious side effect such as:

  • mood changes, confusion, unusual thoughts or behavior;

  • thoughts of suicide or hurting yourself;

  • feeling like you might pass out;

  • weak or shallow breathing;

  • cold, clammy skin;

  • blue lips or skin;

  • painful or difficult urination; or

  • slow heart rate, weak pulse, fainting, slow breathing (breathing may stop).

Less serious side effects are more likely to occur, such as:

  • dizziness, drowsiness;

  • nausea, vomiting, constipation, stomach pain;

  • dry mouth;

  • double vision;

  • itching, sweating; or

  • flushing (warmth, redness, or tingly feeling).

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.

See also: Side effects (in more detail)

Levorphanol Dosing 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.

What other drugs will affect levorphanol?

You should not take levorphanol with any other narcotic pain medications, sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result. Tell your doctor if you regularly use any of these medications, or medicine for seizures, depression, or anxiety.

Tell your doctor about all other medicines you use, especially:

  • pentazocine (Talwin);

  • nalbuphine (Nubain);

  • butorphanol (Stadol); or

  • buprenorphine (Buprenex, Butrans, Subutex).

There may be other drugs that can interact with levorphanol. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about levorphanol.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.01. Revision Date: 2012-07-12, 3:20:21 PM.

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