Levorphanol

Levorphanol is a prescription medication used to treat moderate to severe pain.

• Levorphanol is available under various brand names: Levo-Dromoran

Common side effects of Levorphanol include:

• nausea, vomiting, stomach pain.
• constipation.
• dizziness, drowsiness.
• tiredness; or
• headache.

Serious side effects of Levorphanol include:

• hives. 
• difficult breathing. 
• swelling of the face, lips, tongue, or throat.
• noisy breathing, sighing, shallow breathing, breathing that stops during sleep.
• 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; or
• low cortisol levels-- nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
• symptoms of serotonin syndrome, such as agitation, confusion, fever, sweating, fast heart rate, chest pain, feeling short of breath, muscle stiffness, trouble walking, or feeling faint.
• impaired fertility

Rare side effects of Levorphanol include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Tablet: Schedule II

• 2 mg

Pain management:

Adult dosage

• Initial: 1 to 2 mg every 6 to 8 hours as needed. 
• may increase up to 3 mg every 6 to 8 hours if needed; higher doses may be appropriate in opioid-tolerant patients. Reduce initial dose by above 50% in patients with conditions affecting respiratory reserve or with coadministration with other drugs affecting the respiratory center.

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Levorphanol has severe interactions with the following drug:
  • alvimopan
• Levorphanol has serious interactions with at least 33 other drugs.
• Levorphanol has moderate interactions with at least 189 other drugs.
• Levorphanol has severe interactions with the following drugs:
  • brimonidine
  • dextroamphetamine
  • eucalyptus
  • lidocaine
  • sage
  • ziconotide

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to levorphanol
• severe asthma or breathing problems; or
• a stomach or bowel obstruction (including paralytic ileus).

Effects of drug abuse

• Addiction, 
• Overdose, or 
• Death

Short-Term Effects

• See “What Are Side Effects Associated with Using Levorphanol?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Levorphanol?”

Cautions

• 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.
• Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.
• Do not stop using levorphanol suddenly after long-term use, or you could have serious withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
• Do not drink alcohol. Dangerous side effects or death could occur.
• Avoid driving or hazardous activity until you know how this medicine will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Pregnancy and Lactation

• 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.
• Lactation
  • Do not breastfeed. Levorphanol can pass into breast milk and may cause drowsiness or breathing problems in a nursing baby.