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Levorphanol is available in the following formulation:
- Levorphanol 2mg Tablets: For oral administration
Levorphanol is a synthetic opioid analgesic that is structurally related to morphine but with distinct pharmacological properties. It acts as a full agonist at mu, kappa, and delta opioid receptors, and also has N-methyl-D-aspartate (NMDA) receptor antagonist properties, making it particularly effective for neuropathic pain and opioid-tolerant patients.
Levorphanol is primarily used for:
- Management of moderate to severe chronic pain
- Neuropathic pain conditions
- Pain in opioid-tolerant patients
- Cancer-related pain
- Pain conditions not adequately controlled by other opioids
Dosing is individualized based on the specific medical indication, patient characteristics, and concurrent medications. Typical dosage ranges include:
- For opioid-naïve patients: 2mg every 6-8 hours as needed, with careful titration
- For opioid-tolerant patients: Dosage based on previous opioid requirements, typically starting at 2-4mg every 6-8 hours
- For elderly patients: Lower initial doses with careful titration
Important Safety Information
Levorphanol is a Schedule II controlled substance with potential for abuse and dependence. It should be administered by or under the supervision of healthcare professionals familiar with its use.
Levorphanol has a long half-life (12-16 hours) and can accumulate with repeated dosing, requiring careful titration to avoid overdose. Its potency (4-8 times that of morphine) necessitates precise dosing and monitoring, particularly during initiation and dose adjustments.
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Common side effects include sedation, dizziness, nausea, vomiting, constipation, and sweating. Serious adverse effects requiring immediate intervention include respiratory depression, hypotension, and allergic reactions.
Levorphanol should be used with caution in patients with respiratory impairment, head injury, increased intracranial pressure, impaired hepatic or renal function, and in elderly or debilitated patients.
For more information about pain management medications and opioid safety, please visit these authoritative resources:
- American Society of Anesthesiologists
- FDA Drug Safety Information
- MedlinePlus Levorphanol Information
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Levorphanol is a synthetic opioid analgesic with the following characteristics:
- Chemical Name: (-)-3-hydroxy-N-methylmorphinan tartrate
- Mechanism of Action: Full agonist at mu, kappa, and delta opioid receptors; NMDA receptor antagonist
- Onset of Action: 30-90 minutes when administered orally
- Duration of Action: 6-8 hours for analgesia, though plasma half-life is 12-16 hours
- Metabolism: Primarily hepatic via glucuronidation
- Elimination Half-life: 12-16 hours
- Potency Comparison: Approximately 4-8 times more potent than morphine for analgesia
Levorphanol offers several clinical advantages in specific scenarios:
- NMDA receptor antagonist properties, making it effective for neuropathic pain
- Long half-life allowing for less frequent dosing in chronic pain management
- No active metabolites, potentially beneficial in patients with renal impairment
- Effective in patients who have developed tolerance to other opioids
- May have a role in opioid rotation strategies for difficult-to-manage pain
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- Less histamine release than morphine, potentially causing fewer allergic reactions
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