Levorphanol (Oral)

Overview

Only a doctor should prescribe levorphanol to a patient. Typically, healthcare practitioners recommend the narcotic (or opioid) analgesic for use in the management of moderate to severe pain. The medication is available for oral use under the brand name Levo-Dromoran. You may take the drug after every 6 to 8 hours depending on your prescription, with or without food.

Patients should be wary of the effects of using levorphanol for an extended duration because the medication tends to cause physiological or psychological dependence. Nonetheless, the use of the drug the exact number of times per day and in the same amount and manner the doctor prescribed to help control severe pain should not lead to addiction.

Also, once an individual has become physiologically dependent on levorphanol after extended use, they should not stop taking the medication suddenly, or else they may suffer significant withdrawal effects. A gradual reduction of the amount of the drug the patient takes each day before finally stopping is preferable.

Conditions Treated

  • Moderate to severe pain

Type Of Medicine

  • Narcotic analgesic

Side Effects

It is possible for a patient to experience inability to breathe, muscle twitching, convulsions, sweating, unconsciousness, blurred eyesight, exhaustion (or weakness), agitation, aggression, or quick weight gain while taking levorphanol. In other cases, difficulty or pain urinating, a decline in the frequency of urination or amount of urine, change of skin or lips color to bluish, wheezing, or lightheadedness while an individual is trying to get up quickly from a chair or bed may occur. These side effects call for immediate medical care.

The use of levorphanol may also cause unwanted psychological effects, including confusion, suicidal thoughts, and depression. Cardiac issues related to the use of the drug include stopping of the heart, lack of blood pressure, weakness or absence of a pulse, irregular heart rates, or a slow or fast heartbeat. Do not hesitate to check with your doctor once these side effects occur.

Some treatment complications may come up if the patient uses levorphanol more often or in larger amounts than the doctor ordered. The health concerns are usually severe and require immediate medical attention or emergency care. Such side effects include pinpoint pupils, lack of sleep, swollen body parts, such as eyes, lips, face, fingers, legs, or feet, extreme sleepiness, deep coma, inability to breathe, irregular breathing patterns, shortness of breath, or dilated blood vessels of the neck.

An overdose of the opioid painkiller may also cause an individual to hallucinate and see things or hear sounds/voices that are non-existent. Loss of coordination, disorientation, severe tiredness, headache, muscle stiffness, chest pain, weight gain, change of tone of the skin, lips, or fingernails to blue or pale are also complications that levorphanol abuse may trigger.

It makes sense that you seek qualified, medical clarification regarding the personal safety and clinical ramifications of any levorphanol side effect you may experience. If some of the symptoms (or body reactions) persist or become unbearable despite your regular use of the medication, your doctor should intervene or give practical suggestions for how to alleviate or prevent them. Such side effects include:

  • Unusual dreams
  • Heartburn
  • Belching
  • Itching
  • Loss of the desire to eat
  • Nausea or vomiting
  • Stomach pain
  • Irritability
  • Digestion complications
  • Forgetfulness (or dementia),
  • Dry mouth
  • Interference with the menstruation cycle
  • Loss of libido
  • Erection complications

With your doctor's advice, it may be possible to manage potentially short-lived levorphanol side effects, for example, an increase, lack, or decline of movements of the body, double vision, lack of concentration, anxiety, hives, change of skin color to red, rash, fatigue, or sweating. Similarly, uncontrollable twitching of body parts such as the tongue, limbs, or face as well as any unusual behavior (including aggression) may come up and improve as the patient continues using their medication. The same is true for aloofness and any feeling of sadness (loss of joy).

Some levorphanol side effects

The above list of levorphanol side effects is not exhaustive, and the treatment experience and medical outcomes usually differ from patient to patient. You may notify the FDA about any unfavorable body reactions to the medication at 1-800-FDA-1088.

Dosage

Your healthcare giver writes you a levorphanol prescription that you should follow without any deviation whatsoever. The doctor works out the right dosage after looking into your medical condition, determining your age, and reviewing any other drugs you may be taking. However, your initial dose may change depending on how your body responds to treatment with time.

The use of levorphanol in larger amounts, more often, or for a longer duration than the physician ordered may have adverse symptoms in any patient. However, overdosing hurts the elderly the most because this age group is more vulnerable to painkiller effects. It is worth mentioning that an individual may reach a point where they cannot do without levorphanol after taking too much of the medication for an extended period.

Your doctor or pharmacist may also provide the manufacturer's patient information sheet for your careful review and scrutiny as you begin treatment with levorphanol. You may also obtain the medication guide during your next refill trip. Approach your healthcare practitioner about any prescription information you are unable to process on your own before you start taking the opioid analgesic.

Adults using levorphanol in the management of moderate to severe pain may get an initial dose of 2 milligrams at intervals of 6 to 8 hours. To accommodate responses to treatment, the doctor may at some point recommend an increase in the amount of the medication that a patient takes. Nonetheless, the daily intake of levorphanol does not typically exceed the 6-12 milligrams range. Consult your physician concerning the correct dosing for minors.

In case you miss your levorphanol medication, try to make up for it at your earliest convenience. However, wait for the next regular intake, and do not double the dose or take any two doses at extremely close time intervals just to catch up on any missed medication.

Major Drug Interactions

If any two drugs have potential clinical interactions when used at the same time, they may interfere with the action of one or both of them or expose the patient to severe health complications. As for the use of levorphanol along with other medicines, there are potential drug interactions that should concern you and your doctor. The healthcare practitioner may consider not prescribing the opioid painkiller altogether or adjusting the dosage of one or both of the medicines when simultaneous use is unavoidable.

Watch out for painkillers that may produce unfavorable effects when taken along with levorphanol. For example, doctors do not readily prescribe the narcotic analgesic to patients who are already taking butorphanol, pentazocine, or other mixed opioid agonist-antagonist. Likewise, levorphanol use merits serious consideration before recommending it to an individual that is on naltrexone, cimetidine, or MAO inhibitors like isocarboxazid, methylene blue, rasagiline, and safinamide.

All drugs that produce the same side effects as levorphanol are a cause for concern too. The use of such products along with the opioid pain-reliever may amplify the risk of unwanted treatment outcomes, for example, breathing complications, coma, and profound drowsiness. Unless necessary, your doctor may not prescribe levorphanol to you if you are on other narcotic painkillers or cough medications such as hydrocodone. You may also have to avoid alcohol or any other substance that contains ethanol.

You also are advised against combining levorphanol with marijuana; any medication that enhances sleep or treats nervousness (for example alprazolam and zolpidem); antihistamines (like diphenhydramine); or carisoprodol and other medicines that help relax body muscles. The same precaution is necessary if you are currently using a diuretic; migraine headache drug such as eletriptan or frovatriptan; 5HT3 serotonin blockers such as dolasetron; selective serotonin-reuptake inhibitors such as fluoxetine or paroxetine.

Additionally, most doctors recommend levorphanol together with tricyclic anti-depression medication such as amitriptyline, desipramine, or imipramine only as a last resort. The healthcare practitioners also weigh the benefits against the risks of treatment with the narcotic analgesic if the patient is already taking any serotonin and norepinephrine reuptake inhibitor, for example, milnacipran or venlafaxine.

If you have any doubt over potential clinical interactions between levorphanol and your food, drinks, or other substances you are using, ask your doctor to clarify everything. You may need particular guidelines regarding your diet and the consumption of alcohol or tobacco. Keep in mind that some nutritional supplements, vitamins, and over-the-counter medication or products may also trigger adverse reactions when taken along with your opioid painkiller.

Sometimes, a component of the other medication you are taking may be the cause of medicinal interactions with levorphanol. In that case, it is in your best interests to examine the labels of such drugs for ingredients and ask your pharmacist or doctor about their safe use. For example, medicines for the control of allergies or cold/coughing may include elements that can cause dizziness'an ill-effect that may escalate if you add levorphanol to your current regimen.

Warnings And Precautions

There is the possibility of an individual getting addicted to levorphanol, which may lead to unnecessary or excessive use and, ultimately, death. The narcotic pain-reliever is associated with severe breathing complications that may cause fatalities. To protect the user, the doctor should recommend the smallest initial dose that is effective for pain management, and which the patient should take for the shortest duration possible.

Since levorphanol may be addictive, you should avoid increasing the amount of the medication you take or the frequency of intake unless your physician recommends it. If you or your relative has a history of drinking addiction, use of street narcotics, or abuse of prescription drugs, you are more likely to develop a similar problem once you start taking levorphanol. Share any such background with your doctor so that they may formulate a safe and proper painkiller regimen for you.

The first 1-3 days of regular levorphanol use, as well as an increase of the dose, pose a higher risk of potentially fatal breathing problems. Using the drug along with alcohol or other medications that can cause sleepiness/drowsiness or breathing complications may also have severe symptoms and results, including death. The patient should consult their doctor over all possible medicinal interactions involving the opioid painkiller. The occurrence of overdose side effects, including profound drowsiness, dizziness, trouble getting up, or inability to breathe or slowed breathing, warrants urgent medical care.

Refer to your caregiver before using levorphanol simultaneously with depression medication, such as antihistamines. Muscle relaxants, anti-seizure drugs, anesthetics, sedatives, opioid pain-relievers, sleep-enhancing medicines, and treatments for cold or allergies are also in the list of products that may trigger unwanted body/health reactions when used along with levorphanol.

Getting up from a chair or bed too quickly may cause dizziness or fainting in an individual using levorphanol. Try rising slowly from your lying or sitting stance to alleviate the problem.

Levorphanol side effects such as drowsiness or lightheadedness may affect your concentration and safety while working. Be sure to come up with an appropriate response plan if you are taking the medication while driving or operating equipment.

Due to the physical dependence that you may develop after using levorphanol for a long while, you should not suddenly quit the medication. A gradual reduction of your dose before you may stop using it altogether will help avoid potentially severe withdrawal symptoms, including shaking of the body, abdominal pain, difficulty sleeping, nervousness, or high body temperature. Premature quitting may also worsen your condition.

Once you start taking levorphanol, you need to keep seeing your healthcare giver so that they may monitor your response to the treatment closely. In turn, the doctor will change your dose carefully to alleviate pain while minimizing your risk of developing severe breathing complications.

Be sure to take precautionary measures to prevent other people, including children, from using levorphanol knowingly or unknowingly. Wrong use of levorphanol can cause death or harm the victim in different ways.

If you are expectant or planning on pregnancy, notify your doctor about it before beginning your levorphanol treatment. Exposure of an unborn baby to the drug may cause them life-threatening withdrawal symptoms after birth. If you used the narcotic analgesic while you were pregnant, and your newborn started experiencing abnormal sleep, irritability, hyperactivity, vomiting, severe trembling of any body part, and other side effects, you would have to see your doctor without hesitation.

Share your health records with your doctor, including the presence or history of any conditions that may impact the use of levorphanol. Such medical complications include asthma or slowed breathing, lung disorder (such as chronic obstructive pulmonary disease); injury in the head (or any head trauma that adds to the pressure in your brain); mental illness; severe infection; kidney disease; or problems of the digestive tract. People experiencing complications with passing urine should also use the medication with caution. Older, weak, or malnourished patients are more prone to breathing issues while using levorphanol.

Storage

  • Keep your levorphanol tablets in a sealed prescription box or container at room temperature. Avoid exposing the package to heat, water (or wetness), or direct light. Never freeze the drug.
  • Ensure minors cannot access, open, or use the medication.
  • Do not hold on to excess or expired levorphanol supplies.
  • Consult your doctor or pharmacist about appropriate ways to dispose of any unwanted medicines.

Summary

You may use levorphanol to alleviate severe pain based on your doctor's prescription. The medication influences the way your brain responds to pain, providing relief. The narcotic analgesic is for oral administration, typically after every 6-8 hours depending on the directives of your healthcare practitioner. You do not have to eat (or avoid eating) to take the painkiller.

Taking levorphanol comes with the risk of addiction, making it important for the patient to be wary of abuse or wrong use. Do not increase the dose or amount of this medication or use it in a manner that differs from what your doctor ordered. Uncontrolled dependence on the painkiller can lead to severe or fatal outcomes.

You and your doctor should consider other treatments that you are taking before beginning your treatment with levorphanol. Your healthcare practitioner should advise you about using the pain-reliever safely with other medications, including opioid drugs. Seek medical attention once unsafe medicinal interactions occur. It is also imperative to take your other health conditions into account if you are considering using levorphanol. These factors help the doctor decide whether or not to recommend the narcotic painkiller to you or adjust your dose accordingly.