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Levorphanol (oral). [ leeVOR-fah-nole]
Brand names: Levodromoran
Oral tablet (2.5 mg or 3 mg)
Drug class: opioids (narcotic analgesics)

What is Levorphanol?

Levorphanol, an opioid medication, is used for moderate to severe pain.This medication guide does not list all possible uses of levorphanol.

Side effects of Levorphanol

If you experience any of the following symptoms of an allergic reaction, seek immediate medical attention: difficulty breathing, hives, swelling of your lips, face, tongue, or throat.If you take opioid medicine, it can cause your breathing to slow down or stop. Death may result. If you have long pauses in your breathing, blue lips, or are hard to awaken, someone caring for you may want to give you Naloxone and/or seek immediate medical attention.

Levorphanol may cause serious side effects. If you experience:

  • Breathing that stops; noisy breathing; sighing or shallow breathing;
  • A low heart rate or a weak pulse
  • A feeling of lightheadedness, as if you could pass out.
  • Unusual thoughts or behaviours, mood changes
  • Constipation and severe stomach pain
  • Serotonin levels are high in the body. This can cause agitation, hallucinations, and other symptoms such as sweating, shivering, a fast heartbeat, muscle stiffness, and twitching.
  • Low cortisol levels can cause nausea, vomiting, loss of appetite, dizziness, and worsening fatigue or weakness.

Severe breathing problems are more common in elderly adults, especially those with wasting syndrome and chronic breathing disorders.

Levorphanol can cause a number of side effects.

  • Nausea, vomiting, and stomach pain;
  • Constipation;
  • Dizziness, drowsiness;
  • Tiredness;
  • Headache.

There may be other side effects. Call your doctor for medical advice about side effects. To report adverse effects, you can contact the FDA at 1-800-FDA-1088.

Similar/related drugs

Aspirin, Acetaminophen, Tramadol, Naproxen, Oxycodone, Tylenol, and Diazepam


Misuse of opiod medication can cause addiction, overdose, or death. Store the medication away from others.The withdrawal symptoms of opioid medication during pregnancy may be life-threatening to the baby.You can experience fatal side effects if you combine opioid medication with alcohol or other drugs that make you drowsy or slow down your breathing.

Before you take this drug

Levorphanol should not be used if:

  • Severe asthma or breathing problems
  • Stomach or obstruction.

Inform your doctor if you experience any of these symptoms:

  • A sleep apnea occurs when breathing problems occur during sleeping.
  • A head injury, or seizures;
  • Drug or alcohol abuse;
  • Liver or kidney disease
  • Urination problems can be caused by a number of factors.
  • You may have problems with your thyroid, gallbladder, or pancreas.

Your baby may develop withdrawal symptoms after birth if you take opioids while pregnant. Babies who are born addicted to opioids will need treatment for several months.If you notice that your baby is drowsy or breathing slowly, tell your doctor.Levorphanol should not be used by anyone under the age of 18.

How to take Levorphanol?

Read all the instructions on the label of your medication and follow them. Levorphanol should never be taken in higher doses or for longer periods than prescribed. If you are feeling the urge to take levorphanol more often, tell your doctor.If you have recently taken opioids and your body has become tolerant, your dose may need to be adjusted (ask if you are not sure).Do not share opioid medication with anyone, especially if they have a history of drug abuse. MEDICATION MISUSE CAN CAUSE ADDICTION OR DEATH. Store the medicine in a safe place that others can't reach. It is illegal to sell or give away opioid medication.If you suddenly stop taking levorphanol after long-term usage, you may experience withdrawal symptoms. You should ask your doctor about how to stop this medication safely.Do not crush or break the levorphanol tablet to inhale powder or mix the pill with liquid to inject it into your vein. This could lead to death.Store away from moisture or heat at room temperature. Track your medication. Be aware of anyone who is misusing your medicine or using it without a valid prescription.Keep leftover opioid medications out of the reach of children. One dose of this medication can be fatal for someone who uses it incorrectly or accidentally. You should ask your pharmacist about a drug disposal program. If there isn't a take-back programme available, flush any unused medication down the toilet.

Details on dosage

Adult dose for pain:

As First Opioid Analgesic:
Initial dose: 1 mg to 2 mg every 6–8 hours, as needed.
If you are using around-the-clock dosing, wait 72 hours before adjusting the dose.
Patients with opioid tolerance may require higher doses.
Conversion from other opioids
Due to the variability between patients, it is recommended that a conservative approach be taken.
Levorphanol has a potency 4–8 times that of morphine and a longer half-life.
Consider starting levorphanol with 1/15–1/12 of the total dose of oral morphine daily and adjusting to the clinical response.
Allow 72 hours for the patient to achieve a new stable state before adjusting the dose.
The dose should be adjusted based on the severity of pain, the age, the weight, the physical condition, the underlying disease, and the use of concurrent medications.
Monitor closely for respiratory depression, especially at the beginning and after each dose increase.
This drug is only recommended for patients who have been unable to tolerate alternative treatments or who are unlikely to tolerate them.
Use: To manage pain that is severe enough to warrant an opioid analgesic and when alternative treatments are ineffective.

What happens if I miss the dose?

Levorphanol helps to relieve pain, so you won't miss a dosage. If it's almost time to take your next dose, skip any missed doses. Never take two doses in one go.

What happens if I overdose?

Call the Poison Help Line at 1-800-222-1222 or seek emergency medical care. An overdose of opioids can be deadly, especially if the person is a child or if they are using them without a prescription.You may be advised by your doctor to carry naloxone with you (a medicine that reverses an overdose). If you stop breathing or don't awaken, a person who cares for you can administer naloxone. You must still call for emergency medical assistance, and your carer may have to perform CPR on you while they wait.Naloxone can be purchased at any local pharmacy or health department. You should make sure that anyone who cares for you is aware of where and how you store your naloxone.

What should be avoided?

Don't drink alcohol. Side effects and death can occur.Levorphanol can cause you to feel dizzy or drowsy. Avoid driving and other hazardous activities until you are sure of how they will affect you. Dizziness and drowsiness may cause accidents or serious injuries.

Interaction with other drug

If you stop or start taking certain medicines, you may experience breathing problems or withdrawal. You should tell your doctor if other medications are being used, such as an antifungal, blood pressure or heart medication, seizure medicine, HIV/hepatitis C, or a medication to treat HIV.

Drug interactions can cause dangerous side effects, and in some cases even fatalities.. Tell your doctor if you use:

  • Other narcotic medicines—opioid or prescription cough medication;
  • A sedative such as Valium—diazepam (alprazolam), lorazepam (lorazepam), Xanax (Klonopin), Ativan, and others.
  • Sleeping pills, muscle relaxants, medicines to treat mental disorders, mood disorders, or other drugs that slow down breathing
  • Drugs that increase serotonin in the body, such as stimulants, medicines for depressive disorders, Parkinson’s disease, or migraine headaches

This list is incomplete. Levorphanol may interact with other drugs, such as prescription and over-the-counter medicines, vitamins, and herbal products. The list is not exhaustive.




Prescription only

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