Levorphanol

Information about Levorphanol

Hydromorphone and oxymorphone are semisynthetic derivatives of morphine and potent opiate agonists which are used predominantly to treat moderate-to-severe pain.

Liver safety of Levorphanol

Neither hydromorphone nor oxymorphone have been linked to serum enzyme elevations during therapy or to clinically apparent liver injury.

Mechanism of action of Levorphanol

Hydromorphone and oxymorphone are semisynthetic derivatives that both act by engagement in cell surface opiate receptors (predominant µ type receptors) that are found in the central nervous system, but also heart, lung, vascular and intestinal cells. Current indications are for moderate to severe pain, pre- and postoperative analgesia, and as an adjunct to anesthesia.

FDA approval information for Levorphanol

Hydromorphone was approved for use in the United States in 1984 and is still widely used in treatment of moderate-to-severe pain and, in low doses, as an antitussive. Hydromorphone is available generically and under the brand name Dilaudid as tablets of 2, 4 and 8 mg, as an oral solution of 5 mg/5 mL and as suppositories of 3 mg. Solutions for injection (1 to 10 mg/mL) are also available. The usual dose of hydromorphone in adults is 2 to 10 mg orally every 3 to 6 hours or 2 to 4 mg by injection every 4 to 6 hours. Lower doses (1 mg orally) are used for treatment of cough.

FDA approval information for Levorphanol

Oxymorphone was approved for use in the United States in 1959 and remains in clinical use. Current indications are for treatment of moderate to severe pain, alleviation of anxiety associated with dyspnea of pulmonary edema and as an adjunct to general anesthesia and preoperative sedation.

Brand name for Levorphanol

Oxymorphone is available generically and under the brand name Numorphan and Opana in standard tablets of 5 and 10 mg, extended release tablets of 5 to 40 mg, suppositories of 5 mg and as a solution for injection of 1 mg/mL.

Dosage and administration for Levorphanol

The usual dose of oxymorphone is 5 to 20 mg orally of the standard tablets every 4 to 6 hours or 1 to 1.5 mg by injection every 4 to 6 hours.

Side effects of Levorphanol

The side effects of hydromorphone and oxymorphone are similar to those of other opiates and include sedation, respiratory depression, confusion, euphoria, agitation, constipation, abdominal bloating, nausea, vomiting and constipation. Both drugs are controlled substances and classified as Schedule II drugs, indicating that it has medical usefulness, but also a high potential for physical and psychological dependency and abuse.

Full and partial opiod agonists:

• Alfentanil
• Butorphanol
• Codeine
• Diphenoxylate
• Fentanyl
• Heroin
• Hydrocodone
• Hydromorphone
• Levorphanol
• Loperamide
• Meperidine
• Methadone
• Morphine
• Opium
• Oxycodone
• Oxymorphone
• Pentazocine
• Remifentanil
• Sufentanil
• Tramadol

Opiate antagonists:

• Nalmefene
• Naloxegol
• Naloxone
• Naltrexone

• Dailymed label info on Levorphanol
• FDA Levorphanol

Levorphanol Resources
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