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levorphanol (Rx)Brand and Other Names:Levo Dromoran

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet: Schedule II

  • 2mg
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Pain

Opiate-naive

  • 2 mg PO q6-8hr PRN
  • 1 mg IM/SC q6-8hr PRN
  • 1 mg slow IV q3-6hr; not to exceed 4-8 mg/24 hr PRN

Prior opiate exposure

  • 2-4 mg PO q6-8hr PRN
  • 1-2 mg IV/SC q6-8hr PRN
  • 1 mg slow IV q3-6hr; not to exceed 4-8 mg/24hr PRN

Premedication

1-2 mg/dose IM/SC 60-90 min prior to surgery

Renal Impairment

Use caution; reduce initial dose in severe renal impairment

Hepatic Impairment

Use caution; reduce initial dose in severe hepatic impairment

Other Indications & Uses

General anesthesia, local anesthesia

<18 yo: not recommended

Pain

Opiate-naive

- 2 mg PO q6-8hr PRN

- 1 mg IM/SC q6-8hr PRN

- 1 mg slow IV q3-6hr; not to exceed 4-8 mg/24 hr PRN

Prior opiate exposure

- 2-4 mg PO q6-8hr PRN

- 1-2 mg IV/SC q6-8hr PRN

- 1 mg slow IV q3-6hr; not to exceed 4-8 mg/24hr PRN

Premedication

1-2 mg/dose IM/SC 60-90 min prior to surgery

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Interactions

Interaction Checker

levorphanol and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Dizziness

            Hypoventilation

            Nausea

            Pruritus

            1-10%

            Hypotension

            Constipation

            Vomiting

            Disturbance of consciousness

            Disturbance in mood

            <1%

            Bradyarrhythmia

            Cardiac arrest

            Cardiac dysrhythmia

            Palpitations

            Tachyarrhythmia

            Apnea

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            Warnings

            Contraindications

            Absolute: acute abdominal condition, pseudomembranous colitis, respiratory depression

            Relative: asthma (acute), inflammatory bowel disease, respiratory impairment

            Cautions

            Cardiac arrhythmias, drug abuse/dependence, emotional lability, gallbladder disease, head injury, hepatic impairment, hypothyroidism, increased intracranial pressure, prostatic hypertrophy, renal impairment, seizures with epilepsy, urethral stricture, urinary tract surgery, toxin-mediated diarrhea

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            Pregnancy & Lactation

            Pregnancy Category: B; D if used for prolonged periods or near term

            Lactation: not known if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Narcotic agonist-analgesic of opiate receptors; inhibits ascending pain pathways, which causes alteration in response to pain; produces analgesia, respiratory depression, and sedation

            Pharmacokinetics

            Half-Life: 12-16 hr

            Onset of action: 10-60 min (PO)

            Duration: 4-8 hr

            Peak Plasma Time: 20 min (IV); 60-90 min (SC)

            Metabolism: Liver (conjugation with glucuronic acid)

            Excretion: Urine (primarily)

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            Administration

            IV Incompatibilities

            Additive: aminophylline, ammonium chloride, amobarbital, chlorothiazide, heparin, pentobarbital, phenobarbital, phenytoin, sodium bicarbonate, thiopental

            IV Administration

            IV: inject 3 mg over 4-5 min

            Storage

            Store at room temp

            Protect from freezing

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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