Absorption: Well absorbed following oral administration.
Distribution: Extensive.
Half-Life: 1216 hr; may be as long as 30 hr with chronic dosing.
Contraindicated in:
Use Cautiously in:
CV: hypotension, bradycardia
Derm: flushing, pruritus, sweating
EENT: diplopia, blurred vision, miosis
GI: constipation, vomiting, dry mouth, nausea
Neuro: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams
Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA)
Misc: allodynia, opioid-induced hyperalgesia, psychological dependence, physical dependence, tolerance
Drug-drug:
Drug-Natural Products:
Lab Test Considerations:
Toxicity and Overdose:
The FDA strongly encourages health care professionals to complete a REMS-compliant education program that includes all the elements of the FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain, available at www.fda.gov/OpioidAnalgesicREMSBlueprint. Information on programs can be found at 1-800-503-0784 or www.opioidanalgesicrems.com
.Instruct patient to take levorphanol as directed. If dose is less effective after a few wks, do not ↑ dose without consulting health care professional. Discuss safe use, risks, and proper storage and disposal of opioid analgesics with patients and caregivers with each Rx. The Patient Counseling Guide is available at www.fda.gov/OpioidAnalgesicREMSPCG.