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Levorphanol Coupon - Levorphanol 2mg tablet

levorphanol

Generic Levo-Dromoran
Used for Pain
Used for Pain

Levorphanol is an older opioid medication that's used to help with pain that isn't relieved by non-opioid pain medications. While it typically works well to relieve pain, it's a controlled substance because it has a high risk of misuse, dependency, and addiction. Because of these risks, it might not be the best choice for everyone.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Kristianne Hannemann, PharmD
Last reviewed on March 15, 2023
BasicsWarningsSide effectsPros & consPharmacist tipsFAQsDosageInteractionsCostContraindicationsImagesReferencesPricesMedicare
Levorphanol is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
basics-icon

What is Levorphanol?

What is Levorphanol used for?

  • Pain that isn't relieved by non-opioid pain medications alone

How Levorphanol works

Levorphanol is an opioid receptor agonist. It attaches to certain signaling proteins in your brain called mu-opioid receptors to lower how much pain you feel.

Drug Facts

Common BrandsLevo-Dromoran (brand no longer available)
Drug ClassOpioid
Controlled Substance ClassificationSchedule II
Generic StatusLower-cost generic available
AvailabilityPrescription only
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What are the risks and warnings for Levorphanol?

Levorphanol can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

risk-warning

Potential for addiction and misuse

  • Risk factors: Personal or family history of alcohol or substance use disorder | Personal or family history of mental health problems

    Levorphanol is a controlled substance because it has a risk for addiction and misuse. Take the medication exactly as prescribed. Don't change the dose or how often you take it without talking to your provider first. Misusing this medication might cause it to not work as well. It can also raise the risk for serious and possibly life-threatening side effects, such as dangerously slow breathing, inability to stay awake, and opioid overdose. Your healthcare provider will prescribe the lowest amount of levorphanol that's necessary to manage your pain for the shortest period of time possible.

    risk-warning

    Dangerously slow breathing (respiratory depression)

    • Risk factors: Taking medications that can cause slow breathing | Drinking alcohol | Older age | Being frail | Medical conditions that cause breathing problems (e.g., COPD, asthma, head injury) | Taking too much levorphanol

      Levorphanol can cause dangerously slow breathing, which can be life-threatening. This can happen to anyone and even at recommended doses. But the risk is greatest when you first start treatment or if your dose goes up. Don't take levorphanol with alcohol or other medications that slow your body down (e.g., benzodiazepines, other opioids, muscle relaxants). Doing so raises your risk of extremely slowed breathing. If you or your loved one notices that you have trouble breathing or have bluish-colored lips, fingers, or toes, call 911 to get medical help right away.

      risk-warning

      Opioid overdose

      • Risk factors: History of opioid use disorder | Previous opioid overdose | Taking high doses of levorphanol | Taking more opioids than prescribed | Alcohol use


        Take levorphanol exactly as prescribed. Taking too much levorphanol or taking it more often than prescribed can lead to an accidental overdose. Symptoms of an opioid overdose include not responding to sound or touch, extremely slowed breathing, extreme sleepiness, slow heartbeat, and cold or clammy skin. Be sure you and your loved ones know how to recognize an overdose. Your provider will likely prescribe naloxone (Narcan, Zimhi), an opioid antagonist that can treat an opioid overdose. Make sure you carry naloxone with you at all times in case you experience an overdose. Call 911 right away if this happens. Store your medication out of reach from children, pets, or visitors to prevent accidental exposure or overdose.

        risk-warning

        Difficulty concentrating and extreme sleepiness

        • Risk factors: Taking high doses of levorphanol | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness | Liver problems

          Levorphanol can cause extreme sleepiness and lower your ability to think, react, and focus. Don't drink alcohol or take other medications that can cause sleepiness or "brain fog" (e.g., benzodiazepines, muscle relaxants, sleep medications) with levorphanol. Doing so can worsen these side effects. Make sure you know how levorphanol affects you before driving a car or doing activities where you need to focus. Talk to your healthcare provider right away if you feel too sleepy from taking levorphanol.

          risk-warning

          Harm to newborn babies

          Long-term use of levorphanol during pregnancy can cause your unborn baby to become dependent on the medication. This is because opioids like levorphanol can pass through the placenta to your unborn baby. Once your baby is born, they can experience withdrawal symptoms, such as high-pitched crying, poor feeding and sucking behavior, trembling, abnormal sleep patterns, and seizures. This condition is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Let your healthcare provider know if you've used levorphanol during pregnancy or if you notice these symptoms in your baby.

          risk-warning

          Physical dependence and withdrawal

          • Risk factors: Long-term use of levorphanol

            If taken regularly for a long time, levorphanol can cause physical dependence. This means that your body relies on the medication to function. You might experience withdrawal if you stop taking the medication suddenly. Withdrawal symptoms include anxiety, restlessness, irritability, runny nose, yawning, sweating, and chills. Don't lower your dose or stop taking the medication suddenly without talking to your healthcare provider first. Your provider will slowly lower your dose to prevent withdrawal symptoms. If you have concerns about taking levorphanol because of this risk, talk to your healthcare provider about alternative pain medications.

            risk-warning

            Low blood pressure

            • Risk factors: History of low blood pressure | Unstable blood pressure | Taking certain medications that can slow the body down

              Levorphanol can cause extremely low blood pressure. Your blood pressure might drop suddenly when you stand from a sitting or lying down position. This can lead to dizziness and fainting. To avoid falling, get up slowly if you've been sitting or lying down. If dizziness or lightheadedness doesn't go away, talk to your healthcare provider.

              risk-warning

              Low adrenal hormone levels

              • Risk factors: Taking levorphanol for longer than 1 month

                Some people taking opioids like levorphanol experienced low adrenal hormone levels. This might be more likely to happen after taking opioids for longer than 1 month. Symptoms include tiredness, dizziness, weakness, not feeling hungry, nausea, and vomiting. Let your provider know if you experience these symptoms. If your adrenal hormone levels are too low, you might need to stop levorphanol and be treated with corticosteroids.

                risk-warning

                Seizures

                • Risk factors: History of seizure conditions

                  If you've had a seizure in the past, opioids can raise the risk of having seizures more often. Levorphanol can also raise your risk of seizures in certain situations. Get medical help right away if you have a seizure while taking levorphanol.

                  risk-warning

                  Drug interactions

                  Levorphanol can interact with medications, which can raise your risk of side effects or affect how well your medications work for you.

                  Though rare, taking levorphanol with other medications that raise serotonin levels (e.g., antidepressants, migraine medications) can raise your risk of a potentially life-threatening condition called serotonin syndrome. This condition happens when there's too much of a chemical called serotonin in the brain. Get medical help if you experience symptoms of serotonin syndrome, such as fast heart rate, muscle stiffness or spasms, fever, and confusion.

                  Sometimes, opioids like levorphanol can affect how well diuretics ("water pills") work to lower blood pressure or swelling due to fluid buildup in the body. If you need to take a diuretic at the same time as levorphanol, let your provider know if you experience worsening swelling or higher blood pressure than usual.

                  Tell your provider and pharmacist about all your prescriptions and over-the-counter products you take before starting levorphanol. They can check for any drug interactions.

                  basics-icon

                  What are the side effects of Levorphanol?

                  The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

                  Common Side Effects

                  • Sleepiness
                  • Feeling tired
                  • Headache
                  • Dizziness
                  • Constipation
                  • Nausea
                  • Vomiting
                  • Stomach pain

                  Other Side Effects

                  • Upset stomach or indigestion
                  • Dry mouth
                  • Sweating
                  • Irregular heartbeat
                  • Feeling nervous
                  • Changes to vision
                  • Itching
                  • Rash
                  • Difficulty urinating

                  Serious Side Effects

                  Contact your healthcare provider immediately if you experience any of the following.
                  • Dangerously slow breathing: trouble breathing; bluish-colored lips, fingers, or toes
                  • Accidentally taking too much (overdose): not responding to sound or touch, slowed breathing, extreme sleepiness, slow heartbeat, cold or clammy skin
                  • Opioid withdrawal: anxiety, suicidal thoughts, irritability, restlessness, runny nose, yawning, sweating, chills, wide pupils
                  • Serious allergic reaction: hives; shortness of breath; chest tightness; swelling of lips, tongue, throat, face, or eyes

                  Source: DailyMed

                  The following side effects have also been reported

                  Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

                  Check with your doctor immediately if any of the following side effects occur:

                  Incidence not known

                  Agitation

                  attempts at killing oneself

                  bluish lips or skin

                  blurred vision

                  change in consciousness

                  cold, clammy skin

                  confusion

                  darkening of the skin

                  decrease in the frequency of urination

                  decreased awareness or responsiveness

                  decreased urine output

                  depression

                  diarrhea

                  difficulty in passing urine (dribbling)

                  difficulty swallowing

                  dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

                  extra heartbeat

                  extremely shallow or slow breathing

                  fast, slow, irregular, pounding, or racing heartbeat or pulse

                  fast, weak pulse

                  fever

                  hostility

                  hives or welts, itching, skin rash

                  lightheadedness

                  loss of appetite

                  loss of consciousness

                  muscle twitching

                  nausea

                  no blood pressure or pulse

                  not breathing

                  overactive reflexes

                  painful urination

                  poor coordination

                  puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

                  rapid weight gain

                  restlessness

                  seizures

                  severe sleepiness

                  shivering

                  stopping of the heart

                  sweating

                  swelling of the face, ankles, or hands

                  talking or acting with excitement you cannot control

                  tightness in the chest

                  trembling or shaking

                  twitching

                  unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness

                  vomiting

                  Get emergency help immediately if any of the following symptoms of overdose occur:

                  Symptoms of overdose

                  Chest pain or discomfort

                  constricted, pinpoint, or small pupils (black part of the eye)

                  decreased awareness or responsiveness

                  difficult or troubled breathing

                  difficulty with sleeping

                  dilated neck veins

                  disorientation

                  drowsiness to profound loss of consciousness

                  extreme tiredness or weakness

                  headache

                  irregular, fast or slow, or shallow breathing

                  no muscle tone or movement

                  not breathing

                  pale or blue lips, fingernails, or skin

                  seeing, hearing, or feeling things that are not there

                  sleepiness or unusual drowsiness

                  swelling of the face, fingers, feet, or lower legs

                  weight gain

                  Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

                  Incidence not known

                  Abnormal dreams

                  absence of or decrease in body movement

                  belching

                  change in personality

                  changes in vision

                  discouragement

                  double vision

                  dry mouth

                  false beliefs that cannot be changed by facts

                  feeling sad or empty

                  heartburn

                  increase in body movements

                  indigestion

                  irritability

                  loss of interest or pleasure

                  loss of memory

                  nervousness

                  poor insight and judgment

                  problems with memory or speech

                  redness of the skin

                  seeing double

                  stomach discomfort, upset, or pain

                  sweating

                  trouble concentrating

                  trouble recognizing objects

                  trouble sleeping

                  trouble thinking and planning

                  trouble walking

                  twitching, twisting, uncontrolled repetitive movements of the tongue, lips, face, arms, or legs

                  upper abdominal or stomach pain

                  Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

                  Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

                  See more Levorphanol side effects
                  pros-and-cons

                  Pros and cons of Levorphanol

                  thumbs-up

                  Pros

                  Pain-relieving effect starts within 1 hour and lasts for 6 to 15 hours

                  Can take with or without food

                  Available as a lower-cost generic

                  thumbs-down

                  Cons

                  High risk of misuse and dependency

                  Must slowly lower the dose to stop the medication after long-term use to avoid withdrawal symptoms

                  Might need to take every 6 to 8 hours for continued pain relief, depending on how long the effects last for you

                  A controlled medication, so there are special requirements to get a prescription filled

                  pharmacist-tips

                  Pharmacist tips for Levorphanol

                  pharmacist

                  • Take levorphanol exactly as your provider instructed you to. Don't change your dose or stop taking levorphanol without talking to your provider first. They might need to lower your dose slowly before you can stop taking it completely. This lowers your risk of getting bothersome withdrawal symptoms, like sweating, chills, irritability, anxiety, and trouble sleeping.

                    • You might get constipation as a common side effect of levorphanol. To help lower your risk, make sure to drink plenty of fluids throughout the day and eat fiber-rich foods. If these lifestyle changes aren't enough, talk to your provider about medications that might help with the constipation or a change to your pain treatment plan.

                      • Levorphanol can make you sleepy and affect your ability to think, react, and focus. Don't drive or do activities that you need to concentrate for until you know how this medication affects you.

                        • Avoid drinking alcohol while taking levorphanol. This combination can make you very sleepy, dizzy, and unable to think clearly.

                          • Levorphanol can interact with a lot of medications, such as certain antidepressants, benzodiazepines, sleep medications, and monoamine oxidase inhibitors (MAOIs), among others. These interactions can raise your risk of dangerous side effects or make your medications not work as well for you. Make sure to tell your provider about all the medications you're taking before starting levorphanol. Don't start any new medications while taking levorphanol without talking to your provider first. They can make sure all your medications are safe to take with levorphanol.

                            • Your provider might prescribe naloxone (Narcan) along with levorphanol. Naloxone is a medication that's used to reverse the effects of levorphanol in case of an accidental overdose. Make sure to tell your family and close friends where you keep your naloxone in the event of an emergency. If you do use naloxone for an overdose, make sure to call for emergency medical help because its effects are temporary.

                              faqs

                              Frequently asked questions about Levorphanol

                              Can I take other non-opioid pain medications while I'm taking levorphanol for pain?
                              Yes. In fact, it's recommended to take non-opioid pain medications with levorphanol if you need more relief. Doing so helps lower the amount of levorphanol you take, which lowers the dangerous risks linked to taking opioids. It's generally safe to take non-opioid pain medications, like acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), with levorphanol. But non-opioid pain medications also have risks to consider that shouldn't be ignored (e.g., heart risks, kidney or liver problems). Before using other pain medications with levorphanol, speak with your healthcare provider to make sure it's safe for you to do so.
                              What is a REMS program, and why is levorphanol under this program?
                              Levorphanol has a risk for misuse and dependency. Because of this, the medication is only available through a Risk Evaluation and Mitigation Strategy (REMS) program called the Opioid Analgesic REMS program. The FDA started this restrictive program in 2018 for all opioids that aren't used in a hospital setting. The purpose of a REMS program is to make sure levorphanol is distributed and used in a safe manner. Your healthcare provider must register with the REMS program and receive training on proper medication use. Under this program, they'll discuss with you about safe and responsible storage, use, and disposal of levorphanol.
                              How fast does levorphanol work?
                              Levorphanol starts to work within 1 hour. Its pain-relieving effects can last for 6 to 15 hours. This might make the medication useful for people with long-term pain.
                              Can I take levorphanol if I'm pregnant?
                              Opioids like levorphanol are generally not recommended during pregnancy unless the benefits of the medication are clearly greater than the risks. Taking opioids while pregnant can raise the risk of developmental and growth problems in your baby. Additionally, your baby can become dependent on the opioid and develop neonatal abstinence syndrome after they're born. This is a serious, life-threatening problem where your newborn baby has opioid withdrawal symptoms, like high-pitched crying, poor feeding and sucking behavior, abnormal sleep patterns, and possibly seizures. Your baby will need immediate treatment if this happens. If you're pregnant or thinking of becoming pregnant while taking levorphanol, contact your provider right away to discuss the risks and benefits of using the medication during pregnancy. There might be safer options available.
                              Can I take levorphanol if I'm breastfeeding?
                              Speak with your provider about the risks and benefits of taking levorphanol while breastfeeding. If you need to breastfeed, it's generally recommended to try non-opioid pain medications first before considering levorphanol. It isn't known if levorphanol is found in breast milk, but a similar medication called morphine is. If levorphanol can get into breast milk, the medication can raise the risk of serious and potentially life-threatening side effects in your nursing baby, such as sleepiness and breathing problems. If you're taking levorphanol and breastfeeding, get medical help right away if you notice extreme sleepiness or slowed breathing in your baby. Discuss with your provider about other options that might be safer.
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                              dosage

                              Levorphanol dosage forms

                              The average cost for 60 tablets of 2mg of Levorphanol is $315.78 with a free GoodRx coupon. This is 88.91% off the average retail price of $2848.63.
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                              Tablet
                              DosageQuantityPrice as low asPrice per unit
                              2mg60 tablets$315.78$5.26
                              3mg90 tablets$1579.00$17.54
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                              interactions

                              Interactions between Levorphanol and other drugs

                              Levorphanol may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Levorphanol. Please note that only the generic name of each medication is listed below.

                              Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                              Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                              Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                              See more Levorphanol interactions
                              drug-cost

                              How much does Levorphanol cost?

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                              contraindications-icon

                              Levorphanol contraindications

                              Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Levorphanol will not be safe for you to take.

                              • Severely slowed breathing (respiratory depression)

                              • Severe asthma

                              • Conditions that cause blockage of the stomach passageway

                              images

                              Levorphanol images

                              White V2003 - Levorphanol Tartrate 2mg Tablet
                              This medicine is White, Scored Tablet Imprinted With "V2003".White V2003 - Levorphanol Tartrate 2mg Tablet

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                              References

                              Best studies we found

                              American Society of Addiction Medicine. (2017). Opioid use and opioid use disorder in pregnancy. Committee Opinion. 

                              Centers for Disease Control and Prevention. (2022). About opioid use during pregnancy.

                              Centers for Disease Control and Prevention. (2022). CDC Clinical Practice Guideline for prescribing opioids for pain — United States, 2022.

                              View All References (12)

                              Committee on Obstetric Practice Breastfeeding Expert Work Group. (2021). ACOG Committee Opinion number 820– Breastfeeding challenges. 

                              Food and Drug Administration. (2023). Opioid analgesic Risk Evaluation and Mitigation Strategy (REMS). 

                              Hikma Pharmaceuticals USA Inc. (2022). LEVORPHANOL TARTRATE tablet. DailyMed.

                              Jansson, L. M., et al. (2020). Neonatal abstinence syndrome. Pediatric Clinics of North America. 

                              Larson, J. J., et al. (2019). Cognitive and behavioral impact on children exposed to opioids during pregnancy. Pediatrics. 

                              National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Adrenal insufficiency & Addison’s disease. 

                              National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & causes of adrenal insufficiency & Addison’s Disease.  

                              Opioid Analgesics REMS Program Companies. (n.d.). Risk evaluation and mitigation strategy (REMS). 

                              Prommer, E. (2014). Levorphanol: Revisiting an underutilized analgesic. Palliative Care: Research and Treatment. 

                              Weller, A. E., et al. (2021). Neonatal opioid withdrawal syndrome (NOWS): A transgenerational echo of the opioid crisis. Cold Spring Harbor Perspectives in Medicine.  

                              Yazdy, M. M., et al. (2015). Prescription opioids in pregnancy and birth outcomes: A review of the literature. Journal of Pediatric Genetics.

                              GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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