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Levorphanol is a medication associated with significant risks and potential side effects. It is important to use it responsibly and be aware of the following safety considerations:

• Risk of Addiction and Misuse: Levorphanol is a controlled substance with a potential for addiction and misuse, which can lead to severe consequences like overdose or death. It is crucial to take the medication exactly as prescribed by your healthcare provider. Do not alter the dosage or frequency without medical advice.

• Breathing Problems: This medication can cause dangerously slow or shallow breathing, especially when treatment begins or the dose is increased. The risk is higher if combined with alcohol or other substances that depress the central nervous system. Immediate medical attention is necessary if you experience symptoms like difficulty breathing, bluish lips, fingers, or toes.

• Opioid Overdose: Overdose symptoms include extreme drowsiness, slow heartbeat, and cold, clammy skin. Ensure you and your family recognize these symptoms and know how to respond. Naloxone, an opioid antagonist, should be available to reverse an overdose. In the event of an overdose, call emergency services immediately.

• Pregnancy and Neonatal Risks: Levorphanol can harm an unborn baby if used during pregnancy, potentially leading to neonatal opioid withdrawal syndrome in newborns. Pregnant individuals should only use this medication if absolutely necessary and discuss risks with their healthcare provider.

• Physical Dependence and Withdrawal: Long-term use can lead to physical dependence. Do not abruptly stop the medication without consulting your healthcare provider to avoid withdrawal symptoms like anxiety, restlessness, and sweating.

• Low Blood Pressure: The medication can cause a sudden drop in blood pressure upon standing, leading to dizziness or fainting. Rise slowly from sitting or lying positions and consult your provider if symptoms persist.

• Adrenal Insufficiency: Chronic use may lead to low adrenal hormone levels, causing symptoms such as fatigue and nausea. If this occurs, medical intervention might be necessary.

• Seizures: There is an increased risk of seizures, particularly in individuals with a history of seizure disorders. Seek medical help if a seizure occurs while taking levorphanol.

• Drug Interactions: Levorphanol can interact with other medications, increasing the risk of side effects or reducing effectiveness. Inform your healthcare provider of all medications you are taking.

• Contraindications: Do not use levorphanol if you have conditions like severe asthma, severely slowed breathing, or gastrointestinal blockages. Always consult your healthcare provider to ensure this medication is safe for you.

Store levorphanol securely to prevent misuse or accidental ingestion, particularly by children or pets. If accidental ingestion occurs, seek medical help immediately. Always communicate openly with your healthcare provider about your medical history and any concerns while using levorphanol.

Common side effects:

• Dizziness
• Drowsiness
• Nausea
• Vomiting
• Constipation
• Headache
• Stomach pain
• Dry mouth
• Feeling of tiredness

Less common but important to monitor:

• Upset stomach
• Indigestion
• Sweating
• Itching
• Rash
• Vision changes
• Irregular heartbeat
• Feeling nervous
• Difficulty urinating

Serious side effects:

• Severe breathing problems
• Bluish lips or extremities
• Extreme drowsiness
• Slow heartbeat
• Cold and clammy skin
• Anxiety or restlessness (opioid withdrawal)
• Hives (serious allergic reaction)
• Shortness of breath (serious allergic reaction)
• Swelling of the face, lips, tongue, or throat (serious allergic reaction)

Interactions with high risk of serious adverse effects and should be avoided:

• Nalmefene
• Naltrexone
• Safinamide

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Alprazolam
• Hydrocodone
• Cyclobenzaprine
• Risperidone
• Alcohol
• Marijuana
• Muscle relaxants
• Antihistamines
• Mixed opioid agonist-antagonists (such as Butorphanol, Nalbuphine, Pentazocine)
• MAO inhibitors (such as Isocarboxazid, Linezolid, Metaxalone, Methylene Blue, Moclobemide, Phenelzine, Procarbazine, Rasagiline, Safinamide, Selegiline, Tranylcypromine)
• Cimetidine
• Samidorphan