Pregnancy Category C

Uses. Unlike many pain relievers, levorphanol's oral formulation has an effectiveness almost as good as the intravenous version. An animal experiment demonstrated the drug can work when simply rubbed on an area of the skin that is hurting; that capability is an asset because it avoids the necessity of having the substance circulate through the entire body when only a particular spot needs treatment. Even severe pain can be successfully treated with the drug, which is used for conditions ranging from surgery to cancer. Studies have likened it to fentanyl, meperidine, and morphine. Levorphanol is considered 4 to 15 times stronger than morphine. Pain control doses of levor-phanol take effect at about the same speed as morphine but last longer. Prolonged administration of morphine can reverse pain relief action and instead increase discomfort, while at the same time causing muscle spasms; morphine patients can be switched to levorphanol to avoid those outcomes.

Drawbacks. Levorphanol can cause dangerous and even fatal breathing difficulty. For that reason medical personnel are supposed to carefully adjust dosage to a patient's individual needs rather than depend upon customary amounts of the drug being safe. It is supposed to be used with special caution in patients with asthma, low thyroid function, urinary difficulty, or an enlarged prostate. Wariness is also prudent when using the substance to reduce heart pain, because the drug's influence on cardiac function has not been confirmed. The substance can lower blood pressure and may produce nausea, vomiting, and constipation. Levorphanol can make users woozy and harm skills needed for operating a car or other dangerous machinery. Although levorphanol is a depressant in humans, it increases leg activity in ponies—an effect that may not have escaped notice by persons seeking ways to improve the animals' performance in races.

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