Drug interactions
Codeine + Levorphanol
Severity: Major
Codeine and Levorphanol: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Levorphanol is a potent opioid, and combining it with codeine increases the risk of sedation and respiratory depression without clear benefit.
What this interaction means in plain words
Codeine and Levorphanol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive mu-opioid receptor agonism causing CNS and respiratory depression.
What to do
Avoid using both; if unavoidable, use the lowest effective doses and monitor sedation and respiratory rate.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Codeine
- Alvimopan + Codeine Contraindicated
- Codeine + Isocarboxazid Contraindicated
- Codeine + Olanzapine / samidorphan Contraindicated
- Codeine + Phenelzine Contraindicated
- Codeine + Tranylcypromine Contraindicated
- Alfentanil + Codeine Major
Frequently asked questions
Can I take Codeine with Levorphanol?
MediHelp rates the interaction as major. Codeine and Levorphanol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Levorphanol is a potent opioid, and combining it with codeine increases the risk of sedation and respiratory depression without clear benefit.
How serious is the interaction between Codeine and Levorphanol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid using both; if unavoidable, use the lowest effective doses and monitor sedation and respiratory rate.
What other medicines interact with Codeine?
MediHelp also lists interactions of Codeine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Codeine page.
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