Drug interactions
Levorphanol + Meperidine
Severity: Major
Levorphanol and Meperidine: major interaction.
Last updated
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
Using two opioid agonists together increases the likelihood of profound sedation, respiratory depression, coma and death. Levorphanol has a long half-life, so effects may accumulate.
What this interaction means in plain words
Levorphanol and Meperidine 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 mediated CNS and respiratory depression.
What to do
Avoid routine concurrent use of two opioids; if a switch is needed, reduce doses and monitor respiratory rate and sedation closely. Meperidine neurotoxic metabolite accumulation also warrants caution in renal impairment.
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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Other interactions of Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Levorphanol with Meperidine?
MediHelp rates the interaction as major. Levorphanol and Meperidine 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. Using two opioid agonists together increases the likelihood of profound sedation, respiratory depression, coma and death. Levorphanol has a long half-life, so effects may accumulate.
How serious is the interaction between Levorphanol and Meperidine?
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 routine concurrent use of two opioids; if a switch is needed, reduce doses and monitor respiratory rate and sedation closely. Meperidine neurotoxic metabolite accumulation also warrants caution in renal impairment.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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