Drug interactions
Levorphanol + Methadone
Severity: Major
Levorphanol and Methadone: 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
Both are full opioid agonists, so combined use increases sedation, respiratory depression and overdose risk. Methadone may also cause incomplete cross-tolerance, and each drug has a long half-life.
What this interaction means in plain words
Levorphanol and Methadone 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 with CNS and respiratory depression.
What to do
Avoid concurrent use unless clearly needed, such as during a deliberate opioid rotation. If used, reduce doses and monitor sedation and respiratory rate closely.
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 Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
Frequently asked questions
Can I take Levorphanol with Methadone?
MediHelp rates the interaction as major. Levorphanol and Methadone 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. Both are full opioid agonists, so combined use increases sedation, respiratory depression and overdose risk. Methadone may also cause incomplete cross-tolerance, and each drug has a long half-life.
How serious is the interaction between Levorphanol and Methadone?
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 concurrent use unless clearly needed, such as during a deliberate opioid rotation. If used, reduce doses and monitor sedation and respiratory rate closely.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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