Drug interactions
Levorphanol + Nalbuphine
Severity: Major
Levorphanol and Nalbuphine: 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
Levorphanol is a full mu agonist. Nalbuphine may diminish its analgesia and precipitate withdrawal in opioid-dependent patients, while also adding to sedation and respiratory depression.
What this interaction means in plain words
Levorphanol and Nalbuphine 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
Partial mu antagonism by nalbuphine plus additive opioid CNS depression.
What to do
Avoid in patients on regular levorphanol. If used, monitor for withdrawal and respiratory depression.
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 Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine Major
Frequently asked questions
Can I take Levorphanol with Nalbuphine?
MediHelp rates the interaction as major. Levorphanol and Nalbuphine 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 full mu agonist. Nalbuphine may diminish its analgesia and precipitate withdrawal in opioid-dependent patients, while also adding to sedation and respiratory depression.
How serious is the interaction between Levorphanol and Nalbuphine?
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 in patients on regular levorphanol. If used, monitor for withdrawal and respiratory depression.
What other medicines interact with Nalbuphine?
MediHelp also lists interactions of Nalbuphine with, for example, Alvimopan, Olanzapine / samidorphan, Alprazolam. The full list is on the Nalbuphine page.
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