Drug interactions
Levorphanol + Phenelzine
Severity: Major
Levorphanol and Phenelzine: 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
Opioids used with MAOIs may produce serotonin toxicity or opioid toxicity, including respiratory depression, coma, and blood pressure instability. The risk persists for weeks after the MAOI is stopped.
What this interaction means in plain words
Levorphanol and Phenelzine 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
Probably serotonergic and potentiated CNS depressant effects under MAO inhibition; mechanism not fully defined.
What to do
Avoid levorphanol during and for 14 days after phenelzine. Select an alternative analgesic, and monitor respiration, blood pressure and mental status if an opioid is essential.
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 Phenelzine
- 5-HTP + Phenelzine Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amoxapine + Phenelzine Contraindicated
- Atomoxetine + Phenelzine Contraindicated
- Benzphetamine + Phenelzine Contraindicated
- Brimonidine + Phenelzine Contraindicated
Frequently asked questions
Can I take Levorphanol with Phenelzine?
MediHelp rates the interaction as major. Levorphanol and Phenelzine 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. Opioids used with MAOIs may produce serotonin toxicity or opioid toxicity, including respiratory depression, coma, and blood pressure instability. The risk persists for weeks after the MAOI is stopped.
How serious is the interaction between Levorphanol and Phenelzine?
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 levorphanol during and for 14 days after phenelzine. Select an alternative analgesic, and monitor respiration, blood pressure and mental status if an opioid is essential.
What other medicines interact with Phenelzine?
MediHelp also lists interactions of Phenelzine with, for example, 5-HTP, Amitriptyline, Amoxapine. The full list is on the Phenelzine page.
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