Drug interactions
Levorphanol + Tapentadol
Severity: Major
Levorphanol and Tapentadol: 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 potent opioid agonist, and combining it with tapentadol duplicates opioid therapy. This raises the risk of profound sedation, respiratory depression and overdose.
What this interaction means in plain words
Levorphanol and Tapentadol 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 concurrent use of two full opioid agonists except during a planned rotation. If both are used, reduce doses, titrate slowly 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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Other interactions of Tapentadol
- Calcium / magnesium / potassium / sodium oxybates + Tapentadol Contraindicated
- Isocarboxazid + Tapentadol Contraindicated
- Linezolid + Tapentadol Contraindicated
- Methylene blue + Tapentadol Contraindicated
- Olanzapine / samidorphan + Tapentadol Contraindicated
- Phenelzine + Tapentadol Contraindicated
Frequently asked questions
Can I take Levorphanol with Tapentadol?
MediHelp rates the interaction as major. Levorphanol and Tapentadol 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 agonist, and combining it with tapentadol duplicates opioid therapy. This raises the risk of profound sedation, respiratory depression and overdose.
How serious is the interaction between Levorphanol and Tapentadol?
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 of two full opioid agonists except during a planned rotation. If both are used, reduce doses, titrate slowly and monitor sedation and respiratory rate.
What other medicines interact with Tapentadol?
MediHelp also lists interactions of Tapentadol with, for example, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid, Linezolid. The full list is on the Tapentadol page.
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