|AHFS/Drugs.com||International Drug Names|
|Chemical and physical data|
|Molar mass||283.4079 g/mol|
|3D model (JSmol)|
|(what is this?)|
Levallorphan (INN, BAN) (brand names Lorfan, Naloxifan, Naloxiphan), also known as levallorphan tartrate (USAN), is an opioid modulator of the morphinan family used as an opioid analgesic and opioid antagonist/antidote. It acts as an antagonist of the μ-opioid receptor (MOR) and as an agonist of the κ-opioid receptor (KOR), and as a result, blocks the effects of stronger agents with greater intrinsic activity such as morphine whilst simultaneously producing analgesia.
Levallorphan was formerly widely used in general anesthesia, mainly to reverse the respiratory depression produced by opioid analgesics and barbiturates used for induction of surgical anaesthesia whilst maintaining a degree of analgesia (via KOR agonism). It is now less commonly employed for this purpose as the newer drug naloxone tends to be used instead. Levallorphan was also used in combination with opioid analgesics to reduce their side effects, mainly in obstetrics, and a very small dose of levallorphan used alongside a full agonist of the MOR can produce greater analgesia than when the latter is used by itself. The combination of levallorphan with pethidine (meperidine) was indeed used so frequently, a standardized formulation was made available, known as Pethilorfan.
As an agonist of the KOR, levallorphan can produce severe mental reactions at sufficient doses including hallucinations, dissociation, and other psychotomimetic effects, dysphoria, anxiety, confusion, dizziness, disorientation, derealization, feelings of drunkenness, delusions, paranoia, and bizarre, unusual, or disturbing dreams.
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- Bullough, J. (1959). "Use of premixed pethidine and antagonists in obstetrical analgesia; with special reference to cases in which levallorphan was used" (pdf). British Medical Journal. 2 (5156): 859–862. doi:10.1136/bmj.2.5156.859. PMC . PMID 13805887.
- Williams, G.; Cope, I. (1962). "An evaluation of a combination of pethidine and levallorphan ("pethilorfan") in labour". The Medical Journal of Australia. 49 (2): 499–503. PMID 14000851.
- R.C.W. Hall (6 December 2012). Psychiatric Presentations of Medical Illness: Somatopsychic Disorders. Springer Science & Business Media. pp. 364–. ISBN 978-94-011-7677-4.
- American Hospital Formulary Service Drug Information. authority of the Board of Directors of the American Society of Hospital Pharmacists. 1984. p. 664.
- John B. Williams (1963). Narcotics. Wm. C. Brown Company. p. 203.
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