LEVORPHANOL

Fetal Risk Summary

No reports linking the use of levorphanol with human congenital defects have been located. A single oral dose of 25 mg/kg was teratogenic in mice (1). At this dose, nearly 50% of the mouse embryos died.

Use of the drug during labor should be expected to produce neonatal depression to the same degree as other narcotic analgesics (2).

[*Risk Factor D if used for prolonged periods or in high doses at term.]

Breast Feeding Summary

No reports describing the use of levorphanol during lactation have been located. The molecular weight (about 444) is low enough, however, that passage into breast milk should be expected. Moreover, the drug is structurally similar to morphine, which is excreted into milk (see Morphine). The potential for long-term effects on neurobehavior and development in a nursing infant from exposure to levorphanol in milk are unknown but warrant study.

References

1. Product information. Levo-Dromoran. ICN Pharmaceuticals, 2000.
2. Bonica JJ. Principles and Practice of Obstetric Analgesia and Anesthesia. Philadelphia, PA:FA Davis, 1967:251.