U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C17H23NO.C4H6O6.2H2O
Molecular Weight 443.488
Optical Activity UNSPECIFIED
Defined Stereocenters 5 / 5
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of LEVORPHANOL TARTRATE

SMILES

O.O.O[C@H]([C@@H](O)C(O)=O)C(O)=O.[H][C@@]12CCCC[C@@]13CCN(C)[C@@H]2CC4=C3C=C(O)C=C4

InChI

InChIKey=UMZNDVASJKIQCB-QLFXFZCRSA-N
InChI=1S/C17H23NO.C4H6O6.2H2O/c1-18-9-8-17-7-3-2-4-14(17)16(18)10-12-5-6-13(19)11-15(12)17;5-1(3(7)8)2(6)4(9)10;;/h5-6,11,14,16,19H,2-4,7-10H2,1H3;1-2,5-6H,(H,7,8)(H,9,10);2*1H2/t14-,16+,17+;1-,2-;;/m01../s1

HIDE SMILES / InChI

Molecular Formula C4H6O6
Molecular Weight 150.0868
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 2 / 2
E/Z Centers 0
Optical Activity UNSPECIFIED

Molecular Formula H2O
Molecular Weight 18.0153
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Molecular Formula C17H23NO
Molecular Weight 257.3706
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 3 / 3
E/Z Centers 0
Optical Activity UNSPECIFIED

Levorphanol, brand name Levo-Dromoran, is an opioid medication used to treat moderate to severe pain. Levorphanol is indicated for the management of moderate to severe pain where an opioid analgesic is appropriate. It is a potent synthetic opioid mu-receptor agonist similar in action to morphine. Like other opioid mu-receptor agonists, it is believed to act at receptors in both the brain and spinal cord to alter the transmission and perception of pain. The onset and peak analgesic effects following administration of levorphanol are similar to morphine when administered at equal analgesic doses. Levorphanol produces a degree of respiratory depression similar to that produced by morphine at equal analgesic doses, and like many opioid mu-receptor agonists, levorphanol produces euphoria or has a positive effect on mood in many individuals.

Originator

Curator's Comment: Levorphanol was initially synthesized in Germany in 1946

Approval Year

Targets

Targets

Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Palliative
Levorphanol Tartrate

Approved Use

Levorphanol Tartrate Tablets are indicated for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

Launch Date

1953
Overview

Overview

OverviewOther

Other InhibitorOther SubstrateOther Inducer
Drug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
yes [IC50 11.5 uM]
yes [IC50 >50 uM]
Drug as victim

Drug as victim

PubMed

PubMed

TitleDatePubMed
Relative cataleptic potency of narcotic analgesics, including 3,6-dibutanoylmorphine and 6-monoacetylmorphine.
1984
Differential effects of morphinan drugs on haloperidol-induced catalepsy in rats: a comparative study with an N-methyl-D-aspartate antagonist.
1991 Mar-Apr
Clinical pharmacology of opioids for pain.
2002 Jul-Aug
Antidepressant-like effects of tramadol and other central analgesics with activity on monoamines reuptake, in helpless rats.
2002 Nov 29
Sex-related differences in mechanical nociception and antinociception produced by mu- and kappa-opioid receptor agonists in rats.
2002 Oct 4
Sensitivity to the effects of opioids in rats with free access to exercise wheels: mu-opioid tolerance and physical dependence.
2003 Aug
Differential effects of agonists on adenylyl cyclase superactivation mediated by the kappa opioid receptors: adenylyl cyclase superactivation is independent of agonist-induced phosphorylation, desensitization, internalization, and down-regulation.
2003 Dec
The power of visual imagery in drug design. Isopavines as a new class of morphinomimetics and their human opioid receptor binding activity.
2003 Jan 2
Discrimination of a single dose of morphine followed by naltrexone: substitution of other agonists for morphine and other antagonists for naltrexone in a rat model of acute dependence.
2003 Mar
Opioids and chronic neuropathic pain.
2003 Mar 27
Oral opioid therapy for chronic peripheral and central neuropathic pain.
2003 Mar 27
Opioids ease neuropathic pain, but..
2003 May
Interactions between opioids and cocaine on locomotor activity in rats: influence of an opioid's relative efficacy at the mu receptor.
2003 May
Discriminative stimulus effects of acute morphine followed by naltrexone in the squirrel monkey.
2003 May
Differential regulation of the human kappa opioid receptor by agonists: etorphine and levorphanol reduced dynorphin A- and U50,488H-induced internalization and phosphorylation.
2003 May
The competitive N-methyl-D-aspartate receptor antagonist (-)-6-phosphonomethyl-deca-hydroisoquinoline-3-carboxylic acid (LY235959) potentiates the antinociceptive effects of opioids that vary in efficacy at the mu-opioid receptor.
2003 Nov
10-Ketomorphinan and 3-substituted-3-desoxymorphinan analogues as mixed kappa and micro opioid ligands: synthesis and biological evaluation of their binding affinity at opioid receptors.
2004 Jan 1
Comparison of the effects of dextromethorphan, dextrorphan, and levorphanol on the hypothalamo-pituitary-adrenal axis.
2004 May
Antidepressant-like effect of tramadol and its enantiomers in reserpinized mice: comparative study with desipramine, fluvoxamine, venlafaxine and opiates.
2004 Sep
[Fundamentals of modern treatment of myopia].
2005
Social and environmental influences on opioid sensitivity in rats: importance of an opioid's relative efficacy at the mu-receptor.
2005 Aug
Analgesic therapy in postherpetic neuralgia: a quantitative systematic review.
2005 Jul
Discriminative stimulus effects of acute morphine followed by naltrexone in the squirrel monkey: a further characterization.
2005 Jul
Over-the-counter cold medications-postmortem findings in infants and the relationship to cause of death.
2005 Oct
Restless legs syndrome: diagnosis and review of management options.
2006 Jun
Opioid peptides and receptors in joint tissues: study in the rat.
2006 Jun
Chronic exercise decreases sensitivity to mu opioids in female rats: correlation with exercise output.
2006 Sep
Can levorphanol be used like methadone for intractable refractory pain?
2007 Apr
Levorphanol revisited.
2007 Dec
Role of atypical opiates in OCD. Experimental approach through the study of 5-HT(2A/C) receptor-mediated behavior.
2007 Feb
Cholesterol reduction by methyl-beta-cyclodextrin attenuates the delta opioid receptor-mediated signaling in neuronal cells but enhances it in non-neuronal cells.
2007 Feb 15
Does purity of supplements count?
2007 Jan
The effect of opiates on the activity of human placental aromatase/CYP19.
2007 Jan 15
Current aproach to cancer pain management: Availability and implications of different treatment options.
2007 Jun
Levorphanol: the forgotten opioid.
2007 Mar
High-affinity carbamate analogues of morphinan at opioid receptors.
2007 Mar 15
Synthesis and pharmacological evaluation of 6,7-indolo/thiazolo-morphinans--further SAR of levorphanol.
2007 May 31
Morphine reduces local cytokine expression and neutrophil infiltration after incision.
2007 Oct 2
Chronic morphine treatment up-regulates mu opioid receptor binding in cells lacking filamin A.
2007 Oct 26
Opiates and elderly: use and side effects.
2008
An evaluation of the genotoxicity of the antitussive drug Dextromethorphan.
2008 Apr
Effects of environmental enrichment on sensitivity to mu, kappa, and mixed-action opioids in female rats.
2008 Jul 5
Challenges in using opioids to treat pain in persons with substance use disorders.
2008 Jun
Opioid pharmacology.
2008 Mar
A retrospective study on the impact of comorbid depression or anxiety on healthcare resource use and costs among diabetic neuropathy patients.
2009 Jun 30
Somatostatin and opioid receptors do not regulate proliferation or apoptosis of the human multiple myeloma U266 cells.
2009 Jun 7
Chronic pain: levorphanol, methadone, and the N-methyl-D-aspartate receptor.
2009 Sep
Preoperative oral dextromethorphan does not reduce pain or morphine consumption after open cholecystectomy.
2010 Feb
Exploration of catalytic properties of CYP2D6 and CYP3A4 through metabolic studies of levorphanol and levallorphan.
2010 Jan
Synthesis and opioid receptor binding affinities of 2-substituted and 3-aminomorphinans: ligands for mu, kappa, and delta opioid receptors.
2010 Jan 14
Patents

Sample Use Guides

Usual Adult Dose for Light Sedation Premedication for Anesthesia: 1 to 2 mg IM or subcutaneously, administered 60 to 90 minutes before surgery. Older or debilitated patients usually require less drug. Two mg of levorphanol is approximately equivalent to 10 to 15 mg of morphine or 100 mg of meperidine. Usual Adult Dose for Pain IV: 1 mg every 3 to 6 hours as needed. IM or subcutaneous: 1 to 2 mg every 6 to 8 hours as needed. Oral: 2 mg every 6 to 8 hours as needed. May be increased to 3 mg every 6 to 8 hours.
Route of Administration: Other
In Vitro Use Guide
Levorphanol (5-100 uM), consistently depressed the responses evoked by the putative inhibitory amino acid neurotransmitters glycine and beta-alanine but not GABA in cultured mouse spinal cord neurons.
Substance Class Chemical
Created
by admin
on Fri Dec 15 15:33:59 GMT 2023
Edited
by admin
on Fri Dec 15 15:33:59 GMT 2023
Record UNII
04WQU6T9QI
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
LEVORPHANOL TARTRATE
MART.   ORANGE BOOK   USP   VANDF  
Common Name English
RO-1-5431/7
Code English
Levorphanol tartrate dihydrate [WHO-DD]
Common Name English
LEVO-DROMORAN
Brand Name English
17-Methylmorphinan-3-ol, tartrate (1:1) (salt) dihydrate
Common Name English
LEVORPHANOL TARTRATE [MART.]
Common Name English
LEVORPHANOL TARTRATE DIHYDRATE [MI]
Common Name English
LEVORPHANOL TARTRATE [USP-RS]
Common Name English
MORPHINAN-3-OL, 17-METHYL-, (R-(R*,R*))-2,3-DIHYDROXYBUTANEDIOATE (1:1) (SALT), DIHYDRATE
Common Name English
LEVORPHANOL TARTRATE [USP MONOGRAPH]
Common Name English
LEVORPHANOL TARTRATE [VANDF]
Common Name English
LEVORPHANOL TARTRATE [ORANGE BOOK]
Common Name English
Classification Tree Code System Code
NCI_THESAURUS C1506
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
NCI_THESAURUS C67413
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
Code System Code Type Description
CAS
5985-38-6
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
SMS_ID
100000086127
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
MERCK INDEX
m6794
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY Merck Index
EPA CompTox
DTXSID30975252
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
DRUG BANK
DBSALT000935
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
DAILYMED
04WQU6T9QI
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
CAS
6700-40-9
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
SUPERSEDED
FDA UNII
04WQU6T9QI
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
RXCUI
153973
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY RxNorm
CAS
5985-51-3
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
SUPERSEDED
PUBCHEM
5462348
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
NCI_THESAURUS
C47586
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
RS_ITEM_NUM
1364007
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
EVMPD
SUB02914MIG
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
ChEMBL
CHEMBL592
Created by admin on Fri Dec 15 15:33:59 GMT 2023 , Edited by admin on Fri Dec 15 15:33:59 GMT 2023
PRIMARY
Related Record Type Details
PARENT -> SALT/SOLVATE
ANHYDROUS->SOLVATE
PARENT -> SALT/SOLVATE
PARENT -> SALT/SOLVATE
Related Record Type Details
ACTIVE MOIETY