Narcotic Agonist Analgesic
PREGNANCY RECOMMENDATION: Human Data Suggest Risk in 3rd Trimester
BREASTFEEDING RECOMMENDATION: No Human Data—Probably Compatible
PREGNANCY SUMMARY
The use of levorphanol during labor should be expected to produce neonatal depression to the same degree as other narcotic analgesics (1). If levorphanol is used in pregnancy, healthcare professionals are encouraged to call the toll-free number (800-670-6126) for information about patient enrollment in the Motherisk study.
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 (2). At this dose, nearly 50% of the mouse embryos died.
BREASTFEEDING SUMMARY
No reports describing the use of levorphanol during lactation have been located. The molecular weight (about 444) is low enough 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.Bonica JJ. Principles and Practice of Obstetric Analgesia and Anesthesia. Philadelphia, PA: FA Davis, 1967:251.
2.Product information. Levo-Dromoran. ICN Pharmaceuticals, 2000.