Comparative Pharmacology
Head-to-head clinical analysis: LEVO DROMORAN versus ULTRAM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEVO DROMORAN versus ULTRAM.
LEVO-DROMORAN vs ULTRAM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Levo-dromoran (levorphanol) is a potent opioid agonist primarily at mu-opioid receptors, with additional agonist activity at kappa and delta opioid receptors. It also acts as an NMDA receptor antagonist and inhibits serotonin and norepinephrine reuptake, contributing to its analgesic effects.
Tramadol is a centrally acting synthetic opioid analgesic that binds to μ-opioid receptors and inhibits norepinephrine and serotonin reuptake.
2 mg orally every 6-8 hours as needed for pain; 2-4 mg intramuscularly or subcutaneously every 6-8 hours; intravenous administration: 1-2 mg slowly (over 2-3 minutes) every 6-8 hours.
50-100 mg orally every 4-6 hours as needed for pain; maximum 400 mg/day (for extended-release: 100 mg once daily, titrated up to 300 mg once daily).
None Documented
None Documented
Terminal elimination half-life is 15-30 hours (mean 22 hours) in adults; prolonged in hepatic or renal impairment, requiring dose adjustment.
Tramadol: ~6 hours; M1 metabolite (O-desmethyltramadol): ~7 hours; prolonged in renal/hepatic impairment
Primarily renal (approximately 60% as unchanged drug and metabolites); biliary/fecal elimination accounts for about 30%.
Renal: ~90% (tramadol and metabolites; conjugated metabolites are major), Fecal: ~10%
Category C
Category C
Opioid Analgesic
Opioid Analgesic