Comparative Pharmacology
Head-to-head clinical analysis: LEVORPHANOL TARTRATE versus NUBAIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEVORPHANOL TARTRATE versus NUBAIN.
LEVORPHANOL TARTRATE vs NUBAIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Levorphanol is a potent opioid analgesic that acts as a mu-opioid receptor agonist. It also has NMDA receptor antagonist activity, inhibits norepinephrine and serotonin reuptake, and acts as a sigma receptor agonist, contributing to its analgesic effects and reduced tolerance development.
Nalbuphine is a mixed opioid agonist-antagonist. It acts as an agonist at kappa opioid receptors and as an antagonist at mu opioid receptors, providing analgesia with a ceiling effect for respiratory depression.
2 mg orally every 6-8 hours as needed for pain; for opioid-tolerant patients, doses up to 4 mg orally every 6-8 hours may be used. Parenterally: 1-2 mg subcutaneously or intramuscularly every 6-8 hours; may be given intravenously at 0.5-1 mg every 6-8 hours.
10-20 mg IV, IM, or SC every 3-6 hours as needed for pain; maximum single dose 20 mg, maximum daily dose 160 mg.
None Documented
None Documented
11-16 hours; extended in hepatic impairment (up to 30 hours).
3.5–5 hours (terminal elimination half-life); clinically, in hepatic or renal impairment, half-life may be prolonged, requiring dose adjustment.
Renal: approximately 30% as unchanged drug and 50% as glucuronide conjugates; fecal: 20% via biliary excretion.
Primarily renal (83% as unchanged drug and glucuronide conjugate); fecal excretion accounts for <5%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic