Details About Generic Salt ::  Levometh

Main Medicine Class:: Narcotic analgesic   

(LEE-voe-METH-uh-dill ASS-uh-TATE HIGH-droe-KLOR-ide)
Orlaam
Class: Narcotic analgesic

 

Drugs Class ::

 Action Similar mechanism of action as other opiates; however, its slow onset and long duration of action make use as analgesic inappropriate.

Indications for Drugs ::

 Indications Management of opiate dependence.

Drug Dose ::

 Route/Dosage

ADULTS: PO Induction: 20 to 40 mg 3 times/wk on Monday-Wednesday-Friday or Tuesday-Thursday-Saturday schedule. Higher dose may be needed at end of week to prevent withdrawal symptoms over 72-hour break. Dose can be increased in 5 to 10 mg increments until steady state is reached, usually in 1 to 2 wk. Never give on daily basis; if needed, give small doses of methadone on “off” day. For patients dependent on methadone, initial dose of levomethadyl is 1.2 to 1.3 times daily methadone dose. Maintenance: 60 to 90 mg 3 times/wk (range: 10 to 140 mg/dose); higher doses may be needed. Planned interruptions in therapy: Take-home doses of levomethadyl are not permitted; give methadone instead. Unplanned interruptions in therapy: After single missed dose, restart on every-other-day schedule. Wait until after weekend 72-hour break to reestablish prior schedule. If > 1 dose is missed, restart at 50% to 75% of previous dose. After lapse of > 1 wk, restart using induction schedule.

Contraindication ::

 Contraindications Standard considerations.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Infants may develop neonatal abstinence syndrome. Recommend switching to methadone during pregnancy. Levomethadyl is not recommended for use in pregnancy. Lactation: Undetermined. Children: Not recommended in those < 18 yrs. Daily use: Administration of levomethadyl on a daily basis has led to excessive drug accumulation and risk of fatal overdose. Routine daily dosing after a patient has been inducted onto levomethadyl treatment is not allowed by current treatment regulations. Special-risk patients: Use with caution in patients with myxedema, acute alcoholism, acute abdominal conditions, ulcerative colitis, decreased respiratory reserve, head injury or increased intracranial pressure, hypoxia, supraventricular tachycardia, depleted blood volume or circulatory shock. Drug dependence: Has abuse potential. Renal or hepatic impairment: Duration of action may be prolonged; may need to reduce dosage or convert to methadone.

PATIENT CARE CONSIDERATIONS

Drug Side Effects ::

 Adverse Reactions

CV: Hypertension; orthostatic hypotension; prolonged QT interval; nonspecific ST-T wave changes; peripheral edema. CNS: Drowsiness; insomnia; asthenia; nightmares; depression; euphoria; headache; nervousness. DERM: Sweating; pruritus; urticaria. GI: Nausea; vomiting; dry mouth; constipation; abdominal pain. GU: Urinary retention. RESP: Cough. OTHER: Tolerance; psychological and physical dependence with chronic use.

Drug Mode of Action ::  

 Action Similar mechanism of action as other opiates; however, its slow onset and long duration of action make use as analgesic inappropriate.

Drug Interactions ::

 Interactions

Alcohol or drugs of abuse: Fatal overdose can occur; symptoms may be delayed. Other CNS depressants (eg, tranquilizers, sedatives): Additive CNS depression.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note renal or hepatic impairment or cardiac disease.
  • Assess for hypertension or orthostatic hypotension, arrhythmias, peripheral edema and cough.
  • Carefully monitor patients with cardiac disease or those receiving medications that affect cardiac conduction.
  • Observe for withdrawal symptoms. Dosage may need to be adjusted to prevent unpleasant symptoms.
  • Monitor I&O during therapy. Increasing fiber, fluids and exercise may help prevent constipation.
  • Provide good oral hygiene.
  • Be alert to palpitations, syncope, or other symptoms suggestive of episodes of irregular cardiac rhythm in patients and promptly evaluate such cases.
OVERDOSAGE: SIGNS & SYMPTOMS
  Miosis, respiratory and CNS depression, circulatory collapse, seizures, cardiopulmonary arrest, death

Drug Storage/Management ::

 Administration/Storage

  • Drug may not be dispensed for outpatient use. May be used only by treatment programs approved by FDA, DEA and designated state authorities.
  • Administer in oral form only. Always dilute before administration.

Drug Notes ::

 Patient/Family Education

  • Advise patient that full effectiveness of drug may not occur for several days.
  • Warn patient that drug may cause dependence and that detoxification/withdrawal program will be necessary if drug is discontinued.
  • Advise patient that drug may cause drowsiness or impair judgment and to use caution while driving or performing other tasks requiring mental alertness.
  • Remind patient to notify physicians, dentists and other health care providers of drug regimen.
  • If patient is switching from levomethadyl to methadone, advise patient to wait 48 hours after the last dose of levomethadyl before taking the first dose of the other narcotic.
  • Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
  • Instruct patient not to take otc medications without consulting physician.
  • Encourage patient to wear identification bracelet or necklace and carry ID card.
  • Emphasize importance of comprehensive treatment to include medical evaluation, planning and counseling.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.

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