Lefisyo (Levomethadone Hydrochloride)

Levomethadone Hydrochloride is used in opioid dependence treatment and pain management.

• Opioid dependence: helps reduce withdrawal symptoms and cravings during maintenance therapy.
• Moderate to severe pain: provides analgesia for patients requiring strong opioid analgesics.
• Opioid detoxification: assists in transitioning patients off other opioids under medical supervision.

• Levomethadone Hydrochloride acts as a selective mu‑opioid receptor agonist. By binding to these receptors in the central nervous system, it inhibits the release of neurotransmitters that transmit pain signals and modulates reward pathways, thereby reducing the perception of pain and diminishing cravings associated with opioid dependence.

Levomethadone Hydrochloride may cause a range of adverse reactions.

Common Side Effects

• Nausea: feeling of sickness or urge to vomit.
• Constipation: reduced bowel movements and hard stools.
• Drowsiness: increased sleepiness or fatigue.
• Dizziness: sensation of light‑headedness or imbalance.
• Dry mouth: reduced salivation leading to a parched feeling.
• Sweating: excessive perspiration unrelated to temperature.

Serious or Rare Side Effects

• Respiratory depression: slowed or shallow breathing that can be life‑threatening.
• QT interval prolongation: potential cardiac rhythm disturbances.
• Severe hypotension: marked drop in blood pressure causing faintness.
• Seizures: uncontrolled electrical activity in the brain.
• Anaphylaxis: acute allergic reaction with airway compromise.
• Hepatotoxicity: liver injury indicated by abnormal enzymes.

When prescribing or dispensing Levomethadone Hydrochloride, consider the following precautions.

• Assess patient history: evaluate for respiratory disorders, head injury, or severe hepatic impairment.
• Monitor for dependence: watch for signs of tolerance, misuse, or addiction.
• Avoid concurrent CNS depressants: co‑administration with benzodiazepines or alcohol can increase sedation.
• Caution in renal impairment: dose adjustments may be required in reduced kidney function.
• Educate on overdose risk: inform patients about signs of respiratory depression and emergency measures.
• Store at ambient temperature: keep in the original container, protect from moisture and heat.

Levomethadone Hydrochloride can interact with several drug classes.

Major Interactions (Avoid)

• Other opioids: additive risk of respiratory depression and profound sedation.
• Benzodiazepines: combined CNS depression may be life‑threatening.
• Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): increase levomethadone plasma levels, heightening toxicity.

Moderate Interactions (Monitor Closely)

• CYP3A4 inducers (e.g., rifampin, carbamazepine): may reduce therapeutic effect.
• Alcohol: enhances sedative effects and impairs judgment.
• Certain antidepressants (e.g., SSRIs, SNRIs): potential for serotonin syndrome when combined with opioids.