Levorphanol

A long-acting opioid pain medicine (tablets) for pain severe enough to need an opioid when other treatments are inadequate.

psilodex.org/m/levorphanol · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: 11–16 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado Condition rules (3)

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Levorphanol”, v2026.10.05. psilodex.org/m/levorphanol

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

Availability

Generic only in US

FDA-approved for

Pain severe enough to require an opioid when other treatments are inadequate

Sources [1]

Other safety

Boxed warning: addiction, abuse and misuse; life-threatening respiratory depression; and profound sedation, respiratory depression, coma and death when combined with benzodiazepines or other CNS depressants, including alcohol.

About the medication itself, separate from any interaction with psilocybin.

Sources [1]

01 Interaction with psilocybin

Its sedation and nausea may add to psilocybin's; it can slow breathing, which psilocybin does not. Stopping it suddenly after regular use can cause withdrawal.

Detail Levorphanol is a full mu-opioid agonist with a long half-life (11–16 h), so blood levels build up over days of regular use. Its sedation and nausea may add to psilocybin's effects. Respiratory depression (slowed breathing) is an opioid risk that rises with other CNS (central nervous system) depressants; psilocybin does not depress breathing. Its label reports serotonin syndrome when opioids are combined with serotonergic drugs (no psilocybin data). Also, the label reports severe hypotension (low blood pressure) and more frequent seizures in seizure disorders. Stopping it abruptly can cause withdrawal. Sources [1]

Human data with psilocybin: No psilocybin data; based on how it works and its label
Half-life: 11–16 h (FDA label, checked 2026-10-04) Terminal half-life after IV dosing; steady state by about day 3.

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

6 listed · counted on reports

Sedating or CNS depressant: Slows the central nervous system: drowsiness, slower reactions and impaired coordination, and slowed breathing at high doses. Effects add with other sedating substances. Sources [1]
Withdrawal or rebound if stopped abruptly: Stopping suddenly can cause withdrawal or a rebound of symptoms. Sources [1]
Lowers blood pressure or causes orthostasis: Lowers blood pressure, or causes a drop on standing (orthostasis) that can bring dizziness or fainting. Sources [1]
Opioid: Activates opioid receptors, causing pain relief, sedation and slowed breathing at higher doses. Psilocybin does not slow breathing, but stopping an opioid suddenly can cause withdrawal. Sources [1]
Lowers seizure threshold or carries seizure risk: Makes a seizure more likely, or has been linked to seizures. Sources [1]
Serotonergic: Increases serotonin activity, for example by blocking its reuptake or releasing it. Psilocybin acts on serotonin receptors, so effects can add together. With antidepressant use, the psilocybin response can be weaker. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not namedCondition rules (3)

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

Screening items in state rules

This medication is usually taken for a condition. State rules screen for some conditions directly, so the medication is a prompt to ask about them. Confirm with the participant; never assume a condition from the medication.

Chronic pain
- CO 2.5(A)(2) · Clinical Facilitator licensees
- CO 6.16(F)(2)(a) · Facilitators without a clinical facilitator license
- CO 6.16(F)(1) · All licensees

05 Sources

Levorphanol Tartrate Tablets (SpecGx) · FDA label (DailyMed) — Opioid: Mechanism of Action "Levorphanol is a full opioid agonist and is relatively selective for the mu-opioid receptor" | Sedating or CNS depressant: Boxed Warning "Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death." | Serotonergic: Precautions, Drug Interactions "The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system" ... "has resulted in serotonin syndrome" | Lowers blood pressure or causes orthostasis: "Levorphanol Tartrate Tablets may cause severe hypotension including orthostatic hypotension and syncope in ambulatory patients." | Lowers seizure threshold or carries seizure risk: "may increase the frequency of seizures in patients with seizure disorders" | Withdrawal or rebound if stopped abruptly: "Do not rapidly reduce or abruptly discontinue Levorphanol in a patient physically dependent on opioids." | "terminal half-life of 11 to 16 hours" "steady-state plasma concentrations should be achieved by the third day of dosing"

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

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