Levorphanol for Treatment of Intractable Neuropathic Pain in Cancer Patients.

Abstract

Neuropathic pain in cancer patients is often difficult to treat, requiring a combination of several different pharmacological therapies. We describe two patients with complex neuropathic pain syndromes in the form of phantom limb pain and Brown-Sequard syndrome who did not respond to conventional treatments but responded dramatically to the addition of levorphanol. Levorphanol is a synthetic strong opioid that is a potent N-methyl-d-aspartate receptor antagonist, mu, kappa, and delta opioid receptor agonist, and reuptake inhibitor of serotonin and norepinephrine. It bypasses hepatic first-pass metabolism and thereby not subjected to numerous drug interactions. Levorphanol's unique profile makes it a potentially attractive opioid in cancer pain management.

• Authors: Akhila Reddy, Amy Ng, Tarun Mallipeddi, Eduardo Bruera
• Journal: Journal of palliative medicine (J Palliat Med) Vol. 21 Issue 3 Pg. 399-402 (Mar 2018) ISSN: 1557-7740 [Electronic] United States
• PMID: 29377758 (Publication Type: Journal Article)

Chemical References

• Analgesics, Opioid
• Levorphanol

Topics

• Adult
• Amputation, Surgical
• Analgesics, Opioid (therapeutic use)
• Breast Neoplasms (pathology)
• Cancer Pain (drug therapy)
• Female
• Humans
• Humerus
• Levorphanol (therapeutic use)
• Neuralgia (drug therapy)
• Osteosarcoma (surgery)
• Pain Measurement
• Pain, Intractable (drug therapy)
• Spinal Neoplasms (radiotherapy, secondary)