Opioid analgesic
Pharmaceutical compound
Levomethorphan Dependence liability High Addiction liability High ATC code Legal status
Elimination half-life 3-6 hours
(1R ,9R ,10R )-4-methoxy-17-methyl-17-azatetracyclo[7.5.3.01 ,10 .02 ,7 ]heptadeca-2(7),3,5-triene
CAS Number PubChem CID ChemSpider UNII KEGG ChEBI ChEMBL CompTox Dashboard (EPA ) ECHA InfoCard 100.004.320 Formula C 18 H 25 N O Molar mass 271.404 g·mol−1 3D model (JSmol )
COc1ccc2C[C@@H]3[C@@H]4CCCC[C@]4(CCN3C)c2c1
InChI=1S/C18H25NO/c1-19-10-9-18-8-4-3-5-15(18)17(19)11-13-6-7-14(20-2)12-16(13)18/h6-7,12,15,17H,3-5,8-11H2,1-2H3/t15-,17+,18+/m0/s1
Y Key:MKXZASYAUGDDCJ-CGTJXYLNSA-N
Y
N Y (what is this?) (verify)
Levomethorphan (LVM) (INN , BAN ) is an opioid analgesic of the morphinan family that has never been marketed.[ 2] It is the L -stereoisomer of racemethorphan (methorphan).[ 2] The effects of the two isomers of racemethorphan are quite different, with dextromethorphan (DXM) being an antitussive at low doses and a dissociative hallucinogen at much higher doses.[ 3] Levomethorphan is about five times stronger than morphine.[ 4]
Levomethorphan is a prodrug to levorphanol , analogously to DXM acting as a prodrug to dextrorphan or codeine behaving as a prodrug to morphine .[ 5] As such, levomethorphan has similar effects to levorphanol but is less potent as it must be demethylated to the active form by liver enzymes before being able to produce its effects.[ 5] As a prodrug of levorphanol, levomethorphan functions as a potent agonist of all three of the opioid receptors , μ , κ (κ1 and κ3 but notably not κ2 ), and δ , as an NMDA receptor antagonist , and as a serotonin-norepinephrine reuptake inhibitor .[ 5] Via activation of the κ-opioid receptor, levomethorphan can produce dysphoria and psychotomimetic effects such as dissociation and hallucinations .[ 6]
Levomethorphan is listed under the Single Convention on Narcotic Drugs 1961 and is regulated like morphine in most countries. In the United States it is a Schedule II Narcotic controlled substance with a DEA ACSCN of 9210 and a 2014 annual aggregate manufacturing quota of 195 grams, up from 6 grams the year before. The salts in use are the tartrate (free base conversion ratio 0.644) and hydrobromide (0.958).[ 7] At the current time[when? ] , no levomethorphan pharmaceuticals are marketed in the United States.[citation needed ]
See also
References
^ Anvisa (2023-03-31). "RDC Nº 784 - Listas de Substâncias Entorpecentes, Psicotrópicas, Precursoras e Outras sob Controle Especial" [Collegiate Board Resolution No. 784 - Lists of Narcotic, Psychotropic, Precursor, and Other Substances under Special Control] (in Brazilian Portuguese). Diário Oficial da União (published 2023-04-04). Archived from the original on 2023-08-03. Retrieved 2023-08-16 .
^ a b Elks J (14 November 2014). The Dictionary of Drugs: Chemical Data: Chemical Data, Structures and Bibliographies . Springe. pp. 656–. ISBN 978-1-4757-2085-3 .
^ Hornback JM (31 January 2005). Organic Chemistry . Cengage Learning. pp. 243–. ISBN 0-534-38951-1 .
^ Wainer IW (1996). "Toxicology Through a Looking Glass: Stereochemical Questions and Some Answers" . In Wong SH, Sunshine I (eds.). Handbook of Analytical Therapeutic Drug Monitoring and Toxicology . CRC Press. ISBN 9780849326486 .
^ a b c Gudin J, Fudin J, Nalamachu S (January 2016). "Levorphanol use: past, present and future". Postgraduate Medicine . 128 (1): 46–53. doi :10.1080/00325481.2016.1128308 . PMID 26635068 . S2CID 3912175 .
^ Bruera ED, Portenoy RK (12 October 2009). Cancer Pain: Assessment and Management . Cambridge University Press. pp. 215–. ISBN 978-0-521-87927-9 .
^ "Conversion Factors for Controlled Substances" . DEA Diversion Control Division . U.S. Department of Justice, Drug Enforcement Administration (DEA). Archived from the original on 2016-03-02. Retrieved 2014-06-18 .
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