What the FDA labels say about taking them together
Levorphanol and nalbuphine
Levorphanol's FDA label of January 13, 2026 names nalbuphine in its drug interactions section; nalbuphine's label does not name levorphanol itself but warns about its class (Opioids (opioid agonists)). The levorphanol label: “Mixed Agonist/Antagonist and Partial Opioid Analgesics The concomitant use of opioid with other opioid analgesics, such as butorphanol, nalbuphine, pentazocine, may reduce the analgesic effect of levorphanol tartrate …”
Check it at the source: the levorphanol FDA label on DailyMed (effective January 13, 2026, Sun Pharmaceutical Industries, Inc.); the nalbuphine FDA label on DailyMed (effective December 31, 2025, Hospira, Inc.).
What does the levorphanol label say about nalbuphine?
Levorphanol label, drug interactionsMixed Agonist/Antagonist and Partial Opioid Analgesics The concomitant use of opioid with other opioid analgesics, such as butorphanol, nalbuphine, pentazocine, may reduce the analgesic effect of levorphanol tartrate tablets and precipitate withdrawal symptoms.
Levorphanol label, warningsAdditionally, avoid the use of mixed agonist/antagonist (e.g., pentazocine, nalbuphine, and butorphanol) or partial agonist (e.g., buprenorphine) analgesics in patients who are receiving a full opioid agonist analgesic, including levorphanol.
Source: FDA drug label (Levorphanol Tartrate), Sun Pharmaceutical Industries, Inc., effective January 13, 2026 (SPL set 438cf3ea-04fe-4626-9f0f-adcda7633651), via openFDA; the full label on DailyMed
What does the nalbuphine label say about levorphanol?
Nalbuphine's label does not name levorphanol itself; it warns about its class (Opioids (opioid agonists)):
Nalbuphine label, warningsLife-Threatening Respiratory Depression Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended.
Nalbuphine label, boxed warningSERIOUS AND LIFE-THREATENING RISKS FROM USE OF NALBUPHINE HYDROCHLORIDE INJECTION Addiction, Abuse, and Misuse Because the use of Nalbuphine Hydrochloride Injection exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient's risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see WARNINGS ].
Source: FDA drug label (Nalbuphine Hydrochloride), Hospira, Inc., effective December 31, 2025 (SPL set 6025e8d4-5083-4c3a-58a0-050e7b0b6150), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Levorphanol | Nalbuphine | |
|---|---|---|
| Labeled for | Pain | Pain |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $10.65 per tablet 2 mg tablet | $4.32 per mL 10 mg/mL ampul |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once