Interactions of levallorphan and meperidine

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Abstract
The respiratory effects of meperidine and levallorphan mixtures were studied in 5 healthy volunteers. The majority of pulmonary function tests and gas uptake studies gave either no evidence of change or only changes typical of opioids in general. Meperidine, 1.65 mg. per kilogram, intramuscularly, increased the end‐tidal CO2 tension by 6 torr with concommitant reduction in minute ventilation. Addition of levallorphan, 0.01, 0.02, or 0.04 mg. per kilogram caused only greater sedation. Even the sensitive test of ventilatory response to carbon dioxide challenge failed to distinguish mixtures of meperidine and levallorphan. During periods of controlled, elevated alveolar CO2 tension (48 ± 1 torr), meperidine, 1.1 mg. per kilogram, intravenously, depressed respiration 8 L. per minute. This depression was not significantly prevented or antagonized by levallorphan (0.014 mg. per kilogram). Levallorphan, 1.0 mg., produced respiratory depression equivalent to that produced by 40 mg. of meperidine. The interaction of the two is compatible with the hypothesis of competitive dualism.

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