Medical Editor: John P. Cunha, DO, FACOEP
Orlaam (levomethadyl acetate hydrochloride) is an opiate agonist used to manage opiate dependence. The brand name Orlaam is discontinued, but generic versions may be available. Common side effects of Orlaam (levomethadyl acetate hydrochloride) include:
- general feeling of being unwell (malaise)
- abdominal pain
- joint pain
- difficulty ejaculating
- decreased sex drive
- back pain
- dry mouth
- flu symptoms
- hot flashes
- abnormal dreams
- runny nose
- rash, and
- blurred vision
The initial dose of Orlaam for street addicts should be 20 to 40 mg. Most patients will be stabilized on doses in the range of 60 to 90 mg, 3-times-a-week. Orlaam may interact with antiarrhythmics, antihistamines, antimalarials, calcium channel blockers, neuroleptics, antidepressants, diuretics, laxatives, steroids, sedatives, tranquilizers, propoxyphene, benzodiazepines, alcohol, other narcotic antagonists, pentazocine, nalbuphine, butorphanol, buprenorphine, meperidine, propoxyphene, rifampin, carbamazepine, phenobarbital, phenytoin, erythromycin, cimetidine, and anti-fungal drugs. Tell your doctor all medications and supplements you use. Orlaam is not recommended for use in pregnancy. Consult your doctor. It is unknown if this drug passes into breast milk in sufficient quantities to affect a nursing infant. Breastfeeding while using this drug is generally not recommended. Consult your doctor before breastfeeding. Withdrawal symptoms may occur if you suddenly stop taking this medication.
Our Orlaam (levomethadyl acetate hydrochloride) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Physicians should be alert to palpitations, syncope, or other symptoms suggestive of episodes of irregular cardiac rhythm in patients taking ORLAAM and promptly evaluate such cases (see WARNINGS , Effects on Cardiac Conduction ).
Patients presenting for ORLAAM (levomethadyl acetate) treatment are frequently in withdrawal from heroin or other opiates. They may display typical withdrawal symptoms which should be differentiated from ORLAAM (levomethadyl acetate) 's side effects. Patients may exhibit some or all of the following signs and symptoms associated with withdrawal from opiates: lacrimation, rhinorrhea, sneezing, yawning, perspiration, gooseflesh, fever, chilliness alternating with flushing, restlessness, irritability, insomnia, weakness, anxiety, depression, dilated pupils, tremors, tachycardia, abdominal cramps, body aches, anorexia, nausea, vomiting, diarrhea, and weight loss. Control of such symptoms is a primary goal of therapy. However, because of the slow onset and long half-lives of ORLAAM (levomethadyl acetate) , nor-LAAM and dinor-LAAM, overly aggressive increases in dosage to control these withdrawal symptoms with ORLAAM (levomethadyl acetate) may result in overdose (see INDIVIDUALIZATION OF DOSAGE ).
Signs and Symptoms of ORLAAM (levomethadyl acetate) Excess
The interaction between the development and maintenance of opioid tolerance and ORLAAM (levomethadyl acetate) dose can be complex. Dose reduction is recommended in cases where patients develop signs and symptoms of excessive ORLAAM (levomethadyl acetate) effect, characterized by complaints of "feeling wired", poor concentration, drowsiness, and possibly dizziness on standing.
ORLAAM (levomethadyl acetate) Withdrawal
Patients may experience withdrawal symptoms (nasal congestion, abdominal symptoms, diarrhea, muscle aches, anxiety) over the 72-hour dosing interval if the dose of ORLAAM (levomethadyl acetate) is too low. This may be managed as described under INDIVIDUALIZATION OF DOSAGE , but physicians should be alert to the possible need for dose or dose schedule adjustments if patients complain of weekend withdrawal symptoms in the last day of the 72-hour dosing interval.
Adverse Reactions on Stable Therapy
The following adverse events were observed in the 25-site, 623-patient usage study in male and female opiate addicts (see CLINICAL TRIALS ). These signs and symptoms were reported during the second and third months of treatment with ORLAAM (levomethadyl acetate) , and were considered severe enough to require medical evaluation. In this study, both questionnaires and spontaneous reports were used to gather information. Questionnaire-elicited symptom frequencies were about five times as frequent as the spontaneous reporting frequencies given below.
Incidence greater than 1%, Probably Causally Related
*Reactions in 3-9% of patients; reactions in 1-3% are unmarked.
Musculoskeletal Arthralgia *
Special Senses Blurred vision.
Incidence less than 1%, Probably Causally Related
Special Senses Tearing.
Causal Relationship Unknown
These reactions were reported with low frequency in controlled and uncontrolled studies of LAAM, are not known to be causally related to the administration of the drug, and are provided as alerting information for physicians.
The following adverse reactions have been reported in the post-marketing setting (all reactions in less than 1% of patients).
Urogenital Breast enlargement.
ORLAAM (levomethadyl acetate) is a Schedule II controlled substance under the Federal Controlled Substances Act. ORLAAM (levomethadyl acetate) produces dependence of the morphine-type and has potential for abuse. Tolerance and physical dependence will develop upon repeated administration. As with methadone and any other narcotic administered to narcotic addicts, ORLAAM (levomethadyl acetate) is at risk for diversion and illicit use, and should be handled accordingly (see WARNINGS ).
Read the entire FDA prescribing information for Orlaam (Levomethadyl Acetate)
© Orlaam Patient Information is supplied by Cerner Multum, Inc. and Orlaam Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.