Levacetylmethadol

The Uses of Levacetylmethadol

Analgesic (narcotic).

Definition

ChEBI: Levacetylmethadol is an acetate ester and a tertiary amino compound. It has a role as an opioid analgesic and a mu-opioid receptor antagonist.

brand name

Orlaam.

Clinical Use

Levomethadyl acetate is an orally active methadone derivative with a slow onset and a long duration of action. The compound is extensively metabolized and active metabolites contribute to the long duration of action. Levomethadyl acetate was used mainly for substitution treatment of opioid dependence . Oral doses from 20 up to 140 mgare given every 2–3 d. Supplementation with short acting opioids is necessary during the first days because of the delayed onset of action.
Levomethadyl acetate induces opioid-type side effects with respiratory depression, bradycardia, and impairment of cardiac contractility . The compound inhibits cardiac electric conductivity and increases the QT interval in the electrocardiogram and may induce ventricular arrhythmias and Torsade de pointes . Because of the cardiovascular side effects (Q/T-interval prolongation), the compound was recently withdrawn from the market.

Synthesis

Levomethadyl acetate is prepared by reduction of dextromethadone and subsequent acylation .