Low dose naltrexone (other name LDN)

Common use

Low Dose Naltrexone (LDN) means taking a dose of naltrexone that is up to one-tenth, or 10%, of the dose that is usually taken for opioid addiction. A low dose of naltrexone is approximately 4.5mg of naltrexone a day compared with the usual dosage of naltrexone for opioid addiction which is 50mg to 100mg a day.
Low Dose Naltrexone (LDN) has been used to treat: Autoimmune thyroid disorders, Cancer, Chronic fatigue syndrome, Chronic pain, Crohn’s disease, Fibromyalgia, Gulf War syndrome, Multiple sclerosis, Myalgic encephalomyelitis.

Dosage and direction

Always take this medicine exactly as your doctor has told you. Take this medication once a day by mouth as your doctor tells you to. The amount of time you should take this medication will be decided by your doctor. In certain cases, a longer period of treatment may be beneficial. It may take up to 8 to 10 weeks for low dose naltrexone to work. It is important to keep taking it until at least then to know if it works for you.
Low Dose Naltrexone should be started at an extremely low dose, such as 1 to 1.5mg/day, and the dosage should be increased by 1mg every week to a maximum of 4.5 mg/day.
Benefits of low dose naltrexone became apparent when people on a tapering schedule of naltrexone reported improvement in pain and fatigue symptoms with lower dosages of naltrexone rather than higher dosages. Small trials have shown that low dose naltrexone is beneficial for some conditions such as fibromyalgia, Crohn's disease, and pain.

Precautions

Tell your doctor or other health care provider of any recent use of opioids or any history of opioid dependence before starting low dose naltrexone to avoid having an opioid withdrawal. Your doctor may require that you pass a naloxone challenge test and/or a urine screen for opioids prior to low dose naltrexone use.
If you have been taking opioids of any kind, allow at least 7 days after your last dose of short-acting opioids or 10 to 14 days after your last dose of long-acting opioids to pass before starting low dose naltrexone.
Low dose naltrexone should also be stopped at least 7 days before surgery.

Contraindications

Low Dose Naltrexone blocks opioid receptors and can precipitate opioid withdrawal, so it is important that you do not take any opioid (narcotic) pain relieving drugs at the same time as low dose naltrexone.
You should not use low dose naltrexone treatment if you: Are receiving opioid (narcotic) analgesics; Are addicted to opioids; Are withdrawing from opioids or have symptoms of opioid withdrawal; Have failed a naloxone challenge test or have a positive urine screen for opioids; Have acute hepatitis but may be allowed in patients with stable or compensated cirrhosis after considering the risks versus benefits; Are allergic to or have had a hypersensitivity reaction to naltrexone, polylactide-co-glycolide (PLG), or any other diluent or inactive ingredient in the product.
If you are on opioids long term for conditions such as chronic fatigue and do not want to stop them, then you cannot take low dose naltrexone.

Possible side effect

Side effects with Low Dose Naltrexone are uncommon because the dose is so low and have been reported by less than 8% of people. Low dose naltrexone is unlikely to cause the same side effects as high dose naltrexone. Side effects of low dose naltrexone may include: Difficulty sleeping (insomnia); Nausea; Nightmares or wild dreams; Rarely, prolonged erections (priapism); Rarely, weight loss.

Drug interaction

Tell your healthcare provider if you take any opioid-containing medicines for pain, cough or colds, or diarrhea. If you are being treated for alcohol dependence but also use or are addicted to opioid-containing medicines or opioid street drugs, it is important that you tell your healthcare provider before starting naltrexone to avoid having sudden opioid withdrawal symptoms when you start treatment.

Missed dose

If you forget to take your tablet, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take a double dose to make up for a forgotten dose.

Overdose

If you take more naltrexone tablets than you should, tell your Doctor or Pharmacist or contact your nearest hospital emergency department immediately.

Storage

Store LDN tablets at 20° to 25°C. Keep away from children.