What is low-dose naltrexone?
Low-dose naltrexone is the use of naltrexone at roughly one-tenth or less of its standard dose — typically 1.5 to 4.5 mg, compared with the 50 mg used for opioid and alcohol dependence. At these low doses it is thought to act differently, briefly blocking opioid receptors so the body increases its own endorphin production, with additional effects on inflammatory signalling. Every use of LDN is off-label, and it must be compounded since it is not commercially available at these doses.
How the low dose differs
At 50 mg, naltrexone blocks opioid receptors continuously — that is the intended effect for treating dependence. At 1.5 to 4.5 mg taken at night, the block is brief and partial, and the working theory is that the body responds by upregulating its own endorphins and receptor sensitivity.
The proposed anti-inflammatory effect involves modulating glial cells in the nervous system, which is the rationale behind its use in chronic pain and some autoimmune conditions.
Why it has to be compounded
Naltrexone is manufactured commercially as 50 mg tablets. Doses in the low-dose range are not produced commercially, so LDN is prepared by a compounding pharmacy — usually as a capsule or liquid, which also makes gradual dose titration straightforward.
It is generally taken at night, and starting low and increasing slowly is common practice because vivid dreams and sleep disturbance are the most frequent early effects.
What off-label means here
Naltrexone is FDA-approved for opioid and alcohol dependence. It is not FDA-approved for any of the conditions LDN is prescribed for, so all such use is off-label. Off-label prescribing is legal and common, but it does mean the evidence for any given condition should be discussed specifically.
Research interest is genuine and growing, and evidence is stronger for some conditions than others — but for most uses it remains preliminary rather than established.
More about Low-Dose Naltrexone Therapy
Find out whether LDN fits your situation
Book a consultation with our Folsom naturopathic team to discuss your history and whether low-dose naltrexone is worth considering.
Bring recent lab work if you have it — we’ll review it with you.
Medical disclaimer: The information on this page is for general education and is not medical advice, diagnosis, or treatment. Low-dose naltrexone is used off-label for all of the conditions it is prescribed for, and evidence for most uses is still developing. Naltrexone blocks opioid receptors and can interact dangerously with opioid medications — always inform every healthcare provider you see that you are taking it. Whether LDN is appropriate for you can only be determined by a licensed provider familiar with your full medical history.