LDN — Low Dose Naltrexone Patient Guide walkthrough.
Low Dose Naltrexone (LDN) is compounded naltrexone used at doses far below those used for addiction treatment (typically 1.5-4.5 mg vs. 50 mg). It is prescribed off-label for autoimmune conditions, fibromyalgia, chronic pain, and inflammatory disorders. This guide covers how to take it and what to expect.
Step by step.
- 01
Take at bedtime
LDN is almost always prescribed to be taken at bedtime (between 9 PM and midnight). This timing aligns with the body's natural endorphin production rhythm and is important for its proposed mechanism of action.
- 02
Start low, titrate slowly
Many protocols start at 1.5 mg and increase by 1.5 mg every 2-4 weeks up to a target of 3-4.5 mg. Your prescriber will specify your titration schedule. Do not increase the dose faster than instructed.
- 03
Expect mild early side effects
Vivid dreams and mild sleep disruption in the first 1-2 weeks are common and typically resolve. If significant sleep disruption persists beyond 2 weeks, contact your provider — a dose adjustment may help.
- 04
Avoid opioid medications
LDN temporarily blocks opioid receptors. Do not take opioid pain medications (hydrocodone, oxycodone, tramadol, codeine, etc.) within 4-6 hours of your LDN dose. If you require opioids for a procedure or acute pain, skip your LDN dose that day and notify your prescriber.
- 05
Store correctly
Compounded LDN capsules are stored at room temperature. Liquid formulations should be refrigerated. Keep away from moisture and light.
Notes
- Timeline for benefit: LDN often requires 3-6 months of consistent use before full benefit is apparent. Do not discontinue early without consulting your provider.
- LDN is an off-label use of naltrexone — evidence is emerging and varies by condition. Follow your prescriber's instructions and attend follow-up appointments to assess response.
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