Prescribing
Licensed to be prescribed on the NHS for management of opioid dependence when recommended by a specialist
Unlicensed for for all other conditions - so prescribed privately
Dosing
Initiation
Rx Naltrexone hydrochloride liquid 5mg/5ml x 100ml
1ml daily for 14 days then 1.5mls daily for 14 days and keep increasing by 0.5mls until 3mg and then review with prescriber
Maintenance
3mg - 4.5mg caps daily
Minimum maintenance dose 3mg daily, maximum maintenance dose 4.5mg daily
Prescribing for Cancer
1.5mg daily for 7 days increasing by 1.5mg weekly until on 4.5mg for 7 days. Once stable on dose of 4.5mg for 7 days - start alternating 3 days on 3 days off if indicated.
Children (unlicensed)
Children under 40kg 0.1mg / kg start at 0.1mg and increase over a period of 4 weeks to calculated dose. Children >40kg—treat as adult.
Formulations
LDN is most commonly administered in liquid form, taken by an oral medicine syringe.
LDN is also available as a capsule at 3mg and 4.5mg doses or as sublingual drops, which are a higher dose to liquid LDN and are used by people who have trouble swallowing.
Why is it called Low Dose Naltrexone?
Naltrexone on its own has very little effect on the body. Typically, it is used to reverse the effects of poisoning by opiates such as morphine. The usual dose of naltrexone to treat opiate poisoning is 50mg. The daily dose of low dose naltrexone is 4mg for opioid dependence.
How does Naltrexone work?
As an opioid antagonist, naltrexone is thought to inhibit endorphins – the body’s natural painkiller. It is believed that by inhibiting endorphins, the body reacts by producing more. This increase in endorphins reduces pain and increases a sense of wellbeing. Once the LDN has been processed by the body, the elevated endorphins produced as a result can now act together with the receptors and assist in regulating cell growth and immunity.
Nalterxone for MS
LDN has been used in the USA to treat the symptoms of autoimmune conditions, such as multiple sclerosis (MS), since 1985. In the UK it is unlicensed in the treatment of MS, Crohn’s disease, fibromyalgia, chronic fatigue syndrome and Ulcerative Colitis as the evidence supporting its use is not robust. Different studies have come to conflicting conclusions. As of 2015 the UK NHS had concluded that it could not be recommended for treating the symptoms of multiple sclerosis due a lack of evidence.
Patient impact
According to the LDN Research Trust, the majority of people using LDN will have a positive impact on symptoms quite quickly after starting treatment. They also say that in less than 10% of people with MS that are treated, increased symptoms may be more severe or more prolonged than usual, lasting sometimes for several weeks. Rarely, symptoms may persist for two or three months before the appropriate beneficial response is achieved.
Side effects
Some of the common initial side effects from taking LDN are increased fatigue, sleep disturbance (if taken at night time) and increased spasticity however many people starting on LDN do not experience any side effects.
Click here for lots more information from LDN researchtrust
