Conditions where LDN may be considered
Low dose naltrexone (LDN) is prescribed off-label. Here are the areas where providers most often consider it, and how strong the evidence is today.
Naltrexone is FDA approved at 50 mg for alcohol and opioid dependence. At much lower doses, typically 0.5 to 4.5 mg, it is being studied for effects on pain signaling and immune and inflammatory pathways. None of the uses below are FDA approved, and most of the research is early: small randomized trials, open-label studies and case reports. Your provider decides whether LDN fits your care.
Chronic pain conditions
- Fibromyalgia
- Complex regional pain syndrome (CRPS)
- Other chronic pain conditions
Evidence: small randomized trials with mixed results, plus case series.
Inflammatory bowel disease
- Crohn's disease
- Ulcerative colitis
Evidence: small randomized and open-label studies; systematic reviews rate the evidence as limited.
Multiple sclerosis
- Quality of life and fatigue in MS
Evidence: small trials and observational data with mixed results. LDN is not a substitute for disease-modifying therapy.
Fatigue syndromes
- Myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS)
- Post-COVID conditions (long COVID)
Evidence: observational studies and case series; randomized trials are under way.
Inflammatory skin conditions
- Hailey-Hailey disease
- Lichen planopilaris
- Psoriasis and other inflammatory dermatoses
Evidence: case reports and case series.
Pelvic and vulvar pain
- Vulvodynia
- Interstitial cystitis / bladder pain
Evidence: case series and retrospective reviews.
Selected references
- Toljan K, Vrooman B. Low-dose naltrexone (LDN): review of therapeutic utilization. Med Sci (Basel). 2018;6(4):82. doi:10.3390/medsci6040082
- Younger J, Parkitny L, McLain D. The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clin Rheumatol. 2014;33(4):451-459. PMC3962576
- Parkitny L, Younger J. Reduced pro-inflammatory cytokines after eight weeks of low-dose naltrexone for fibromyalgia. Biomedicines. 2017;5(2):16. doi:10.3390/biomedicines5020016
- Parker CE, et al. Low dose naltrexone for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2018. doi:10.1002/14651858.CD010410.pub3
- Smith JP, et al. Low-dose naltrexone therapy improves active Crohn's disease. Am J Gastroenterol. 2007;102(4):820-828.
- Gironi M, et al. A pilot trial of low-dose naltrexone in primary progressive multiple sclerosis. Mult Scler. 2008;14(8):1076-1083.
- Lee B, Elston DM. The uses of naltrexone in dermatologic conditions. J Am Acad Dermatol. 2019;80(6):1746-1752.
- Jasans-Barceló M, et al. Improvement of Hailey-Hailey disease with low-dose naltrexone. Br J Dermatol. 2020. doi:10.1111/bjd.18861
- Bridgman AC, et al. Treatment of psoriasis vulgaris using low-dose naltrexone. JAAD Case Rep. 2018;4(8):827-829.
Learn more: The LDN Research Trust, a registered charity, offers patient guides and research summaries. EpitomeRx is not affiliated with the LDN Research Trust. ldnresearchtrust.org ↗
How LDN is prepared
Because naltrexone is manufactured as 50 mg tablets, low strengths are compounded. We prepare LDN as capsules, oral liquid or topical cream in the strength your provider prescribes, including titration schedules that start low and increase gradually.
Common side effects reported early in treatment include vivid dreams and trouble sleeping. Do not take LDN with opioid medications unless your provider directs you to.
For prescribers
Call to talk through a starting dose, titration schedule or dosage form. Our order form includes a titration section.
This page is educational and is not medical advice. Compounded medications are not FDA approved. The uses listed are off-label and are described to reflect the published research, not to recommend treatment.
Have questions about personalized compounding?
Call our pharmacist to talk through your prescription, pricing and options.