From Dr. Eugene Papantoniou, Pharm.D.
As a pharmacist, I have often found that many patients that are new to LDN (low dose naltrexone) therapy tend to have many questions about it. This isn’t surprising, given that LDN is not a mass-marketed medication and there is a lack of good, reliable information online available. The following is an FAQ for LDN therapy that I hope will help answer many common questions I receive about LDN.
What are the side effects of Low Dose Naltrexone (LDN)?
In general, most patients tend to have few, if any side effects when starting low dose naltrexone therapy. The most common side effect that can occur from LDN therapy is sleep interference. Some patients sleep better and more deeply, some have difficulty staying asleep. It seems to be a flip of the coin. From my experience, patients who experienced sleep difficulites or insomnia before starting LDN tend to sleep better after starting LDN therapy. I have not encountered a patient yet who had sleep issues, started LDN, and then had their sleep quality worsened.
I would say I tend to see about 5% of patients have either side effect. Most patients have no issues at all with their sleep while taking LDN. I recommend to patients that if LDN is causing them difficulty sleeping, to simply take their LDN in the morning vs at night. I firmly believe that they will still reap the benefits of LDN, without the sleep difficulties.
Is LDN expensive?
No – at Trinova Health, it is less than $1 per day. A one month supply is approximately $20 to $27.50 depending on the strength you are prescribed. We also offer discounts for 2 month and 3 month supplies to save you even more money!
Does my insurance cover it?
As a rule of thumb, the general answer is no. I always advise patients to check with their plan to see if their health plan provides coverage for compounded medications, but in general, many insurance plans do not cover compounded medications. There are cases when your insurance company may actually reimburse you after you purchase your prescription. The usual cost per month often ends up being less expensive than a typical monthly copay.
One good option for many patients using an FSA or HSA card to cover the prescription cost, as these are able to be used for compounded medications.
How long until I see results?
This is a tough question to answer. I have had patients report feeling better the next day after their first dose. I definitely do not think this is average, though. I would say that most patients tend to start seeing results 2-4 weeks after starting therapy. Keep in mind that this is just an average, simply because all patients are different. Some patients do take several months of low dose naltrexone therapy to see results, and I encourage patients not to be discouraged if they don’t notice anything right away.
Did LDN cause my _________ (insert side effect)
LDN can sometimes cause random or odd side effects. The best way to find out if LDN is causing a certain side effect you may be experiencing is to stop taking your dose for a few days, and see if the side effect goes away. Then, start taking your normal dose again and see if the side effect returns. If this occurs, it’s fair to say that the low dose naltrexone could be causing the side effect you are experiencing.
Why haven’t I heard about LDN before?
Because low dose naltrexone has never been mass produced by a pharmaceutical manufacturer, it has never been promoted, marketed or heavily advertised to doctors or patients. Generally, many doctors we speak with have never heard of LDN before, through no fault of their own. It is not taught to them in medical schools, and so many are unaware of it’s use. Because it has only ever been FDA approved in a high dose form (50mg), most physicians are only aware of the use of naltrexone for alcoholism.
Why did my doctor prescribe LDN to me?
We see patients take LDN for a pretty wide variety of conditions. The most common reason a patient is prescribed LDN is for an autoimmune condition. This could be something like Hashimoto’s, MS (Multiple Sclerosis), CFS (Chronic Fatigue Syndrome), or RA (Rheumatoid Arthritis). We have also seen low dose naltrexone prescribed for patients to potentially support weight loss efforts as well. It’s always important to ask your doctor why they are prescribing a particular medication to you.
What can LDN be prescribed for?
Among the many uses of LDN, it has been known to be prescribed and may be helpful for:
Ankylosing Spondylitis
Behcet’s Disease
Celiac Disease
Chronic Fatigue Syndrome
CREST syndrome
Crohn’s Disease
Dermatomyositis
Dystonia
Endometriosis
Fibromyalgia
Hashimoto’s Thyroiditis
Irritable Bowel Syndrome (IBS)
Myasthenia Gravis (MG)
Nephrotic Syndrome
Pemphigoid
Primary Biliary Cirrhosis
Psoriasis
Rheumatoid Arthritis
Sarcoidosis
Scleroderma
Sjogren’s Syndrome
Stiff Person Syndrome (SPS)
Systemic Lupus (SLE)
Ulcerative Colitis
Wegener’s Granulomatosis
HIV/AIDS
Depression
Various cancers
Does LDN help with chronic pain?
In my experience, I have spoken with many patients that use LDN daily to help manage their chronic pain. I believe that the increase in endorphins that occur due to LDN are responsible for helping to alleviate various pains that a patient may experience. I have never seen a patient who’s pain has become worse due to LDN – I have only ever heard of the opposite effect. Obviously, every patient is different and there is no medication that is effective in every individual that takes it.
Last updated March 16th, 2022
Disclaimer – Low Dose Naltrexone is not an FDA approved drug for any of the conditions listed above and has not been evaluated by the FDA for safety or efficacy concerning any of the above listed conditions. Naltrexone has been approved by the FDA for other indications, such as alcohol dependence . The above conditions are simply known example uses that have been described in the medical literature and/or my personal experience as a pharmacist in speaking with patients. You should always speak directly with your physician before taking any drug.
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