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How does a drug that was developed to treat addiction have so many other benefits when taken at a much lower dose?

Naltrexone is a medication approved as a treatment for opioid addiction and alcoholism. In 1985, while working at addiction clinics in New York, Harvard-educated Bernard Bihari, MD, discovered many novel benefits of using low doses of naltrexone (about 4.5 mg, or 1/10th of the typical dose of 50 mg that is used to treat addiction).

Ongoing research has shown that Low Dose Naltrexone (LDN) has potential benefits for patients with problems such as:

  • Pain and Inflammation
  • Hashimoto’s Thyroiditis
  • Autism Spectrum Disorder
  • Allergies & Asthma
  • Chronic Pruritus
  • Mood Disorders
  • Lyme Disease
  • Multiple Sclerosis
  • Crohn’s and Ulcerative Colitis
  • Diabetic Neuropathy
  • Complex Regional Pain Syndrome (CRPS)
  • Chronic Fatigue & Fibromyalgia
  • Autoimmune Disorders


Cancer and LDN
Intermittent Dosing with LDN causes increased cell death and has been reported to increase cell sensitivity to chemotherapeutic agents. LDN should not be taken during treatment with PD-1 inhibitors, e.g. pembrolizumab (Keytruda®) and nivolumab (Opdivo®).

Side Effects/Cautions
LDN is well tolerated in most patients and side effects are usually transient. LDN should not be taken by patients taking opioids such as morphine, oxycodone, or hydrocodone. It is possible that even a low dose of naltrexone could cause blockade of opioid receptors and reduce the effectiveness of opioid analgesics or induce withdrawal symptoms.


Low Dose Naltrexone (LDN) is not commercially available but can be compounded by prescription.
We welcome your questions!

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References

Clin Rheumatol. 2014; 33(4): 451–459.


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