From the Research
Low-dose naltrexone (LDN) may be considered as an adjunctive treatment for some patients with Systemic Lupus Erythematosus (SLE), although it is not an FDA-approved treatment for this condition, and its use should be based on the most recent and highest quality evidence available, such as the 2023 study on current treatment of SLE 1. The relationship between SLE and LDN is not well-established in the provided evidence, but LDN has been used off-label for various autoimmune conditions, including SLE.
- Typical LDN dosing ranges from 1.5 to 4.5 mg daily, usually taken at bedtime, with most patients starting at a lower dose (1.5 mg) and gradually increasing over several weeks to minimize side effects.
- For lupus specifically, LDN is considered an off-label, complementary approach that may help reduce inflammation and pain by modulating the immune system.
- It works by temporarily blocking opioid receptors, which may lead to increased endorphin production and reduced inflammatory cytokines.
- Common side effects include vivid dreams, sleep disturbances, and headaches, which often resolve within the first few weeks of treatment.
- LDN should be used under medical supervision and not as a replacement for conventional lupus treatments like hydroxychloroquine, corticosteroids, or immunosuppressants, as emphasized in the 2023 study on current treatment of SLE 1.
- The 2025 study on real-world treatment patterns and clinical characteristics in patients with moderate-to-severe SLE highlights the need for new treatment options for patients with SLE, and LDN may be considered as an adjunctive therapy in this context 2.
- However, the 2022 study on biological drugs for SLE or active lupus nephritis and rates of infectious complications suggests that immunotherapy, including biological drugs, may impose specific risks for infections, and LDN should be used with caution in patients with active LN or other infections 3.