What is the dosing for Low-Dose Naltrexone (LDN)?

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Last updated: February 8, 2025View editorial policy

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From the Guidelines

Low-Dose Naltrexone (LDN) dosing is typically started at 1.5 mg at bedtime and gradually increased to a maximum dose of 4.5 mg.

Key Points

  • The initial dose of LDN is 1.5 mg at bedtime 1
  • The dose can be increased bi-weekly by 1.5 mg until a maximum dose of 4.5 mg is reached 1
  • A common dosing range for LDN is 3-5 mg 1
  • A specific study used 4.5 mg of LDN and found significant decrease in pain and improved satisfaction with life in patients with fibromyalgia 1

Side Effects and Considerations

  • Common side effects of LDN include headache, tachycardia, and vivid dreams 1
  • LDN has been shown to be effective in treating various types of chronic neuropathic pain, including fibromyalgia, complex regional pain syndrome, low-back pain, and painful diabetic neuropathy 1

From the Research

Dosing for Low-Dose Naltrexone (LDN)

  • The daily dose of LDN is considered to be in the range of 1 to 5 mg 2
  • A dosing range between 1 μg and 1 mg is referred to as very low-dose naltrexone (VLDN) 2
  • Doses as low as 5.4 mg have been found to reduce pain in 95% of patients with fibromyalgia 3
  • Oral naltrexone in a dosage range from 1 mg to 4.5 mg is commonly used as LDN 4
  • The final daily dose of oral LDN has been reported to range from 0.8 to 9.0 mg, with the most common dose being 4.5 mg once daily 5

Key Findings

  • LDN has been shown to reduce glial inflammatory response and upregulate endogenous opioid signaling 2
  • LDN has been used to manage chronic pain, autoimmune disorders, and dermatologic conditions 4
  • LDN may have utility in improving mood disorders and enhancing quality of life 6
  • LDN is a relatively safe pharmacologic option that may benefit patients with chronic pain conditions 5

Dosage Variations

  • Ultra low-dose naltrexone/naloxone (ULDN) is used in a dosing range of less than 1 μg per day 2
  • Very low-dose naltrexone (VLDN) is used in a dosing range between 1 μg and 1 mg 2
  • LDN is typically used in a dosing range of 1 to 5 mg per day 2, 3, 4, 6, 5

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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