What is the treatment duration for low-dose Naltrexone (Naltrexone) for Post-Acute COVID-19 Syndrome (Long COVID)?

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Last updated: April 14, 2025View editorial policy

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From the Guidelines

The optimal treatment duration for low dose naltrexone (LDN) in Long COVID is at least 6-12 months, as this allows for adequate assessment of its effectiveness in reducing neuroinflammation and improving symptoms. According to the study published in Nature Reviews Microbiology 1, low-dose naltrexone has shown promise in treating long COVID, particularly in addressing neuroinflammation. The treatment approach for long COVID often involves a combination of pharmacological and non-pharmacological options, and LDN is one of the strategies that have been effective for subsets of populations.

Some key points to consider when using LDN for Long COVID include:

  • Starting with a low dose of 1.5mg daily and gradually increasing to 4.5mg daily as tolerated
  • Taking the medication at bedtime to minimize potential side effects
  • Continuing treatment for extended periods, as symptoms may return upon discontinuation
  • Monitoring for common side effects, such as vivid dreams, sleep disturbances, and headaches, which typically resolve within the first two weeks

It is essential to note that LDN requires a prescription and must be obtained from a compounding pharmacy, and regular follow-up with a healthcare provider is necessary to monitor effectiveness and adjust treatment as needed. The study 1 highlights the importance of developing and validating biomarkers for long COVID, which will not only aid in diagnosis but also in objectively defining treatment responses, including the use of LDN.

From the Research

Treatment Duration for Low Dose Naltrexone in Long COVID

  • The treatment duration for low dose naltrexone in Long COVID varies across studies, with some studies assessing treatment outcomes over a period of 12 weeks 2 or 2 months 3.
  • In one study, participants were prescribed 2 months of low-dose naltrexone, with a dose of 1 mg in the first month and 2 mg in the second month 3.
  • Another study found that treatment with low-dose naltrexone for 12 weeks resulted in significant improvements in fatigue symptoms and quality of life in patients with persistent moderate/severe fatigue after COVID-19 2.
  • A upcoming randomized controlled trial plans to assess the efficacy of low-dose naltrexone over a period of 16 weeks, with assessments at baseline, 6,12, and 16 weeks 4.

Key Findings

  • Low-dose naltrexone has been shown to be safe and potentially beneficial in improving symptoms and quality of life in patients with Long COVID 2, 3.
  • The optimal treatment duration for low-dose naltrexone in Long COVID is not yet established and may require further research to determine 2, 3, 4.

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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