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Pioneering Naltrexone at Low Doses

As early as 1985, Bernard Bihari, MD, a New York physician, found that smaller doses of naltrexone (~3mg) influenced the immune system. He prescribed low doses naltrexone (LDN) at bedtime for HIV patients to enhance their immune response to HIV infection.  He found that LDN alone slowed disease progression. Additionally, as an add-on therapy to antiretroviral help, LDN accelerated immune system healing. Since that time, Dr. Bihari also used LDN to help cancer and autoimmune diseases with beneficial results.

Other practitioners have seen notable benefits with LDN in several disease states including: Crohn’s disease, irritable bowel syndrome, multiple sclerosis, systemic lupus erythematosus (SLE), fibromyalgia, rheumatoid arthritis and various other pain syndromes.

Formulation Matters

Since Dr. Bihari’s original discovery of LDN, a better understanding of dosing and medication preparation best practices have been identified. Typical adult therapeutic dosing ranges between 1.5mg to 4.5mg taken at bedtime. LDN must be prepared accurately at lower doses as an immediate release dosage form. Slow-release or timed-released formulations will not achieve the required “spike” in the bloodstream that is essential for LDN to have therapeutic results. Choice of filler is imperative as it should be hypoallergenic to avoid patient intolerances or interference with LDN absorption, as seen with calcium carbonate.

Pharmacy Specialists Compounding Pharmacy is able to prepare low dose naltrexone (LDN) and ultra-low dose naltrexone (ULDN) therapy for patients.

A very popular LDN dosage form created by Pharmacy Specialists is our scored LDN tablets. Formulated to contain no calcium carbonate or lactose and free of dyes, preservatives, gluten, and soy. This immediate release scored tablet allows for flexible dosing changes without the need for a new prescription. Additionally, these tablets can be dissolved in a patient’s preferred liquid of choice for easy oral administration.

Our pharmacy can prepare low dose naltrexone in liquid, cream, and sublingual forms in addition to our common capsules and tablets. While typically prescribed at doses of 1.5mg to 4.5mg, we can compound LDN in various strengths as required for patient tolerability and response.