Low Dose Naltrexone (LDN) Online Prescription (2026)
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Low dose naltrexone (LDN) is naltrexone prescribed at 1.5–4.5 mg/day, far below the 50 mg/day dose used for opioid and alcohol dependence. At these low doses, it acts as an immunomodulator rather than an opioid antagonist, and has accumulated a substantial off-label evidence base for autoimmune conditions, fibromyalgia, Crohn's disease, and multiple sclerosis (see the Smith et al. 2011 Crohn's RCT and Younger et al. 2013 fibromyalgia RCT). It is also used in combination with bupropion (Contrave, FDA-approved 2014) for weight management. Telehealth platforms can prescribe LDN after a brief online consultation.
At low doses (1.5–4.5 mg/day), naltrexone transiently blocks opioid receptors, triggering a rebound increase in endorphin production and modulating microglial activation in the central nervous system. This immunomodulatory effect is distinct from its mechanism at standard doses. LDN is compounded by 503A pharmacies, as no FDA-approved low-dose formulation exists. The Contrave combination (naltrexone 8 mg + bupropion 90 mg) is FDA-approved for chronic weight management.
Adults with autoimmune conditions (Crohn's, MS, lupus, fibromyalgia) seeking an adjunct therapy, or adults seeking weight management support via the Contrave (naltrexone/bupropion) combination. LDN is not appropriate for patients currently taking opioid medications.
LDN is typically started at 1.5 mg/day and titrated to 4.5 mg/day over 4–8 weeks. Initial side effects include vivid dreams and mild sleep disturbance (take in the morning to reduce this). Response for autoimmune conditions is typically assessed at 3 months. For weight management via Contrave, meaningful weight loss is typically seen at 12 weeks.
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What the Studies Actually Show
LDN is not FDA-approved for autoimmune or longevity indications. The evidence base is primarily small RCTs and observational studies. The figures below summarise key efficacy data.
| Endpoint | Finding |
|---|---|
| Crohn's disease remission (Smith et al., Am J Gastroenterol 2011)1 | 88% response rate and 33% remission rate vs 40% response / 8% remission for placebo (LDN 4.5 mg/day, n=40) |
| Fibromyalgia pain reduction (Younger et al., Pain Med 2013)2 | 30% reduction in pain scores vs placebo (LDN 4.5 mg/day, n=31, crossover RCT) |
| Weight management (Contrave FDA approval, 2014)3 | Naltrexone/bupropion (Contrave) produced 5.4% greater weight loss vs placebo at 56 weeks (n=4536) |
Frequently Asked Questions
Can I get low dose naltrexone online without an in-person visit?
Yes. Telehealth platforms can prescribe LDN after a brief online consultation. Because LDN is compounded (no FDA-approved low-dose formulation exists), it must be dispensed by a 503A compounding pharmacy.
How much does LDN cost online?
Compounded LDN typically costs $25–60/month through telehealth platforms, including the consultation fee. It is one of the most affordable off-label medications in the longevity and autoimmune space.
Is LDN safe?
LDN has a well-established safety profile at 1.5–4.5 mg/day. The most common side effects are vivid dreams and mild sleep disturbance, which typically resolve within 2–4 weeks. It is contraindicated in patients taking opioid medications.
What conditions does LDN treat?
LDN has off-label evidence for Crohn's disease, fibromyalgia, multiple sclerosis, lupus, and other autoimmune conditions. It is also used in combination with bupropion (Contrave) for weight management.
Can I take LDN if I'm on other medications?
LDN is contraindicated with opioid medications (it will precipitate withdrawal). It should be used with caution in patients on immunosuppressants. Always disclose all medications to your prescribing clinician.
- Smith JP et al.. Am J Gastroenterol 2011 · Smith JP et al. Low-dose naltrexone therapy improves active Crohn's disease. Am J Gastroenterol. 2011;106(10):1893-1900.
- Younger J et al.. Pain Med 2013 · Younger J et al. Low-dose naltrexone for the treatment of fibromyalgia. Pain Med. 2013;14(6):895-908.
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