Naltrexone Dosing for Chronic Pain Management

Introduction to Low-Dose Naltrexone

• Low-dose naltrexone (LDN) should be initiated at 1.5 mg at bedtime, with gradual increases of 1.5 mg every two weeks to a maximum of 4.5 mg at bedtime, for neuropathic pain conditions, as recommended by medical guidelines 1
• LDN (3-5 mg range) has demonstrated efficacy in fibromyalgia, complex regional pain syndrome, and painful diabetic neuropathy, with a mechanism involving antagonism of toll-like receptor 4, reducing pro-inflammatory cytokines and modulating microglial activity 1
• Common side effects of LDN include headache, tachycardia, and vivid dreams, which should be considered when prescribing this treatment 1