Adverse events reported in clinical studies - temporary insomnia and vivid dreaming in some patients.
Cautionary warnings - according to lowdosenaltrexone.org, special precautions are required if any of the following situations apply:
- If you use opioid agonists, do not take LDN until such medicine is completely out of your system. i.e. narcotic medications such as Ultram (tramadol), morphine, Percocet, Duragesic patch or codeine-containing medication;
- Patients taking thyroid hormone replacement for a diagnosis of Hashimoto's thyroiditis with hypothyroidism need to begin LDN at the very lowest range (1.5mg for an adult). As LDN may lead to a prompt decrease in the autoimmune disorder, which then may require a rapid reduction in the dose of thyroid hormone replacement in order to avoid symptoms of hyperthyroidism.
- People who have received organ transplants. These people are taking immunosuppressive medication on a permanent basis and are cautioned against the use of LDN because it may act to counter the effect of those medications.
LDN should be obtained by prescription - i.e. under medical approval if deemed appropriate; although it can also be obtained OTC cheaply, but admittedly with questionable reliability (E.g. <$50/mth at 4.5mg/day). If purchased in 50mg tablets, they can be ground up and repackaged as 4.5 mg capsules or made into 4.5 mg liquid doses at home
LDN is available as:
• Liquid
• Capsules
• Sublingual drops
• Topical cream
Ideally obtain LDN from a reliable pharmacy - a list of such is given at lowdosenaltrexone.org
• LDN capsules should not contain calcium carbonate as a filler -since it has been found to interfere with absorption of LDN capsule
• DO NOT get LDN in slow-release form
Dose - therapeutic range is 1.5 mg - 4.5 mg every night. Lower doses have no effect and higher doses likely block endorphins for too long, interfering with effectiveness
• Usual adult dosage is 4.5mg taken once daily at night - to avoid interfering with rhythms of the body's production of master hormones, LDN is best taken between 9pm and 3am. Most patients take it at bedtime.
• Exceptions include:
• With multiple sclerosis that has led to muscle spasms - use only 3mg daily and maintain that dosage
• For those with Hashimoto's thyroiditis with hypothyroidism who are taking thyroid hormone replacement medication - please read about intial dosage of LDN in Cautionary Warnings above.
• For Cancer - do not take LDN the week before and the week after cancer chemotherapy (this does not include the drug tamoxifen or daily medications for prostate cancer).
See lowdosenaltrexone.org for more details
• LDN Research Trust (in UK) suggests that one should gradually build up to the therapeutic dose over a period of weeks - until you are stable /side effect free. The starting dose can vary from 0.5mg to 1.5mg - and is usually increased over 4 - 8 weeks to 4.5mg.
• For Autoimmune Diseases - normally start at 1mg and increase to 4.5mg daily over a period of 4 weeks.
• For Hashimotos, Chronic Fatigue Syndrome, Fibromyalgia or cancer - usually start with 0.5mg and increase by 0.5mg a week until 4.5mgis reached.
www.dustysplace.org/docs/nax.pdf
