Low-Dose Naltrexone (LDN) Therapy

“Compounded low-dose naltrexone therapy from Koshland Pharm was critical to breaking a cycle of pain and inflammation for one of my patients.” – Justin Mager, MD

The opiate receptor blocker naltrexone, when given at low doses, has demonstrated an ability to increase endorphin levels; release specific growth factors; and downregulate immune cells responsible for activation of the immune system. Its effects have been studied in clinical trials related to autoimmune, dermatological, neurodegenerative, gastrointestinal, pain, and psychiatric conditions. This medication can be compounded into capsules (or creams or suspensions) of various low dose strengths by a compounding pharmacy. Patients can talk with their doctors to determine if low dose naltrexone therapy might be appropriate for them.

New research and clinical experience have led to updates in the best approach to identifying patients who could benefit from LDN and to finding the appropriate dose for those patients. Pharmacists at Koshland Pharm are experts in low-dose naltrexone therapy and work in collaboration with patients’ doctors to customize each individual treatment plan. Please call us at (415) 344-0600 with further questions.

Quality matters when it comes to compounded medications, including low-dose naltrexone therapy. Not all compounding pharmacies follow the same procedures or test their products equally. For example, at Koshland Pharm:

• We source our ingredients from PCCA, the wholesaler with the highest standards for quality control, performing over 14 checks and analyses on every batch it sends to pharmacies.
• We perform weight capture checks on all compounded capsules to ensure that each capsule has the same amount of medication as another.
• We send 10% of our compounded medications out monthly for testing to ensure accurate potency.

Note: To save on cost, some patients inquire about using the 50mg manufactured naltrexone tablets by dissolving them in water, and using a dropper to attain the small dose typically seen with LDN therapy.  We highly discourage this practice as it makes inaccurate dosing very likely.  For low-dose naltrexone therapy to be effective, the dose must be very precise (often to the 0.1mg).  Only by having the medication compounded can patients be sure that they are being dosed correctly and expect to have the highest chance of a positive clinical outcome.