Ultra Low Dose

Many of you have heard of Low Dose Naltrexone (LDN) and the multitude of the conditions that it can be beneficial for. Some of you may not have heard about the benefits of ULTRA Low Dose Naltrexone. We are talking about 2 mcg to 25 mcg dosage forms that can be very helpful for a specific subset of population. We use this therapy on patients who have developed tolerance to the opiates and are on escalating doses of narcotics without sufficient pain control or on patients who are stable on a specific dose, but would like to have the opiate dose reduced. This compound is actually harder to make because of the 2 step process involved in first making a triturate then being able to weight a measurable amount of naltrexone to make the capsules.

The studies and the personal experience have shown that we can reduce the dosages of opiates from 20-40% on most patients once the therapy is initiated. Give a patient about 5-7 days on the once at bedtime dosing before attempting to reduce opiate dose. The mechanism of action is attributed to the naltrexone binding to the opiate receptors and preventing the downregulation of the receptors, thus making more receptors available for the opiates floating around in the blood. We successfully use this therapy in our pharmacy for Hospice patients and pain management clinics to achieve better pain control with fewer narcotics. Keep in mind that LDN at 2mg-4.5mg will block enough opiate receptors to put patients in withdrawal, but 2mcg will not.