What to Avoid When Taking Low Dose Naltrexone

Introduction: What to Avoid When Taking Low Dose Naltrexone

Low dose naltrexone (LDN) is a medication that has been used to treat alcohol dependence and opioid use disorder for more than 30 years. More recently, researchers found low doses of naltrexone—about 1/30th the standard dose—may be useful for other conditions such as fibromyalgia and chronic fatigue syndrome.

LDN works by blocking the effects of opioid pain relievers and alcohol, as well as modulating the immune system, reducing inflammation, and increasing endorphins. LDN may help relieve pain, fatigue, sleep disturbance, cognitive impairment, depression, and other symptoms associated with these conditions.

However, LDN is not approved by the FDA for these uses and is considered an off-label, experimental treatment. Therefore, it is important to be aware of the potential risks and benefits of LDN therapy and what to avoid when taking it.

What to Avoid When Taking Low Dose Naltrexone in 2023

If you are considering taking LDN for fibromyalgia, chronic fatigue syndrome, or any other condition, you should consult with your doctor first and follow their instructions carefully. You should also avoid the following things when taking LDN:

Opioid pain relievers: LDN blocks the effects of opioids and can cause withdrawal symptoms if you take them simultaneously. You should not use any opioid pain relievers such as codeine, morphine, oxycodone, hydrocodone, tramadol, or fentanyl while on LDN therapy. You should also avoid over-the-counter medications that contain opioids such as cough syrups or cold remedies. If you need pain relief, you can use non-opioid analgesics such as acetaminophen, ibuprofen, or naproxen.

Alcohol: LDN also blocks the effects of alcohol and can reduce your tolerance to it. You should not drink alcohol while on LDN therapy as it can increase your risk of liver damage, intoxication, or overdose. If you do drink alcohol, you should limit your intake to no more than one drink per day for women and two drinks per day for men.

Immunosuppressants: LDN may boost your immune system and interfere with the action of immunosuppressant drugs such as corticosteroids, cyclosporine, azathioprine, or methotrexate. These drugs are used to treat autoimmune diseases such as rheumatoid arthritis, lupus, Crohn’s disease, or multiple sclerosis. If you are taking any immunosuppressant drugs, you should talk to your doctor before starting LDN therapy as you may need to adjust your dosage or monitor your blood levels more closely.

Anticoagulants: LDN may affect your blood clotting and interact with anticoagulant drugs such as warfarin, heparin, or dabigatran. These drugs are used to prevent or treat blood clots in conditions such as atrial fibrillation, deep vein thrombosis, or pulmonary embolism. If you are taking any anticoagulant drugs, you should talk to your doctor before starting LDN therapy as you may need to check your INR (international normalized ratio) more frequently or change your dosage.

Other medications: LDN may interact with other medicines that affect your central nervous system such as antidepressants, antipsychotics, anticonvulsants, sedatives, or stimulants. These medications treat various mental health conditions such as depression, anxiety, bipolar disorder, schizophrenia, epilepsy, insomnia, or ADHD. If you are taking any of these medications, you should talk to your doctor before starting LDN therapy as you may need to monitor your mood, behavior, or seizures more closely or adjust your dosage.

What to Expect When Taking LDN

LDN is usually taken once a day at bedtime in a dose of 4.5 mg or within a couple of milligrams of that value. The dose may vary depending on your condition, weight, age, and response to treatment. You should start with a low dose and gradually increase it until you reach your optimal dose.

LDN may take several weeks or months to show its full effects. You should not stop taking LDN abruptly as it may cause withdrawal symptoms such as nausea, vomiting, diarrhea, headache, anxiety, or insomnia. You should taper off LDN slowly under your doctor’s supervision.

LDN is generally well tolerated and has minimal side effects. Some common side effects include:

  • Vivid dreams or nightmares
  • Insomnia or difficulty falling asleep
  • Headache or dizziness
  • Nausea or stomach upset
  • Fatigue or drowsiness
  • Mood changes or irritability

These side effects are usually mild and temporary and tend to subside as your body adjusts to LDN. You can reduce the risk of side effects by taking LDN with food, drinking plenty of water, and avoiding caffeine, nicotine, or other stimulants.

LDN is a promising treatment for fibromyalgia, chronic fatigue syndrome, and potentially other conditions. However, it is not a cure-all and it may not work for everyone. You should weigh the pros and cons of LDN therapy and discuss them with your doctor before starting it. You should also follow your doctor’s instructions carefully and avoid anything that may interfere with LDN’s effectiveness or safety. By doing so, you can maximize the benefits of LDN and minimize the risks.


(1) What is low dose naltrexone (LDN)? – Drugs.com.
(2) Low-Dose Naltrexone: Uses, Side Effects, Interactions – Verywell Health.
(3) Low-dose naltrexone – Wikipedia.


Can I drink alcohol while taking low-dose naltrexone (LDN)?

It is generally advised to avoid consuming alcohol while taking low-dose naltrexone (LDN). Naltrexone can increase sensitivity to alcohol, and combining the two can potentially lead to adverse effects or reduce the effectiveness of LDN.

Are there any specific medications that should be avoided when taking low-dose naltrexone?

Low-dose naltrexone can interact with certain medications, so it’s important to consult with your healthcare provider. Medications such as opioid painkillers or cough suppressants may be less effective when combined with LDN. Additionally, drugs that affect the immune system or have immunosuppressive properties may interact with LDN.

Should I avoid taking opioids while on low-dose naltrexone?

Low-dose naltrexone (LDN) can interfere with the effects of opioids. It is generally recommended to avoid using opioids or opioid-containing medications while taking LDN, as it may diminish their effectiveness for pain relief.

Can I take other immune-modulating medications with low-dose naltrexone?

The use of other immune-modulating medications should be discussed with a healthcare professional. Depending on the specific medication, there may be potential interactions or conflicting effects with low-dose naltrexone. It is important to consult with your doctor to determine the most appropriate treatment plan.

Are there any dietary restrictions when taking low-dose naltrexone?

There are typically no specific dietary restrictions associated with low-dose naltrexone (LDN). However, it’s always advisable to follow a balanced and healthy diet to support overall well-being.

Is there anything else I should avoid while on low-dose naltrexone?

Avoid abrupt discontinuation of LDN without medical supervision. It’s essential to follow your healthcare provider’s instructions and not make any dosage adjustments or stop the medication without their guidance.