For most patients, a starting titration rx would be:
Rx: Naltrexone 1.5 mg #63 & Naltrexone 0.5 mg, quantity #42
SIG: Take 1 (1.5 mg capsule) orally daily prior to bedtime, increasing by 0.5 mgweekly (every 7 days) until a dose between 3 mg to 4.5 mg is achieved
Once dose of 3 mg – 4.5 mg/day is achieved, next rx can be written as:
Rx: Naltrexone __mg capsules, quantity, typically choose #30__ #60__ or #90__ Other__
SIG: Take 1 capsule daily as maintenance therapy
If a lower starting dose is desired, the rx can be written as:
Rx: Naltrexone 0.5 mg #___ (#100-300 is suggested)
SIG: Take 1 capsule (0.5 mg) daily prior to bedtime and increase each week by 1 capsule (0.5 mg) until an effective dose is reached. (Typically a dose between 3 mg to 4.5 mg)
Once dose of 3 mg – 4.5 mg/day is achieved, next rx can be written as:
Rx: Naltrexone __mg capsules
SIG: Take one capsule daily as maintenance therapy. (#30, #60, or #90 is typical).
Patients with Hashimoto’s and Graves’ disease: Patients should be monitored for symptoms of fast pulse, palpitations, or sudden onset of insomnia. If any of these occur, thyroid adjustment may be needed.
Contact PD Labs and talk to our Texas Low Dose Naltrexone (LDN) Experts TODAY!
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It really does take an experienced pharmacist and experienced physician working together to get to the sweet spot with dosing for the specific condition. It’s not as simple as starting a titration at 1.5mg and then going all the way to 4.5. We have seen situations where the patient gets full pain relief at 3mg and must stop, but if they keep going, they will lose the results.
This is the dosing that most physicians are aware of, however, over the past couple of years, the dosing has been greatly expanded. Many physicians are not aware that when we have patients on chronic opioid therapy we will sometimes start the dose as low as 0.001mg (1mcg) and have witnessed chronic pain patients receive relief on doses as low as 0.002mg (2mcg) daily. We have also seen where someone will titrate up too quickly for their body and miss the positive results. Depending on the disease, we may want to start much lower.  And…when dealing with opioids, it is critical to work with a pharmacy such as PD Labs who has experience with titration protocols for both ultra-low dose naltrexone and very low dose naltrexone. PD Labs works with some of the most experienced pain physicians out there and we are currently working on partnering with them for various clinical trials; this is very exciting.
We have worked with doctors to look at what the patient is on and we help slowly wean off the opioid while starting with either very low dose naltrexone or ultra-low dose naltrexone (microgram dosing). Then, we help slowly add-back LDN into a customized LDN titration and then offer suggestions to complement this therapy depending on the situation. Many practitioners are not aware of these new dosing protocols and PD Labs is able to educate them on these protocols and assist them with their patients.
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PD Labs works with the most prestigious providers. We work with you and health providers/specialists to formulate the most customized medication regimens to fit your specific needs. Medication is not one-size-fits-all, our compounding specialists use precise compounding techniques & equipment to get you the best solution.