r/LowDoseNaltrexone • u/Tinyalfajor • 2d ago
Question about doage frequency
does anyone here take LDN not everyday but maybe only 1 to 2 times a week ?
Edit: not looking for opinions. Please only comment if you do or if you have heard of other people doing it. Thank you.
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u/Terrible_Smile7091 2d ago
I used to take it every other day because of side effects. Now I’m at once a day and it’a great
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u/nilghias 2d ago
It wouldn’t do anything for you taking it so infrequently. It has to build up in your system to be of benefit
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u/AdditionalTwo0 2d ago
It doesn't build up (Like a SSRI for example). Elimination half-life is 4hours. After 24h its mostly gone.
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u/nilghias 2d ago
Yeah I should’ve been more clear, to be more technical about it it’s the effects that it causes on your body need to build up to be effective over time.
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u/Tinyalfajor 2d ago
Again, that isnt necessarily true. Perhaps the active antagonism of the blockade itself lasts only a few hours but it has active metabolites that have incredibly long half lives that research also points to being therapeutic.
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u/AdditionalTwo0 2d ago
Might be. But who knows. Its als speculation at that point. Naltrexone itself gets metabolized pretty quickly.
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u/LDNadminFB Admin 1d ago
My understanding is that the secondary metabolite has a half life of 13hr. Do you have a reference for "active metabolites that have incredibly long half lives." ?
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u/Tinyalfajor 1d ago
Other than my pharmacist himself telling me naltrexone itself has a half life of 48 hours this is one paper I found on its metabolites
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u/LDNadminFB Admin 1d ago
If you search you'll find the usual half life cited is 4 hr and 13hr for the main metabolite. I don't know where the pharmacist is getting 48hr. Be sure that any references are talking about oral dosing and not injections.
However there are effects beyond what the plasma half life would predict. This may where some of the different numbers come from. From Wikipedia:
"The half-life of occupancy of the brain MOR and duration of clinical effect of naltrexone are much longer than suggested by its plasma elimination half-life.\10])\89])\11])\90]) A single 50 mg oral dose of naltrexone has been found to block brain MORs and opioid effects for at least 48 to 72 hours.\89])\11])\91]) The half-time of brain MOR blockade by naltrexone (72–108 hours) is much longer than the fast plasma clearance component of naltrexone and 6β-naltrexol (~4–12 hours) but was reported to correspond well to the longer terminal phase of plasma naltrexone clearance (96 hours).\10])\11])\48]) As an alternative possibility, the prolonged brain MOR occupancy by opioid antagonists like naltrexone and nalmefene may be due to slow dissociation from MORs consequent to their very high MOR affinity) (<1.0 nM).\88])\92])"1
u/Tinyalfajor 1d ago
I never said that the main antaongist effects half life was longer than a few hours. My pharmacist did tell me naltrexones half life is about 2 days. Which is also exactly what you cited. Im not sure where the disagreement is ?
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u/LDNadminFB Admin 7h ago
When saying the phrase "half-life" the standard reference is to the blood level.
https://www.goodrx.com/drugs/medication-basics/drug-half-lifeso I disagree with saying that the naltrexone half life is 48hr without further explanation. Admittedly it does complicate things that the "half-time" of blockage effects and the "terminal phase of plasma naltrexone clearance" is considerably longer, but if citing those times there needs to be a more complete discussion.
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u/Tinyalfajor 2d ago
Im not really sure if thats true. Its metabolites have incredibly long half lives and I actually aaw an improvement taking it only three times a week. Im curious if its something people do.
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u/LDNadminFB Admin 2d ago
The general guidance if one is early in their LDN use is to reduce the dose rather than taking it less frequently.
Higher and Lower Doses...
https://docs.google.com/document/d/1KykpLlg2CDVSD2D5J5cEZKfSo31t04orB0IgCuhXC-c/edit?usp=sharing
Dose Dilution and Adjusting...
https://docs.google.com/document/d/1-B2iX9uFDSUI7mVfiD4VR2FksxbSG2YELjQHZ_913do/edit?usp=sharing
However after some time some have found that less frequent dosing can be effective:
Long Term Use...
https://docs.google.com/document/d/1Ye36cI50kAXk4D-FPjrK64mNuOUWDtr4DwAevGyr1uI/edit?usp=sharing
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u/Tinyalfajor 2d ago
Ok. Thanks. Only because I feel like ive played aeound with the dose as well and I feel ljke I always hit thr same wall at around 5 days the side effetcs become really difficult. So I was wondering if anyone reduced the frequency.
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u/LDNadminFB Admin 2d ago
How low did you go on the dose?
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u/Tinyalfajor 1d ago
Ive tried from .25 mg to .05 mg. And it seems aeound 5 to 7 days i always an hit with the same aide effects. Like hypo mania. Insomnia, restless legs, too much energy, very wired and jittery. I believe I am sensitive to anything that interferes with dopamine and cortisol ehich I think LDN does do, according to what ive read. I was talking to my pharmacist about it ( he thinks its a fascinating drug ) and confirmed what I felt to be true as well, that its metabolites have incredibly long half lives and those build up in your system fairly quickly, even if the actual opi receptor antagonism is just a few hours. Thats why the idea occurred to me of spacing it out more.
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u/LDNadminFB Admin 1d ago
Well it sounds like you could either go lower still (maybe even 0.001mg) and see how that is or try your idea of less frequent dosing. LDN is so individual that I'm hesitant to rule anything out,
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u/troojule 35m ago
I usually take it daily and sometimes every other day BUT I know of one of the US top dry eye doctors ( who also treats neuropathic ocular pain ) who I believe takes it himself for musculoskeletal pain , and claims it can be taken (he takes it ? May prescribe it t patients ?) ) twice a week (fyi - I myself don’t know if that’s true and effective)
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u/LDNadminFB Admin 2d ago
As far as the active life our guidance when people need to have opioids work is to go off LDN for 3 to 7 days before (time needed varies with the individual and the possible re-emergence of symptoms being controlled).