Next Article in Journal
Ischemic Heart Disease during Acute Exacerbations of COPD
Previous Article in Journal
Evolution of Pretreatment Assessment and Direct Acting Antiviral Regimens in Accordance with Upgrading Guidelines: A Retrospective Study in HIV/HCV Coinfected Patients
Open AccessReview

Low-Dose Naltrexone (LDN)—Review of Therapeutic Utilization

by Karlo Toljan 1,* and Bruce Vrooman 2,3
1
Department of Pathophysiology, University of Zagreb School of Medicine, Kispaticeva 12, 10 000 Zagreb, Croatia
2
Section of Pain Medicine, Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH 03756, USA
3
Department of Anesthesiology, Geisel School of Medicine at Dartmouth, Hanover, NH 03756, USA
*
Author to whom correspondence should be addressed.
Med. Sci. 2018, 6(4), 82; https://doi.org/10.3390/medsci6040082
Received: 5 August 2018 / Revised: 16 September 2018 / Accepted: 18 September 2018 / Published: 21 September 2018
Naltrexone and naloxone are classical opioid antagonists. In substantially lower than standard doses, they exert different pharmacodynamics. Low-dose naltrexone (LDN), considered in a daily dose of 1 to 5 mg, has been shown to reduce glial inflammatory response by modulating Toll-like receptor 4 signaling in addition to systemically upregulating endogenous opioid signaling by transient opioid-receptor blockade. Clinical reports of LDN have demonstrated possible benefits in diseases such as fibromyalgia, Crohn’s disease, multiple sclerosis, complex-regional pain syndrome, Hailey-Hailey disease, and cancer. In a dosing range at less than 1 μg per day, oral naltrexone or intravenous naloxone potentiate opioid analgesia by acting on filamin A, a scaffolding protein involved in μ-opioid receptor signaling. This dose is termed ultra low-dose naltrexone/naloxone (ULDN). It has been of use in postoperative control of analgesia by reducing the need for the total amount of opioids following surgery, as well as ameliorating certain side-effects of opioid-related treatment. A dosing range between 1 μg and 1 mg comprises very low-dose naltrexone (VLDN), which has primarily been used as an experimental adjunct treatment for boosting tolerability of opioid-weaning methadone taper. In general, all of the low-dose features regarding naltrexone and naloxone have been only recently and still scarcely scientifically evaluated. This review aims to present an overview of the current knowledge on these topics and summarize the key findings published in peer-review sources. The existing potential of LDN, VLDN, and ULDN for various areas of biomedicine has still not been thoroughly and comprehensively addressed. View Full-Text
Keywords: naltrexone; naloxone; low-dose naltrexone; fibromyalgia; Crohn’s disease; pain; glia naltrexone; naloxone; low-dose naltrexone; fibromyalgia; Crohn’s disease; pain; glia
Show Figures

Graphical abstract

MDPI and ACS Style

Toljan, K.; Vrooman, B. Low-Dose Naltrexone (LDN)—Review of Therapeutic Utilization. Med. Sci. 2018, 6, 82.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Search more from Scilit
 
Search
Back to TopTop