Drugs To Avoid When Taking Low Dose Naltrexone
Currently, there is some controversy over what drugs are and are not compatible with Low Dose Naltrexone (LDN). In general, however, most authorities agree that LDN should not be taken concurrently with opioid-containing drugs, nor, ideally, with immunomodulator drugs, or with any drug that depends for its successful action on suppressing the immune system. For a discussion of chemotherapy and LDN, visit
Do not take Naltrexone with any of the following without first consulting your doctor:
• disulfiram (Antabuse®);
• thioridazine (Mellaril®);
• buprenorphine (Buprenex®, Subutrex®);
• codeine (Tylenol with Codeine®, and other brand names);
• hydrocodone (Lorcet®, Lortab®, Vicodin®, Vicoprofen®, and other brand names);
• hydromorphone (Dilaudid®);
• levorphanol (Levo-Dromoran®);
• meperidine (Demerol®);
• methadone (Dolophine®, Methadose®);
• morphine (Kadian®, MS Contin®, MSIR®, OMS®, Roxanol®, Oramorph SR®, and other brand names);
• oxycodone (M-Oxy®, OxyContin®, OxyIR®, Roxicodone®, Percocet®, Percodan®, and other brand names);
• oxymorphone (Numorphan®);
• propoxyphene (Darvon®, and other brand names).
Because LDN blocks opioid receptors throughout the body for three or four hours, people using medicine that is an opioid agonist, i.e., a narcotic (such as morphine, Percocet®, Duragesic Patch® or codeine-containing medication) should not take LDN until such medicine is completely out of one's system. Patients who have become dependant on daily use of narcotic-containing pain medication may require 10 days to 2 weeks of slowly weaning off of such drugs entirely (while first substituting full doses of non-narcotic pain medications) before being able to begin LDN safely.
In regard to the use steroids, chemotherapeutic agents, and other immunosuppressants to treat MS and other autoimmune diseases, Dr. M.R. Lawrence, an English physician with MS who treats his condition with LDN, has this to say:
Because LDN stimulates the immune system and many of the drugs routinely used by the NHS in the treatment of MS [and other autoimmune conditions] further suppress the immune system, LDN cannot be used in company with steroids, beta interferon, methotrexate, azathioprine or mitozantrone or any other immune suppressant drug. If there is any doubt, please submit [to your doctor] a full list of the drugs you are presently taking so that their compatibility may be assessed.
Dr. Lawrence has suggested a non-steroidal protocol for treating MS exacerbations. For more information, visit
Prednisone in daily doses for adults of 10 mg or less is not considered immunosuppressive.
To date, the only clinical trial of LDN that did not have any positive results whatsoever was conducted in Ohio in 2007 with a group of MS patients. The lead investigator explained the unfortunate outcome of the study as follows:
We did not exclude patients on existing immunosuppressants...The existing immunosuppressants may have inhibited the LDN effects in this population.
Another study of LDN in the treatment of MS was conducted in California. Here, too, the participants were allowed to take MS disease-modifying drugs concurrently with LDN. The only significant benefit shown was psychological. Not a single physical parameter was affected.
Of the various drugs currently approved to treat MS, only Copaxone is deemed compatible with LDN.
Painkillers approved for use with LDN include Moxxor, aspirin, Tylenol®, Advil®, Motrin®, Aleve®, Naprosyn®, Ansaid®, Dolobid®, Orudis®, Voltaren®, Feldene®, Mobic®, and the food supplement, DL-Phenylalanine (DLPA). DLPA, which is also said to enhance the effectiveness of LDN, should be taken twice a day on an empty stomach in doses of 500 mg. It should not, however, be used by people with high blood pressure, pregnant or
lactating women (breast feeding),
in cases of phenylketonuria (a rare medical condition), by patients taking MAOI’s (monamineoxidase inhibitor drugs for mental illness), and by children under the age of 14 years.
In regard to alcohol consumption concurrent with taking LDN, Dr. Skip Lenz, a Florida pharmacist, has this to say:
One of the uses of LDN is to help alcoholics get off the juice. You should never use alcohol and LDN at the same time. Now, there will be folks who say they always have had a drink with no problems; on the other side of the coin, I know of several dozen cases where the patient has had projectile vomiting.
Alcohol is also a neurotoxin, even in small amounts.
Drugs That May Interact With Low Dose Naltrexone - Generic Name (Brand Name*)
Mixed Opiate Agonists/Antagonists
Buprenorphine (Buprenex®, Suboxone®, Subutex®)
Butorphanol (Dorolex®, Stadol®)
Pentazocine (Naloxone®, Talwin®)
Dronabinol THC (Marinol®)
Fentanyl (Duragesic®, Aqtic®, Sublimaze®, Fentora®)
Hydrocodone (Lorcet®, Lortab®, Vicodin®)
Meperidine (Demerol®, Meperitab®)
Methadone (Dolophine®, Methodose®)
Morphine (Kadian®, MSContin®)
Oxycodone (Percocet®, Endocet®, Roxicodone®, Endocodone®)
Oxymorphone (Opana®, Numorphone®)
Propoxyphene (Darvocet®, Darvon®)
* May not include each brand name available on the market in the United States