LDN Product Guide

Before you begin

This guide summarizes our official Low Dose Naltrexone protocol for your reference. It does not replace guidance from your provider, and clinical response to LDN varies and is not guaranteed. LDN is an oral capsule, so there is nothing to mix, measure or inject. You swallow your capsules once a day, at bedtime, and step up on a schedule. Always follow the specific dose your provider prescribed and the directions on your prescription label.

We provide LDN in capsule form with sucrose as the standard filler. If you are sensitive to a filler, a dye, or the capsule material itself, message your care team before your next refill rather than stopping on your own. Store your capsules at room temperature, 68 to 77°F, somewhere dry and out of direct sunlight. Keep them in the original labeled bottle so the strength stays with them, follow the storage line on your pharmacy label if it says anything different, and keep them out of reach of children.

You’re making a great choice

It is completely normal to feel a little uncertain before starting something new, especially a medication you will take every night. Here is what LDN may help with.

Immune balance

LDN is naltrexone prescribed off label at a fraction of the standard dose, and it may help support a more balanced immune response. Most people tolerate it well.

Less inflammation

LDN may help reduce the low-grade inflammation that can build quietly in the background over years, though the research in this area is still developing.

Everyday comfort

Some people report less day-to-day pain and fatigue as the weeks go on. Responses vary widely.

A slow build

Whatever LDN does, it tends to do quietly, so many people notice that early changes are subtle rather than dramatic and that anything they do notice builds slowly with consistent nightly use.

Results vary from person to person, and most reported benefits build gradually rather than arriving in the first week. The key is consistency at a dose you tolerate. If you have been steady at your target dose for a few months and genuinely notice nothing, that is worth a conversation with your care team rather than a quiet stop.

Read first: safety

LDN is well tolerated by most people, but a few situations mean you should pause and check in. Keep this short list in mind every time.

Stop and seek help if you experience:

Signs of opioid withdrawal, such as agitation, sweating, cramping, nausea or vomiting, after taking LDN alongside any opioid or narcotic pain medication.
Heart racing, increased anxiety, restlessness or trouble sleeping while you are on thyroid medication. These can be symptoms of hyperthyroidism. Stop LDN and talk to the provider who prescribes your thyroid medication.
Any side effect that is more than mild, or that is not settling after the first week. More troubling side effects usually point to a deeper health issue that should be addressed by a functional medicine provider before you resume LDN.

If symptoms are severe, call emergency services (911). For milder but persistent concerns, contact your care team before your next dose.

This is normal

When starting LDN you may experience mild to moderate vivid dreams, mild anxiety, trouble sleeping or a headache during the first 3 to 5 days. These typically diminish on their own as the body adjusts to the medication, usually by the fifth day.

Daily target

↑4.5 mg

The top of our standard protocol is 4.5 mg once nightly, taken as three 1.5 mg capsules together. Doses below 10 mg a day are what “low dose” naltrexone means, and 4.5 mg is the most commonly used. Never take more than the dose on your prescription label. AgelessRx does not offer higher than 4.5 mg.

About your shipment

Check the strength on your label first

Before your first capsule, read the pharmacy label. It names the strength of each capsule, 0.5 mg or 1.5 mg, and how many capsules make up your nightly dose. People are often surprised to find three small capsules where they expected one larger one. That is simply how a 4.5 mg dose is dispensed. If the strength on the label does not match the protocol you signed up for, message your care team before you start rather than adjusting the count yourself.

Storing your capsules

Keep your capsules at room temperature, 68 to 77°F, in a dry place rather than a bathroom cabinet, and out of direct sunlight. There is nothing to refrigerate. Keep them in the original labeled bottle and out of reach of children, and if the storage line printed on your pharmacy label says anything different, follow the label. The expiry date to go by is the one your pharmacy printed on that label.

Working out how long a bottle lasts

Your supply divides by the number of capsules you take each night, not by the number of nights. On the standard protocol that is one capsule a night for ten nights, two a night for the next ten, then three a night ongoing, so a bottle empties faster once you reach your target dose. If you have built up more supply than you need, message your care team to move your refill date or change your quantity.

Dosing

There are two things to keep in mind as you get started: how many capsules you take each night, and the strength of each capsule. Start low and increase gradually, so the body has time to adjust and side effects are more likely to stay mild. Always follow the specific dose your provider prescribed.

Finding your dose

Our standard protocol steps up on a fixed schedule. Move to the next step only if the one before it felt comfortable.

Step	Dose each night	When to move up
Days 1 to 10	1x capsule (1.5 mg)	Your first ten nights. Take it at bedtime and hold here.
Day 11 to 21	2x capsules (3 mg)	After ten nights, if you are tolerating the first step.
Day 22 onward	3x capsules (4.5 mg)	Your ongoing target, taken as three capsules together.

Missed a dose?

Take your next scheduled dose at the usual bedtime window and carry on from there, rather than doubling up to make up the one you missed.

Struggling to move up?

If you are having difficulty tolerating your LDN or are unable to ramp up to the full dose, report this on your LDN Check-in or contact your care team. Settling at a lower dose you tolerate is a reasonable outcome, not a failure.

Starting lower and going slower

Some people are sensitive to LDN and do better easing in on 0.5 mg capsules, adding one more capsule roughly every two weeks, with a slightly longer hold at 3 mg before the final step up. Reaching the target dose on this schedule takes about three months rather than three weeks, which is the trade you make for a gentler start.

Weeks	Capsules each night	Daily dose
Weeks 1 to 2	1x capsule of 0.5 mg	0.5 mg
Weeks 3 to 4	2x capsules of 0.5 mg	1 mg
Weeks 5 to 6	3x capsules of 0.5 mg	1.5 mg
Weeks 7 to 8	4x capsules of 0.5 mg	2 mg
Weeks 9 to 10	5x capsules of 0.5 mg	2.5 mg
Weeks 11 to 13	6x capsules of 0.5 mg	3 mg
Week 14 onward	3x capsules of 1.5 mg	4.5 mg

Can I get a single 3 mg or 4.5 mg capsule?

Your prescription is filled in 0.5 mg or 1.5 mg capsules, so a 4.5 mg nightly dose is three 1.5 mg capsules swallowed together, not one larger capsule. If you were previously prescribed a single 3 mg or 4.5 mg capsule elsewhere, or checkout only offers you a strength lower than you expected, message your care team before you order so they can confirm what can be dispensed for you. Do not make up a difference in strength by taking extra capsules on your own.

When to take it

Take your dose once a day at bedtime, between 9pm and 2am. Keeping the timing consistent matters more than the exact hour.

Bedtime, 9pm to 2am, the window our protocol recommends.
If your sleep is disturbed, occasionally the disruption is bad enough to warrant taking LDN in the morning or afternoon instead of at night. Some people report feeling groggy on a daytime dose, so make that change with your care team rather than on your own.
Splitting your daily dose across morning and night is not recommended. Take all of your capsules together, in one nightly dose.

Ramp-up timeline

Nights 1 to 10

Start low. 1x capsule (1.5 mg) at bedtime.

This is the window where mild side effects are most likely: vivid dreams, mild anxiety, trouble sleeping or a headache. They usually settle on their own by about the fifth day.

Day 11

Step up to 2x capsules (3 mg) at bedtime for the next ten nights.

Only move up if the first step felt comfortable. If it did not, hold where you are and report it on your LDN Check-in rather than pushing through.

Day 22

Reach your target. 3x capsules (4.5 mg) at bedtime, ongoing.

4.5 mg a day is the most commonly used low dose. Some people settle at 3 mg and stay there, and that is a perfectly good place to be.

Ongoing

Maintain and monitor. Stay at the dose you tolerate.

Much of what LDN does builds over months rather than days. If side effects appear or worsen at any point, step back down and increase again more slowly. Restarting after a break? Contact your care team before you resume, because you may need to ramp up again from a lower step.

Your dosing at a glance

The full LDN protocol in one view. Start low, step up on schedule, and hold at the dose you tolerate. Your care team can adjust any of this to fit you.

〰Starting dose: 1x capsule (1.5 mg) at bedtime, or 0.5 mg on the slower schedule

◎Target dose: 3x capsules (4.5 mg) at bedtime, reached as tolerated

♡Frequency: once a day at bedtime, between 9pm and 2am

≈Daily maximum: the dose on your prescription label, typically 4.5 mg. Do not exceed it

⌄Storage: keep capsules in the original labeled bottle, at room temperature, 68 to 77°F, dry and out of direct sunlight

Message your care team ›

Signals to adjust your dose

Let your body set the pace. These are the cues to move up, hold, or ease back, and when in doubt your care team can look at it with you.

Sleeping normally and no side effects? You may be ready to step up, once you have finished the full ten nights at your current step.

Comfortable but not noticing anything yet? Hold where you are and reassess with your care team, because a few more weeks at the same dose is often the answer.

Vivid dreams or headaches? Hold at your current number of capsules, or step back one, and give it a few more nights before trying again.

Message your care team ›

Signs you may be ready to increase

You have finished the full ten nights at your current step and are tolerating it well, with no headaches and no disrupted sleep.
Your sleep settled back to normal after the first few days.
You are comfortable, but not yet noticing the changes you were hoping for.

Signs to decrease or hold your dose

Vivid dreams or broken sleep, hold at your current number of capsules rather than adding another, and give it a few more nights.
Headache or mild anxiety past the first week, step back to the last number of capsules that felt comfortable.
Anything more than mild, stop and contact your provider. More troubling side effects usually point to something else that needs looking at first.
Thinking about stopping altogether? Message your care team first, because a lower dose is often the better answer, but if not, we’ll help you taper down.

Tips for staying comfortable

Keep the timing consistent

The same window every night, between 9pm and 2am, is easier on your sleep than moving the dose around.

Go slower, don’t stop

If side effects appear, hold at your current number of capsules or drop back one, rather than giving up entirely.

Log what you notice

One line a week, your dose and how you slept, makes the conversation with your provider much easier.

Safety and interactions

Do not take LDN if any apply

You are taking opioid or narcotic pain medication such as codeine, tramadol, oxycodone (Percocet) or hydrocodone (Vicodin, Norco). Naltrexone blocks opioid receptors and the combination can cause serious withdrawal symptoms.
You have a surgical or diagnostic procedure requiring sedation within the next 48 hours. You must stop LDN at least 48 hours beforehand. If you are not sure whether to stop, ask the clinician ordering the test or procedure.
It has been less than 48 hours since you finished any medication prescribed for that procedure. Do not resume until the full 48 hours have passed.

Talk to your provider first if any apply

Thyroid conditions
Lyme disease or other chronic infections (EBV, CMV, babesiosis, borrelia)
Mast Cell Activation Syndrome or Disease (MCAS/MCAD)
Ehlers Danlos Syndrome (EDS)
Multiple chemical sensitivities, or three or more drug allergies
Mold or black mold illness or exposure
Mental illness, for example schizophrenia
Recent opioid or narcotic use

Drug interactions

Opioid and narcotic pain medication is the important one. The two cannot be taken together. For short-term use, such as a tooth extraction, stop LDN for as long as you need the pain medication and resume 48 hours after your last dose of it. If you are on thyroid medication, you may need to monitor your thyroid levels more closely as you start LDN. Beyond those two, the medicines to watch are anything else that contains an opioid, such as a codeine cough syrup or an opioid-containing anti-diarrhea medicine, because they run into the same blocked receptors. Tell your provider about everything you take, including supplements and other AgelessRx treatments.

One common misconception

Naltrexone is not a controlled substance and is not classified by the DEA, despite the common misconception among many prescribers and pharmacists. If your pharmacy or another provider questions it, that is the answer.

Side effects

When starting LDN, you may experience mild to moderate levels of the side effects below during the first 3 to 5 days. These typically diminish on their own as the body adjusts to the medication, usually by the fifth day. Starting on the schedule your provider set, standard or slower, is the best way to keep them mild.

Common

Vivid dreams
Mild anxiety
Insomnia or disturbed sleep
Headache

Less common

Nausea or an upset stomach
Daytime grogginess or fatigue
Night sweats
A rash or a skin flare

Rare

Symptoms of hyperthyroidism, such as heart racing, increased anxiety, restlessness or trouble sleeping, in people taking thyroid medication
Serious withdrawal symptoms if LDN is taken alongside opioid or narcotic pain medication

Side effects are most likely in the first few days and after each step up. If they are mild, hold at your current number of capsules and give it a few more nights. If they are more than mild, or are still there after the first week, stop and contact your provider. The less common column above is drawn from what people tell us rather than from a published rate, so if you notice something that is not listed here, report it to your care team through the portal so your care team can act on it, and do not restart on your own.

Troubleshooting

LDN is giving me vivid dreams and disturbing my sleep

Vivid dreams, broken sleep and mild anxiety are the most commonly reported early effects, and they usually diminish on their own by about the fifth day. If they do not, hold at your current number of capsules instead of stepping up, and give it another week. Occasionally sleep disturbance is bad enough to warrant taking LDN in the morning or afternoon instead of at night. Ask your care team before you make that switch, since the bedtime window is part of the standard protocol.

I have a rash, a headache or an upset stomach. Do I stop or push through?

Anything mild that is fading day by day is usually the adjustment period, and holding at your current dose is reasonable. Anything more than mild, anything getting worse, or a rash that comes back each time you restart, is a reason to stop and contact your provider. More troubling side effects are usually an indication of deeper health issues that need to be addressed by a functional medicine provider before you resume LDN. Report side effects through your AgelessRx portal so they are recorded on your chart.

The capsules in my bottle are not the strength I expected

Read the pharmacy label first. It lists the capsule strength and how many capsules make one dose. A 4.5 mg nightly dose is dispensed as three 1.5 mg capsules rather than one large capsule, and the slower schedule uses 0.5 mg capsules, so a bottle of small capsules is not necessarily an error. If the label still does not match what you were prescribed, message your care team before taking anything, and do not try to make up the difference with extra capsules.

I cannot get up to the target dose

That is common, and it is not a failure. Report it on your LDN Check-in or contact your care team. Your provider can move you to the slower schedule, which adds one 0.5 mg capsule roughly every two weeks instead of stepping up in ten-day blocks, or can leave you at the dose you tolerate. Plenty of people settle at 3 mg and stay there.

Frequently asked questions

What is LDN used for, and how long until I notice a difference?

LDN is naltrexone prescribed off label at a fraction of the standard dose, and it is used to support the immune system and may help reduce inflammation. It is not FDA approved for this use, most people tolerate it well, and clinical response varies from person to person. Doses below 10 mg a day are what “low dose” naltrexone means, and 4.5 mg a day is the most common. Timelines vary a lot between people. Early changes are often subtle and build over months of consistent nightly use rather than showing up in the first week. If you have been steady at your target dose for a few months and genuinely notice nothing, message your care team before you cancel, because the answer is sometimes a dose change rather than stopping.

Should I take it at night or in the morning?

Bedtime, between 9pm and 2am, is what our protocol recommends, and consistency helps. Occasionally sleep disturbance is bad enough to warrant moving LDN to the morning or afternoon instead. Some people report feeling groggy through the day on a daytime dose, so make that change with your care team rather than experimenting on your own. Splitting the daily dose across morning and night is not recommended. Take all of your capsules together in one nightly dose, and ask your care team before you split them.

What is in the capsule, and can I get a different filler?

We provide LDN in capsule form with sucrose as the standard filler. If you need a different filler such as microcrystalline cellulose, a non-gelatin capsule, or a dye-free or lactose-free formulation, message your care team before your next order rather than after it ships, because the request has to be on the prescription the pharmacy fills. A standard capsule contains three things: naltrexone hydrochloride, sucrose as the filler, and a gelatin capsule shell. If you need the exact excipient breakdown for the bottle you were sent, ask your care team and they can request it from the pharmacy, which matters if you have MCAS, EDS or multiple drug allergies.

Do I need to taper off if I want to stop?

Message your care team first, particularly if you are stopping because of side effects, since a lower dose is often the better answer — but if not, we’ll help you taper down. Naltrexone is not a controlled substance and is not classified by the DEA, and nothing published for LDN describes withdrawal when you stop.

Can I take LDN with my other medications and treatments?

Tell your provider everything you take. The two interactions to know about are opioid and narcotic pain medication, which cannot be combined with LDN at all, and thyroid medication, which may need closer monitoring as you start. Combinations with other AgelessRx treatments are reviewed at intake. The other thing to watch for is any other medicine that contains an opioid, such as a codeine cough syrup, which runs into the same blocked receptors. Nothing else is published as interacting with LDN, so check anything new with your care team before you add it.

I have too much supply. Should I cancel?

Pausing is almost always the better move here, and cancelling outright is rarely the right answer. A pause keeps your titration progress in place, so restarting does not mean beginning the ramp again from scratch. Message your care team to move your refill date or change your quantity. Restarting after a longer break? Contact your care team before you resume, so they can tell you whether to pick up where you left off or ramp again from the start.

What are ways I can monitor my response to Low Dose Naltrexone?

In the short term, people often notice an improvement or reduction of symptoms related to inflammation and rampant oxidative stress. These symptoms will vary from person to person, but can include chronic flatulence, cramping, diarrhea, constipation, headache, joint pain, brain fog, muscle pain, fatigue, unexplained weight gain, lower back pain, skin issues/rashes, excessive mucus production, seasonal allergies, food sensitivities, trouble falling asleep, or trouble staying asleep.

Questions? We’re here

Your care team can help with dosing questions, side effects, filler or capsule requests, refill timing, or anything that does not feel right. Reach out any time before your next dose.

Message your care team ›

References and support

About LDN ›

Take LDN once a day at bedtime, between 9pm and 2am, and keep the timing consistent.
Standard protocol: 1x capsule (1.5 mg) a day for the first 10 days, 2x capsules (3 mg) from day 11, 3x capsules (4.5 mg) from day 22 onward. A slower 0.5 mg schedule is available if you are sensitive.
Missed a dose? Take your next scheduled dose at the usual time rather than doubling up.
Stop LDN at least 48 hours before any procedure requiring sedation, and do not resume until at least 48 hours after you finish any medication prescribed for it. Naltrexone cannot be taken with opioid or narcotic pain medication.
Having difficulty tolerating LDN, or unable to ramp up to the full dose? Report it on your LDN Check-in or contact your care team, and do the same for questions about your dose, your filler, or restarting after a break.
This guide is not a substitute for personal medical advice. Always consult your provider before changing your dose or routine.

This guide is for general educational purposes and does not replace personalized medical advice. Always follow the instructions from your AgelessRx provider and the dosing on your prescription. If you experience a medical emergency, call 911.