Low Dose Naltrexone (LDN) and Chronic Wounds

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Low Dose Naltrexone (LDN) and Chronic Wounds

Nat Jones: We've done it topically a lot. Both Sebastian and I have used naltrexone. In fact I was just talking to a pharmacist down in Georgia today and they were kind of stalled out on closure of the wound, and when they added naltrexone in it, it closed up almost immediately. We're doing a half a percent or less in a lot of the wound formulations, but it depends on what else is going on with the wound. As a single standalone ingredient, I don't usually use it as a single standalone. As Sebastian mentioned earlier, when you see patients, because of that snip and their TLR4 receptors and the genetic predisposition, you don't know who’s going to respond well, who's not going to respond well. We've actually seen a few patients when they're treated topically do get some paradoxical inflammation from it right. 

I think that oral is always the safest route to go, just saying from a reduced adverse event perspective. And to get the immune modulation, because a lot of times wound closure is hard, especially in older patients, because their immune system is not as happy, their hormones are not as happy. It's kind of hard to close a wound if you don't have adequate androgens on board. So, it's a bigger-picture thing for a lot of people. 

Sebastian Denison: And I'm going to roll along with this one. For any chronic wounds, orally works extremely well. We’ve seen patients using things topically and it really and truly depends upon the patient and what success you're having. 

So the nice flexibility within the group that of compounding pharmacists is if this way doesn't work well, we have we always have an option. We have a cream for that, or we have a capsule for that. Take your pick. But we can adjust the patient’s best outcome at the end of the day.

Sebastian Denison, BScPharm, RPh, Clinical Compounding Pharmacist, PCCA Training and Education Pharmacist
and
Nat Jones, RPh, Clinical Compounding Specialist, PCCA Clinical Services