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The People's Pharmacy: Could low-dose naltrexone ease arthritis pain?
JOE AND TERESA GRAEDON Special correspondents 28th April 2024
QUESTION: I have painful osteoarthritis throughout my body. Because I am on the blood thinner Pradaxa for life, I am not able to take aspirin or NSAIDs for the pain.
I have been taking low-dose naltrexone (LDN) for a couple of years. I didn’t quite realize how well it relieved my pain until I went on vacation and forgot to bring it along. I couldn’t wait to get home and get back to my LDN!
My doctor doesn’t really like to prescribe it, but she does because my former doctor, her colleague, did. I’m grateful.
ANSWER: Naltrexone was first approved by the Food and Drug Administration in 1984 under the brand name Trexan. The drug was developed to treat opioid dependence but currently is used primarily for people with alcohol use disorder at a dose of 50 milligrams.
The FDA has not approved the use of low-dose naltrexone (1.5 to 4.5 milligrams), but many practitioners prescribe it for a variety of painful conditions. These include fibromyalgia, multiple sclerosis, inflammatory bowel disorders and diabetic neuropathy (Journal of Pain Research, June 14, 2023).
Researchers have not studied low-dose naltrexone for osteoarthritis, although some believe it might be helpful (Biomedicines, June 2023). One intriguing study suggests that LDN might also help people with symptoms of long COVID-19 (Clinical Therapeutics, March 2024). Most clinicians will want to see well-conducted randomized clinical trials before prescribing LDN for either long COVID-19 or arthritis, however.