Is Sublingual Low Dose Naltrexone (LDN) absorbed as well as other forms, and is it meant to be swallowed?

Is Sublingual Low Dose Naltrexone (LDN) absorbed as well as other forms, and is it meant to be swallowed?

For those using a sublingual dose to avoid GI issues, if the person wanted to hold the dose in their mouth for X minutes and then spit it out to minimize GI absorption, how should they hold it for adequate absorption? 

That's a great question. You may want to just change from a liquid to a trochee, which is a small wafer that can be held in the mouth because that way, when it's fully dissolved, then you know it is fully dissolved and you're ready to go. 

Liquids, it really depends on the base that it is in. Is it in an oil base, is it in a water base? And then spit it out. If you are having that much GI distress by swallowing the rest of your sublingual dose, I would ask to switch to a different dosage form and maybe that would alleviate those issues. 

Some pharmacies are also compounding a rapid dissolved tablet which would dissolve in the buccal cavity either under the tongue or inside the cheek and that might be helpful. 

It sounds like the sublingual liquid LDN, isn't absorbed as well. Do you find doses therefore need to be higher? My pharmacist doesn't seem to offer alternatives other than just liquid. 

So I'm sorry, I didn't mean to construe that the sublingual liquid wasn't as well absorbed. It really depends on the base. So a lot of sublingual LDN liquids are compounded in an oil base so that it's beyond use date can be longer. In the United States, water bases have to be given anywhere from a 14 to a 35-day beyond-use date, which means that beyond that, we don't know what's growing in it, So we don't recommend anybody using it. 

Oil bases, we can usually give anywhere from a 90 to 180 days. But again, it really depends on what's going on in your mouth. Sometimes bacterial load or fungal load, if somebody has Lichen Sclerosis, that may or may not be absorbed as well. 

Most of the time, sublingual dosage forms are expected to be held in the mouth for a minute or two and then swallowed. Not necessarily spit out.