Is There a Reason to Avoid Long-Term Use of Topical Low Dose Naltrexone (LDN)?

Clinical Pharmacist Nat Jones
Answered by Nat Jones, R.Ph. FAPC

Is There a Reason to Avoid Long-Term Use of Topical Low Dose Naltrexone (LDN)?

Is there a reason to avoid long-term use of topical LDN?  Are there conditions where daily use is advised?  If daily dosing is ineffective for a patient's derm condition would you advise changing to every two days or every three day application to provide off periods for in keflan and endorphin effect?  

Let’s start with the first question:  is there a reason to avoid long-term use?   I would say only if the patient has a reaction and that can happen.  I’ve seen it a couple times with topical use.  We don't know the exact reason why.   I was assuming the patient might have been one of those folks who has a snip in their total receptors.  I don't know that though. Once we discontinued it the inflammation went away.  

Are there conditions to where daily use is advised?  Yeah.  Typically I use the topical Naltrexone twice daily for pretty much all these inflammatory conditions.  In the periodic conditions it's very effective at twice daily.  You don't need a lot though.

If daily dosing is ineffective for patients with derm conditions would you advise changing to every two days or every three days for topical?  I don't know that you need to take a break. In fact I wouldn't think you would need to take a break.  We've not had to do it in our patients that we're treating derm conditions with.  Just the topical application alone for the pruritus primarily is what we're using to treat.  Once the pruritus goes away and the inflammation has died you know because a lot of times pruritus is a temporary condition.  Based on the short term condition you were dealing with.  If that's gone away you know then the pruritus is going to go away.  You can stop the disease. Stop the treatment I should say because the disease is no longer being stimulated.