Naltrexone at about a tenth of the usual dose, stepped up slowly. Off-label, with the evidence told plainly.
$2.05/dayBilled $369 every 180 days
Medication is charged only if your clinician prescribes it.
Start with a $20 clinician review
Less pain
In 4 randomized trials of 222 people with fibromyalgia, low-dose naltrexone lowered pain scores more than placebo
Source: Vatvani AD, et al. Korean J Pain 2024;37(4):367-378 (meta-analysis)Mixed overall
Across 7 trials in all chronic pain, no significant overall difference; the fibromyalgia subgroup did beat placebo
Source: Hegde NC, et al. Curr Pain Headache Rep 2025;29(1):96 (meta-analysis)50 mg
is the FDA-approved naltrexone dose, for alcohol and opioid dependence. Our 1.5 to 4.5 mg doses are an off-label use
Source: Naltrexone hydrochloride tablets prescribing informationLow-dose naltrexone has no FDA-approved use. Trials are small and cover mainly fibromyalgia, and our preparation is compounded and was not the product studied. Individual results vary.
A clinician-checked low-dose naltrexone plan with a built-in step-up schedule, prescribed only if it fits and explained honestly.
Clinician review of your history and medicines
A US-licensed clinician checks for opioids, liver issues and mood before prescribing.
Flex-dose naltrexone from a licensed US pharmacy
A 90-day first fill with the dose steps built in: 1.5 mg, 3 mg, then 4.5 mg.
A built-in step-up schedule
Two weeks at 1.5 mg, two weeks at 3 mg, then 4.5 mg at bedtime.
Free, discreet shipping
Ships 2 to 5 business days after approval.
Care team messaging
Ask about dreams, nausea or timing any time.
Free lab panel at month 3
Biological Age Reveal, as a progress check.
“Is this just another wellness fad?”
Evidence told straight
The page and your clinician say what trials show and what they do not.
“I do not want a lab visit first.”
No required labs to start
You do not need a blood draw to begin.
Biological Age Reveal
At the standard 50 mg dose, naltrexone blocks opioid receptors for most of the day and treats alcohol and opioid dependence. Low doses of 1.5 to 4.5 mg block them only briefly, and researchers think this shifts immune and inflammatory signalling.
That is a hypothesis. Randomized trials are small, with the best signal in fibromyalgia pain, so we offer it as an off-label option and tell you what is and is not known.
One tablet at bedtime. You start on the lowest dose and step up slowly, as your clinician directs.
Your symptoms, medicines (especially any opioids), liver history and what you hope to change.
About 5 minutes
They prescribe only if low-dose naltrexone fits, and they explain what the evidence does and does not show.
Within 24 hours
If prescribed, free plain-packaged shipping arrives 2 to 5 business days after approval.
You start at 1.5 mg, move to 3 mg after two weeks, then to 4.5 mg for maintenance. Message your care team any time.
You start at 1.5 mg at bedtime. Vivid dreams and lighter sleep are the most common early effects and often settle.
The dose rises to 3 mg for two weeks, then to 4.5 mg for maintenance.
Judge it once you have been on the maintenance dose for a while, because most trials ran for weeks to months.
The best evidence is for fibromyalgia pain, with a modest effect. For other conditions, trials are small or missing.
Three things you can do alongside your treatment.
Poor sleep drives inflammation and makes pain and fatigue worse, and vivid dreams are the usual early side effect. A fixed wake time, a dark cool room and no caffeine late in the day help both.
Functional medicine guidance for fatigue and pain recommends graded exercise: start easy, build slowly and stay inside your daily energy allowance, because pushing too hard backfires.
A pattern built on vegetables, fruit, olive oil and oily fish, with fewer ultra-processed foods and less sugar, gives the medication an easier job.
| Feature | Low-dose naltrexone | Standard naltrexone | Medicines approved for fibromyalgia |
|---|---|---|---|
| Dose | 1.5 to 4.5 mg at bedtime | 50 mg daily | Set by the product |
| Regulatory status | Off-label and compounded; no FDA-approved low-dose product | FDA approved for alcohol and opioid dependence | FDA approved for fibromyalgia: duloxetine, pregabalin, milnacipran |
| Evidence | Small randomized trials, mainly in fibromyalgia | Large, for its approved uses | Large phase III programs |
| Common effects | Vivid dreams, nausea; serious effects were not more common than placebo in trials | Nausea, headache, dizziness; liver warnings on the label | Vary by drug |
| Opioid painkillers | Blocks them; do not combine | Blocks them; do not combine | Depends on the drug |
Low-dose naltrexone is an option to discuss, not a replacement for approved treatment of a diagnosed condition.
Take 1.5 mg at bedtime for 2 weeks, then 3 mg at bedtime for 2 weeks, then 4.5 mg at bedtime for maintenance, as your clinician directs.
Naltrexone is FDA approved at 50 mg for alcohol dependence and to block opioids. Low dose naltrexone is a small fraction of that dose and has no FDA approved use. The side effects below come from the 50 mg label, so they may overstate what happens at a low dose.
Tell your care team straight away if your eyes or skin turn yellow, your urine goes dark or you get pain in your upper right belly, you get opioid withdrawal symptoms, you get low mood or thoughts of harming yourself, or you need opioid pain relief for any reason.
Common side effects
Rare but serious
Do not take this if you take opioid painkillers, you are dependent on opioids including methadone or buprenorphine, or you are in opioid withdrawal.
This is not a complete list of side effects. Message your care team about any symptom that worries you. What we dispense is a compounded preparation made by a licensed US pharmacy. Compounded medications are not approved by the FDA for safety, efficacy or quality.
The dose is roughly a tenth of the 50 mg tablet. At standard doses naltrexone blocks opioid receptors for most of the day. At low doses the block is brief, and researchers think the effect is on immune and inflammatory signalling. That mechanism is still a hypothesis.
The clearest signal is fibromyalgia pain, where a meta-analysis of four small randomized trials favored low-dose naltrexone over placebo. Across chronic pain conditions overall the results were mixed, and for conditions such as Crohn's disease the trials are too small to conclude anything. Expect measured, not dramatic.
There is no FDA-approved product at this dose. A licensed US pharmacy prepares it, which means the FDA has not reviewed its safety, effectiveness or quality, and a clinician prescribes it off-label.
Vivid dreams and light sleep are the most commonly reported effects, usually in the first weeks. Your directions say to take it at bedtime. If they persist, message your care team before changing the timing.
Not with opioid painkillers, because it blocks them. Tell your clinician about any opioid you take, and about planned surgery where you might need opioid pain relief.
The 50 mg label reports cases of liver injury, and safety data at low doses are limited. Your clinician may suggest a liver panel (ALT and AST) as a baseline. Tell your care team right away if your eyes or skin turn yellow, your urine turns dark or you get pain in the upper right of your belly.
180-day supply · $2.05/day · Billed $369 every 180 days
