Step 1
The therapeutic dosage range for LDN is from 1.75mg to 4.5mg every night. Dosages below this range are likely to have no effect at all, and dosages above this range are likely to block endorphins for too long a period of time and interfere with its effectiveness.
Ideal dosage when treating most illnesses is 4.5mg, however many people prefer to start with the lower 3.0mg dosage. It is recommended that those with Fibromyalgia begin with 3.0mg and slowly work up to 4.5mg, since starting at the higher dosage may cause some side effects like minor sleep disturbance.

Step 2
Begin by taking 3.0mg each night before going to bed. Whether using compounded tablets or liquid LDN, drink a full glass of water with me low dose naltrexone. Continue taking 3.0mg for 1-4 weeks. If you experience side effects of hyperness, or sleep disturbances, do not increase the dosage until side effects disappear. The usual adult dosage is 4.5mg taken once daily at night. Because of the rhythms of the body's production of master hormones, LDN is best taken between 9pm and 3am. Most patients take it at bedtime.

Step 3
When side effects subside, increase dosage to 3.5mg each night. Continue for 1-4 weeks, then increase to 4.0mg for 1-4 weeks, finally, increase to 4.5mg and maintain this dosage.

Step 4
Keep a symptom log. Track all Fibro symptoms and LDN side effects, so you can see at a glance how the low dose naltrexone effects you.

Step 5
Talk to your doctor or pharmacist about each dosage increase.

Cautionary Warnings or Side Effects

LDN has virtually no side effects. Occasionally, during the first week's use of LDN, patients may complain of some difficulty sleeping. This rarely persists after the first week. Should it do so, dosage can be reduced from 4.5mg to 3mg nightly.

1. Because LDN blocks opioid receptors throughout the body for three or four hours, people using medicine that is an opioid agonist, i.e. narcotic medication -- such as Ultram (tramadol), morphine, Percocet, Duragesic patch or codeine-containing medication -- should not take LDN until such medicine is completely out of one's system. Patients who have become dependant on daily use of narcotic-containing pain medication may require 10 days to 2 weeks of slowly weaning off of such drugs entirely (while first substituting full doses of non-narcotic pain medications) before being able to begin LDN safely.
2. Those patients who are taking thyroid hormone replacement for a diagnosis of Hashimoto's thyroiditis with hypothyroidism ought to begin LDN at the lowest range (1.5mg for an adult). Be aware that LDN may lead to a prompt decrease in the autoimmune disorder, which then may require a rapid reduction in the dose of thyroid hormone replacement in order to avoid symptoms of hyperthyroidism.
3. Full-dose naltrexone (50mg) carries a cautionary warning against its use in those with liver disease. This warning was placed because of adverse liver effects that were found in experiments involving 300mg daily. The 50mg dose does not apparently produce impairment of liver function nor, of course, do the much smaller 3mg and 4.5mg doses.
4. People who have received organ transplants and who therefore are taking immunosuppressive medication on a permanent basis are cautioned against the use of LDN because it may act to counter the effect of those medications.