Custom Compounding · LDN
Compounded micro-doses of naltrexone (typically 1.5mg – 4.5mg) for autoimmune and chronic pain conditions. We compound LDN as standard capsules, custom titration doses, and liquid preparations — working from your provider's exact prescription. Our Defiance lab fills LDN prescriptions for patients across Northwest Ohio and Northeast Indiana regularly.
What LDN Is
Naltrexone has been around since the 1980s as an FDA-approved 50mg medication for opioid and alcohol use disorder. At much smaller doses — typically 1.5mg to 4.5mg — it has different effects on the body and is prescribed off-label by a growing number of providers for chronic conditions.
Standard LDN doses are 1.5mg, 3mg, and 4.5mg — roughly 1/10th to 1/30th of the manufactured dose. Some providers prescribe custom doses (0.5mg, 1mg, 2mg) for slow titration. All of these come from a compounding pharmacy, not a retail shelf.
Most LDN protocols call for once-daily dosing at bedtime. The reasoning involves how LDN interacts with the body's endorphin system during sleep cycles. Your provider may adjust timing (morning dosing is sometimes prescribed if bedtime dosing causes sleep disruption).
"Off-label" means a medication is being prescribed for a use that isn't in its original FDA approval — common, legal, and not unusual. Naltrexone the active ingredient is FDA-approved; the low-dose use for chronic conditions is the off-label part. Your provider documents the off-label use in your record.
Why It Has to Be Compounded
The only FDA-approved manufactured naltrexone is 50mg. LDN protocols call for 1.5–4.5mg — about a tenth of the manufactured dose. That gap is the entire reason LDN comes from a compounding pharmacy.
We compound LDN from bulk pharmaceutical-grade naltrexone hydrochloride into capsules at the exact dose your provider prescribes. Standard sizes (1.5mg, 3mg, 4.5mg) and custom titration doses both come from the same process.
For patients whose providers want very precise dose adjustments — or for patients who've had trouble with capsules — we compound LDN as an oral liquid. Liquid allows for very small dose increments during titration.
Many LDN patients are sensitive to common fillers used in capsules — lactose, calcium carbonate, etc. We use hypoallergenic fillers like avicel or rice-based powder when your provider specifies, and can adjust the capsule shell type for patients with specific sensitivities.
LDN protocols typically titrate up over several weeks. When your provider sends an updated prescription with a new dose, we compound the new preparation without you having to switch products or wait for a new manufactured strength.
Conditions Providers Prescribe For
LDN is prescribed off-label for a range of conditions where reducing inflammation or modulating the immune system may help. We don't prescribe — that's a conversation between you and your provider — but here are the categories we see most often in the prescriptions we fill.
This list reflects the conditions we most commonly see in LDN prescriptions — not an endorsement of LDN as treatment for any specific condition. If you're researching LDN for yourself, work with a provider who can evaluate your specific situation.
Formulations We Compound
Most LDN prescriptions are standard capsules, but your provider can prescribe other forms depending on your protocol, sensitivity profile, or titration needs.
1.5mg, 3mg, and 4.5mg sizes — the most commonly prescribed LDN strengths. Capsules can be opened and the contents mixed with water for patients who have trouble swallowing.
Doses below 1.5mg (0.5mg, 1mg) and intermediate doses (2mg, 3.5mg) for slow-titration protocols. Particularly useful for patients sensitive to medications or starting LDN for the first time.
For patients whose providers want very precise dose adjustments. Liquid allows dosing changes in 0.1mg increments, which capsules can't practically match. Typically dispensed with an oral syringe for measured dosing.
Capsules using hypoallergenic fillers (avicel, rice powder) for patients with sensitivities to common excipients. Vegetable-cellulose capsule shells available for patients avoiding gelatin.
How It Works
Whether you're new to LDN or switching pharmacies, here's the path.
Many primary care providers haven't worked with LDN. Functional medicine practitioners, integrative medicine providers, and certain specialists are the most common LDN prescribers. We can suggest providers in the area — call our Defiance location.
Your provider sends the prescription to us electronically, by fax, or by phone. LDN scripts are usually written for a 30 or 90 day supply, with refills authorized for ongoing protocols.
Standard LDN prescriptions typically take 24-48 hours from when we receive the script. New prescriptions with non-standard fillers or liquid preparations may take slightly longer if we need to source specific ingredients.
Most LDN protocols start at a low dose (often 1.5mg) and titrate up over 2-4 weeks. Your provider gives you the titration schedule. We can adjust the compound mid-protocol when your provider sends an updated prescription.
Common Questions
The questions we hear most from patients starting LDN, transferring an existing prescription, or doing research before talking to their provider.
Already on LDN?
If you're already on LDN and want to switch pharmacies — maybe yours has had supply issues, slow turnaround, or doesn't handle the filler sensitivities you need — we'd like to help. We compound LDN every week and can take over your prescription with one phone call to your provider.
