If your prescriber has written you a prescription for low dose naltrexone, you may already have found that no retail pharmacy can simply hand you a bottle of it. That is not a supply problem. It is a manufacturing one, and it is the reason LDN prescriptions go to a compounding pharmacy.
This page covers the practical side: why LDN is compounded, what strengths and forms Bayview compounds, what it costs, how to get a prescription sent to us, and where we are licensed to ship.
Why low dose naltrexone has to be compounded
Naltrexone is sold commercially as a 50 mg tablet, approved by the FDA for opioid and alcohol use disorders. The doses used in low dose naltrexone are a fraction of that, commonly somewhere between 1 mg and 6 mg, and no manufacturer makes a product at those strengths.
That leaves compounding as the route. A licensed 503A compounding pharmacy prepares naltrexone at the exact strength on your prescription, in the form your prescriber specifies, for you individually. Please do not try to split or dissolve a 50 mg tablet at home to approximate a low dose: a tablet is not formulated to divide that finely, and you cannot verify what you end up with.
LDN is prescribed off-label. Compounded preparations are not FDA-approved, and whether LDN is appropriate for you is a decision for your prescriber, not for a pharmacy.
What strengths and forms we compound
| Form | Strengths | Notes |
|---|---|---|
| Capsules | 1, 2, 4, 4.5, 5, 6 and 9 mg | The most commonly prescribed form. |
| Compounded tablets | 1.5, 3 and 4.5 mg | Prepared in house. |
| Oral liquid | 1 mg/mL | Suspension or flavored solution. Allows very small dose steps, and suits patients who cannot swallow a solid dose. |
Other strengths are compounded to order. If your prescriber is planning a gradual titration, the oral liquid is often the practical choice because it lets you move in increments a capsule cannot.
What LDN costs, and why insurance usually is not involved
Compounded LDN starts at $100 for 90 capsules at Bayview. The final price depends on the strength, the form and the quantity your prescriber ordered, so a 90-day supply of capsules and a bottle of oral liquid are not priced alike.
Compounded prescriptions are almost always paid out of pocket. A compounded preparation is made for one patient against one prescription, so it does not carry the national drug code a pharmacy benefit plan uses to price a claim, and many plans exclude compounded ingredients outright. We will run your insurance before compounding if you ask us to, so you know where you stand. HSA and FSA cards are accepted, as are credit cards.
Call us at 401-284-4505 with the strength and quantity on your prescription and we will quote it before we make it. Shipping is quoted separately, because the cost depends on the destination and on whether the preparation needs temperature protection. More detail on all of this is in our guide to what compounded medications cost.
How to get your LDN prescription filled
You need a prescription from a licensed prescriber. Bayview is a dispensing and compounding pharmacy: we do not write prescriptions and we do not provide consultations. If you already have a prescriber, there are three ways for the prescription to reach us.
- E-prescribe. Ask your prescriber to search for Bayview Pharmacy, Warwick, RI in their EHR. Our NCPDP number is 4106882.
- Fax. 401-284-4506. Providers can use the order form for the relevant product line, available on our provider page.
- Phone. 401-284-4505.
If you are currently getting LDN from another pharmacy, you can ask us to transfer the prescription instead of asking your prescriber to write a new one.
When we receive the prescription we verify it, confirm the details and the price with you, and then compound it. Nothing is made before you have agreed to the price.
Where we can ship
Bayview fills and ships prescriptions for patients in Rhode Island, Massachusetts, Connecticut, New Jersey, New Hampshire, Florida, New York and Maine. Prescriptions go out by UPS or USPS in plain packaging, and transit is typically 1 to 2 business days.
If you live outside those states, a compounding pharmacy licensed where you live can prepare the same thing. What matters is the license, not the distance, which is the subject of our guide to choosing a compounding pharmacy.
Refills and dose changes
Refills are coordinated with your prescriber and with what is left on your prescription. If your prescriber changes your strength, that is a new prescription, so let us know when you call and we will make sure the next fill matches what has been written rather than what you had last time.
Questions we cannot answer for you
Two things sit with your prescriber rather than with us: whether LDN is right for your situation, and what dose to take. Pharmacists can talk you through how to take and store your preparation, what the label means, and what to do about a missed dose, and we are glad to. Tell your prescriber and your pharmacist about every medication you take, including any opioid pain medication, before you start.
Frequently asked questions
What is Low Dose Naltrexone?
Low Dose Naltrexone, often called LDN, is naltrexone prepared in much smaller doses than the commercially available 50 mg tablet. Because these low strengths are not sold as a standard manufactured product, they are commonly prepared by a compounding pharmacy with a prescription.
Why is LDN compounded?
Naltrexone is commercially manufactured only as a 50 mg tablet, so the low doses commonly used, such as 1.5 mg, 3 mg, or 4.5 mg, are not available as a standard product. Compounding allows a licensed pharmacy to prepare naltrexone at the exact strength your provider prescribes, and in the form that suits you: a capsule, a tablet, or an oral liquid. Please do not attempt to split or dissolve a 50 mg tablet at home, that cannot deliver an accurate low dose.
What strengths are available?
Bayview Pharmacy prepares LDN in the strength and form your prescriber orders. Capsules are available in 1, 2, 4, 4.5, 5, 6, and 9 mg; compounded tablets in 1.5, 3, and 4.5 mg; and an oral liquid at 1 mg/mL, which allows very small dose steps for patients who need them or who cannot swallow a solid dose. Other strengths can be compounded to order. Many providers start at a lower strength and adjust gradually.
How do I take LDN?
Take LDN exactly as prescribed by your provider, whether it is a capsule, a tablet, or an oral liquid. It is often taken once daily, sometimes at bedtime, but your directions may be different. If you have been prescribed the liquid, measure each dose with the oral syringe provided rather than a household spoon. Do not change your dose, timing, or frequency unless your prescriber tells you to.
Is Low Dose Naltrexone FDA-approved?
Naltrexone is FDA-approved at standard doses for opioid and alcohol use disorders. Low Dose Naltrexone is prescribed off-label and compounded at lower strengths, so it is not FDA-approved for these uses. Your prescriber determines whether it is appropriate for your treatment plan.
What side effects can happen with LDN?
LDN is generally well tolerated at these doses. The effects reported most often, and more often than with placebo in pooled trial data, are vivid or unusual dreams and nausea. Others reported include sleep disturbance, headache, dizziness, stomach upset, and fatigue. Worth knowing: in the two largest randomized trials the overall rate of side effects was about the same on naltrexone as on placebo, so many reported effects were not attributable to the medication. Contact your prescriber if anything is bothersome, persistent, or unexpected.
Can I take LDN if I use opioid pain medication?
You should not take LDN with opioid medications unless your prescriber specifically determines it is safe. Naltrexone blocks opioid receptors, which may reduce the effect of opioid pain medications and may trigger withdrawal in someone who is physically dependent on opioids. Tell your provider and pharmacist about all medications you take.
How long does it take to notice a response?
LDN does not produce an immediate effect. Patient-facing references commonly suggest allowing up to eight to ten weeks, though no clinical trial has established a reliable time-to-response figure, and published studies describe it inconsistently. Response can vary with the individual, the dose, and the overall treatment plan. Follow your prescriber’s instructions and check in as directed rather than stopping early on your own.
How should I store LDN?
Store capsules and tablets at room temperature unless the prescription label says otherwise. Keep the container tightly closed, away from excess heat, moisture, and direct light, a bathroom cabinet is a poor choice because of humidity. If you have been prescribed a liquid, check your label to see whether it needs refrigeration. Keep all medication out of reach of children and pets, and do not use any preparation past the beyond-use date on the label.
What states do you ship to?
Bayview fills and ships prescriptions for patients in Rhode Island, Massachusetts, Connecticut, New Jersey, New Hampshire, Florida, New York, and Maine.
One exception applies in New York: we do not ship controlled substances to New York addresses at this time. Non-controlled medications, including most of our compounded preparations, ship normally, and we are working to expand what we can offer patients in New York.
If you are not sure whether your prescription is affected, call us at (401) 284-4505 and we will check before anything is prepared.
What Bayview compounds for this
Important: Compounded medications are prepared to a prescriber's order for an individual patient. They are not FDA-approved, and the FDA has not evaluated them for safety, effectiveness, or manufacturing quality. This article is educational and is not a substitute for advice from your prescriber or pharmacist.
This preparation contains a controlled substance. Controlled-substance prescriptions carry refill limits, must be e-prescribed, and can only be shipped to states where Bayview holds the required licensure.
Uses discussed here may be off-label, meaning they are not part of any FDA-approved labeling. Off-label use is a decision for you and your prescriber, based on the available evidence.
Veterinary preparations are compounded to a veterinarian's order for a specific animal and are not FDA-approved animal drugs. Never give a compounded human medication to an animal without veterinary direction.
Compounded prescriptions are paid for directly rather than billed through insurance. Most are HSA/FSA-eligible, and many patients submit the receipt to their plan for possible reimbursement. Pricing depends on the strength, dose form and quantity your prescriber orders. Read more about cost and insurance.
Compounded LDN starts at $100 for 90 capsules and varies with the strength, form and quantity your prescriber ordered. Compounded prescriptions are cash-priced and are generally eligible for HSA and FSA cards. Call 401-284-4505 for a quote before we compound.
Bayview Pharmacy is an NABP-accredited compounding pharmacy in Warwick, Rhode Island, licensed to fill and ship compounded prescriptions for patients in Rhode Island, Massachusetts, Connecticut, New Jersey, New Hampshire, Florida, New York and Maine. Controlled substances are not shipped to New York addresses. See where we ship and how to get started.
