Using low-dose naltrexone for fibromyalgia: Off label but on trend

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In print

Pharmacotherapy

Using low-dose naltrexone for fibromyalgia: Off label but on trend

8 November 2023

By Penny Clark and Linda Bryant

Wednesday 8 November 2023, 12:35 AM

Sally’s fibromyalgia causes pain, stiffness, fatigue and inability to concentrate, to the extent that some days she is unable to function [Image: Annie Spratt on Unsplash]

There is increased interest in low-dose naltrexone as a potential treatment for fibromyalgia. This article examines what you need to know

Key points, The use of low-dose naltrexone for fibromyalgia is off label and not funded, and it will need to be prepared by a pharmacy. Do not use opioids with, Pract Green w Pale Yellow

Rheumatology

References

Yang J, Shin KM, Do A, et al. The safety and efficacy of low-dose naltrexone in patients with fibromyalgia: A systematic review. J Pain Res 2023;16:1017–23.
Aitcheson N, Lin Z, Tynan K. Low-dose naltrexone in the treatment of fibromyalgia: A systematic review and narrative synthesis. Aust J Gen Pract 2023;52(4):189–95.
Klemp P, Williams SM, Stansfield SA. Fibromyalgia in Māori and European New Zealanders. J Rheumatol 2002;5(1):1–5.
Maffei ME. Fibromyalgia: Recent advances in diagnosis, classification, pharmacotherapy and alternative remedies. Int J Mol Sci 2020;21(21):7877.
Younger J, Parkitny L, McLain D. The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clin Rheumatol 2014;33:451–59.
Knab J, McCauley J. The use of low dose naltrexone in the management of chronic pain. Pract Pain Manag 2020;20(3).
Bolton M, Hodkinson A, Boda S, et al. Serious adverse events reported in placebo randomised controlled trials of oral naltrexone: a systematic review and meta-analysis. BMC Med 2019;17(1):10.
Bennett RM, Friend R, Jones KD, et al. The Revised Fibromyalgia Impact Questionnaire (FIQR): validation and psychometric properties. Arthritis Res Ther 2009;11(5):415.

How to Treat

+How to treat

For older people and frail people, the long-term benefit of medicines reduces and the potential for harm from adverse effects increases. When the benefit–risk balance changes in this way, medicine review and optimisation are important to simplify the therapeutic regimen, reduce inappropriate medicines and minimise risks. In this article, pharmacist prescriber Linda Bryant uses two case studies to illustrate important considerations during medicine reviews

Wednesday 28 May 2025, 12:50 AM