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Low-Dose Naltrexone Could Treat Long COVID Symptoms

May 4th, 2025
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By Stephanie Brown | Published on June 7, 2023, Published in very well

Key Takeaways

Long COVID is still not well understood, making it difficult for scientists to develop treatments.

Low-dose naltrexone may be a promising treatment for long COVID, but more studies are needed.

Naltrexone is FDA-approved to treat alcohol use disorder and opioid addiction, but it has also been used off-label in low doses to treat inflammatory diseases.

Naltrexone

Naltrexone is a drug approved by the Food and Drug Administration (FDA) to treat alcohol use disorder and opioid addiction. Low-dose naltrexone (LDN), usually at a fraction of the regular dose, has been used to treat fibromyalgia and multiple sclerosis.

Now, research shows that LDN might also be a promising treatment for long COVID.

As many as 23 million Americans may have been affected by long COVID, but the lack of understanding about this condition makes it hard to develop treatments.

“I want to encourage people that it is possible to improve and for their symptoms to get better, but I want to discourage people from the belief that there’s one medicine that will cure long COVID,” said Jessica A. Bender, MD, MPH, co-director of UW Medicine’s Post-COVID-19 Rehabilitation and Recovery Clinic.

How Might Low-Dose Naltrexone Treat Long COVID?

While LDN might not cure all long COVID symptoms, it could serve as part of a treatment plan. A small study published last year found that LDN improved some self-reported symptoms, such as pain and energy levels, for long COVID patients.

“It looks like it worked for most people. So I think it’s part of the solution because it’s targeting two of the four issues that I see really critical with long COVID, which is brain inflammation and immune dysregulation,” said Jack Lambert, MD, PhD, a co-author of the study and a professor of infectious disease at the University College Dublin School of Medicine in Ireland.

People with long COVID reportedly have an increased level of inflammatory cytokines, which are involved in the body’s immune response, according to Hector Bonilla, MD, co-director of the Stanford Post-Acute COVID-19 Syndrome Clinic.

LDN has demonstrated effects on reducing inflammatory cytokines, which might be why it shows promise as a potential treatment for long COVID patients, Bonilla said.

LDN is sometimes used to treat chronic inflammatory diseases like inflammatory bowel disease (IBD). Lambert said he has used LDN for patients.

LDN isn’t FDA-approved to treat long COVID, so healthcare providers can only prescribe it off-label.

“We’re three years into long COVID, and we’ve not advanced very far in terms of interventions. This is just one of the few promise interventions that I can vouch for based on my clinical experience, and I encourage others to consider using it as well,” Lambert said.

LDN May Not Work for Everyone

LDN doesn’t seem to come with many side effects, but this medication might not work for everyone.

“I’ve had some people who had one or two doses and just didn’t feel like themselves or had some hard-to-describe side effects and so decided to not take it,” Bender said.

When LDN is prescribed, Bender explained, people often start with a very low dose and work their way up to a higher dose. While people might see improvements after a few weeks, she said it is difficult to track how well the drug works because it’s often prescribed along with multiple treatments.

Clinical trials are still needed to help healthcare providers understand exactly how this LDN works. A placebo-controlled study in British Columbia looking at the effects of LDN on long COVID fatigue may be underway soon, which could help provide some answers.

“What we as a scientific community need to do is be able to prove that this medication works for this indication with relatively few side effects and that’s how we can help improve the health of the public and everybody with long COVID,” Bender said.

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At Pain Spa, Dr Krishna is highly experienced in managing patients with long covid. Dr Krishna has prescribed LDN to numerous patients with fatigue, fibromyalgia and long covid symptoms. Please contact us for further details if you are interested in having a consultation with Dr Krishna.