Low Dose Naltrexone (LDN) Compounding
LDN isn't manufactured at the strengths prescribers order, which is why it has to be compounded. Lititz Apothecary is a low dose naltrexone compounding pharmacy on Main Street in Lititz, Pennsylvania, licensed to serve patients statewide, and we prepare it to your prescriber's exact strength on a valid prescription.
Every prescription is compounded by a licensed pharmacist here, not routed to a facility out of state. If you already fill LDN somewhere else, we can handle the transfer. And if you would rather talk it through first, a pharmacist answers our phone during business hours.
What Is Low Dose Naltrexone?
Naltrexone is an FDA-approved medication used at a standard 50 mg dose. Low dose naltrexone — LDN — refers to much smaller doses, typically 1.5 mg to 4.5 mg, that no manufacturer sells. Because those strengths are not commercially available, LDN is compounded: prepared for an individual patient, on a prescriber's order, by a compounding pharmacy.
At these lower doses, naltrexone is thought to act differently than it does at the standard dose. Researchers believe a brief, low-level blockade of opioid receptors may prompt the body to increase its own endorphin production and modulate immune system activity — one reason LDN has been studied in conditions involving inflammation and chronic pain.
Naltrexone itself has been used at the standard dose for decades. Interest in low-dose use grew from research into how the medication behaves at a fraction of that dose — and because no manufacturer makes those strengths, prescribers who use LDN work with a compounding pharmacy to have them prepared.
One distinction matters: naltrexone's FDA approval applies to the standard 50 mg dose. Compounded low-dose preparations are not themselves reviewed or approved by the FDA — they are prepared patient-specifically under section 503A of the Food, Drug, and Cosmetic Act, as prescribed by your healthcare provider.
LDN also comes up in longevity and wellness conversations. If that is the context you are asking about, see LDN in a longevity context.
Conditions Prescribers Use LDN For
LDN is prescribed off-label, which means prescribers apply their clinical judgment beyond the medication's original approved use. These are the categories where prescribers most commonly use it — and where published research has focused.
Autoimmune conditions
Prescribers have used LDN for patients with autoimmune conditions such as Hashimoto's thyroiditis, Crohn's disease, and multiple sclerosis, and it has been studied in several of these areas.
Chronic pain and fibromyalgia
Fibromyalgia is among the most-studied uses of LDN, and prescribers also use it for certain other chronic pain conditions.
Inflammatory conditions
Because researchers believe LDN may modulate immune activity, prescribers sometimes use it for conditions where inflammation plays a role.
Post-viral fatigue
More recently, prescribers have used LDN for post-viral fatigue, including long COVID, and research in this area is ongoing.
Whether LDN is appropriate for any condition is a decision for you and your provider. Everything we prepare is made as prescribed by your healthcare provider.
How We Compound LDN at Lititz Apothecary
As a 503A compounding pharmacy, we prepare every LDN prescription for one specific patient, to the exact strength the prescriber writes — nothing is made in bulk. All of our LDN preparations are oral and non-sterile, made by hand in our on-site lab in Lititz. Every ingredient is documented, our processes follow USP compounding guidance, and a pharmacist performs a final check on each preparation before it leaves the lab.
| Form | Typical use | Notes |
|---|---|---|
| Capsules | The most common form | Prepared to your prescriber's specified strength |
| Slow-release capsules | When a prescriber orders a modified release | Release profile prepared to the prescription |
| Oral suspension | For patients who have difficulty swallowing capsules | Liquid form, measured by volume |
Every preparation is checked by one of our pharmacists — Chet Patel, PharmD, RPh; Vishesh Patel, PharmD, RPh; or Brian Bradshaw, RPh, who brings more than 30 years of compounding experience to the bench. You can read more about them on our Meet the Pharmacists page.
LDN is one of several preparations we make here. You can see the full range of our compounding services, from hormone therapy to veterinary formulations.
How to Get Low Dose Naltrexone
- 1
Talk with your prescriber.
LDN requires a prescription. If you and your provider decide it is worth trying, they will determine the right strength for you. If your provider has formulation questions, they are welcome to call us before writing.
- 2
Have the prescription sent to Lititz Apothecary.
Your prescriber can e-prescribe, fax, or call it in to (717) 626-2222.
- 3
We prepare it to the prescribed strength.
Our pharmacists compound your prescription in our Lititz lab and check it before it is dispensed.
- 4
Pick it up or have it delivered.
Pick up at 100 East Main Street in Lititz, or ask about delivery options within Pennsylvania. Refills after that are a phone call or text away.
Already have an LDN prescription somewhere else?
If your current pharmacy has stopped compounding LDN or the turnaround has slipped, transferring is simple: call or text us with your prescription details and current pharmacy, and we handle the rest. See how transfers work.
For prescribers
Questions about strengths, bases, or formulation options? Our compounding pharmacists are available to talk through the prescription before you write it. More for prescribers.
Serving Patients Across Pennsylvania
Lititz Apothecary is licensed to dispense prescription medications throughout Pennsylvania. The pharmacy itself is at 100 East Main Street in Lititz, where patients pick up in person — and local delivery is available in the Lititz and Lancaster County area. Many patients come to us from communities across the state after their prescriber recommends a compounding pharmacy they can call directly.
Prescriptions are a Pennsylvania-only service; we do not ship prescription medications out of state. (Our supplement line is different — those ship nationwide.) If you are elsewhere in Pennsylvania and your prescriber sends us a prescription, call and we will walk through the options for getting it to you.
Questions About Low Dose Naltrexone
What is low dose naltrexone used for?
Prescribers use LDN for autoimmune conditions such as Hashimoto's thyroiditis and Crohn's disease, for chronic pain and fibromyalgia, for inflammatory conditions, and for post-viral fatigue including long COVID. These are off-label uses, which means the decision rests on your provider's clinical judgment. Anything we compound is prepared as prescribed by your healthcare provider.
Do I need a prescription for LDN?
Yes. LDN is compounded only on a prescriber's order, for a specific patient — that is what patient-specific 503A compounding means. If you are a prescriber with formulation questions, our pharmacists are glad to talk before you write.
What strengths and forms do you compound?
We prepare LDN as capsules, slow-release capsules, and oral suspensions, each made to your prescriber's specified strength. All forms are oral and non-sterile. Your prescriber determines the strength and any adjustments over time; we prepare to their order.
Can you fill my LDN prescription if I currently use another pharmacy?
Yes. Call or text us with your current pharmacy's name and phone number and we will handle the transfer for you — including the call to your old pharmacy.
Can you serve patients outside Lancaster County?
Yes. Lititz Apothecary is licensed to dispense across Pennsylvania. The pharmacy is physically in Lititz, with local pickup and delivery in the Lancaster County area — if you are elsewhere in Pennsylvania, call and we will talk through the options. Prescription services are Pennsylvania-only.
Are there side effects I should know about?
Any medication can have side effects, and your prescriber is the right person to explain what to watch for with LDN. Once your prescription is here, our pharmacists are happy to answer questions too.
What does compounded LDN cost?
It depends on the strength and quantity your prescriber writes for, so there is no single answer we can put on a page. Call us with the prescription details and we will walk you through it before we fill anything.
Questions about LDN? Talk to a pharmacist.
Call (717) 626-2222 during business hours and a pharmacist — not a phone tree — will walk you through the next step, whether that's a new prescription or a transfer.
Compounded medications are prepared to a licensed prescriber's order and are not reviewed or approved by the FDA for safety or effectiveness. Nothing on this page is medical advice.