Comparison
Low-Dose Naltrexone vs NMN
Side-by-side of Low-Dose Naltrexone and NMN. Every row below is pulled from the compound schema and will update as our data grows. For deeper reads, follow through to each compound page.
Low-Dose Naltrexone
Low dose naltrexone at 1.5 to 4.5 mg, one-tenth the 50 mg addiction dose. Compounded Rx. Small trials in fibromyalgia, Crohn's, Hashimoto's.
NMN
NMN supplements are oral nicotinamide mononucleotide capsules sold for longevity, energy, and metabolic health. They raise plasma NAD+ 30-90% at 250-1000.
Effects at a glance
Low-Dose Naltrexone
- •Off-label use at 1.5 to 4.5 mg, roughly one-tenth the FDA-approved 50 mg addiction-treatment dose
- •Proposed mechanisms include brief opioid receptor blockade triggering rebound endogenous opioid release, plus TLR4 antagonism
- •Compounded prescription only; insurance rarely covers; cash prices 20 to 80 USD per month
- •Younger 2013 reported ~30% pain reduction in fibromyalgia at 4.5 mg in a small crossover trial
- •Smith 2011 reported endoscopic improvement in active Crohn's disease (n=40 placebo-controlled)
- •Vivid dreams affect 20 to 40% in first 2 weeks; manageable by switching to morning dosing
NMN
- •Plasma NAD+ rises 30-90% at 250-1000 mg/day across human PK studies
- •Tissue NAD+ rise is inconsistent across human trials (Yoshino 2021, Igarashi 2022)
- •No human trials measure hard endpoints (mortality, CV events, cancer); evidence is biomarker-only
- •Most trials cluster at 250-500 mg/day; dose-response above 250 mg/day is poorly characterized
- •FDA position contested; widely sold as supplement but with regulatory uncertainty
- •Marketing claims for fertility and longevity outrun the human trial evidence substantially
Side-by-side
| Attribute | Low-Dose Naltrexone | NMN |
|---|---|---|
| Category | pharmaceutical | supplement |
| Also known as | LDN, naltrexone (low dose) | nicotinamide mononucleotide, beta-NMN |
| Half-life (hr) ↗ | 4 | 4 |
| Typical dose (mg) ↗ | 4.5 | 250 |
| Dosing frequency | once daily, typically at bedtime | 1x daily, often morning |
| Routes | oral | oral, sublingual |
| Onset (hr) | 1 | 1 |
| Peak (hr) | 1.5 | 3 |
| Molecular weight | 341.4 | 334.22 |
| Molecular formula | C20H23NO4 | C11H15N2O8P |
| Mechanism | Brief mu-opioid receptor antagonism proposed to trigger compensatory upregulation of endogenous opioids; secondary TLR4 antagonism on microglia and immune cells contributes to anti-inflammatory effect. | Direct precursor in the NAD+ salvage pathway; converted to NAD+ by NMNAT enzymes in essentially every tissue. Raised NAD+ supports sirtuin and PARP enzyme activity. |
| Legal status | Off-label compounded prescription (naltrexone is FDA approved for opioid and alcohol use disorder at 50 mg) | Contested in US (FDA position 2022); widely sold as supplement; broadly available in EU, UK, Asia |
| WADA status | allowed | allowed |
| DEA / Rx | Rx only (not a controlled substance) | Not scheduled |
| Pregnancy | Insufficient data; not routinely recommended | Insufficient data; precautionary avoidance |
| CAS | 16590-41-3 | 1094-61-7 |
| PubChem CID | 5360515 | 14180 |
| Wikidata | Q426444 | Q418972 |
Safety profile
Low-Dose Naltrexone
Common side effects
- vivid dreams
- sleep disruption
- headache
- mild GI upset
- fatigue (early)
Contraindications
- concurrent opioid use
- acute hepatitis or liver failure
- opioid dependence
- pregnancy (insufficient data)
Interactions
- opioid analgesics (oxycodone, morphine, codeine): blocks analgesic effect; precipitates withdrawal in dependent users(major)
- tramadol: blocks opioid component of analgesia(major)
- thyroid hormone replacement: may alter dose requirements after immune modulation; monitor TSH(minor)
NMN
Common side effects
- mild GI upset (rare)
- occasional headache
- flushing (rare)
Contraindications
- pregnancy and lactation (precautionary, no data)
- active cancer (theoretical concern, not evidence-based)
Interactions
- metformin: no clinically significant interaction documented; both modulate metabolism through different mechanisms(minor)
- chemotherapy agents: theoretical concern about supporting cancer cell proliferation; coordinate with oncology team(moderate)
- CD38 inhibitors: would amplify NMN-induced NAD+ rise; not clinically relevant for most users(minor)
Which Should You Take?
NMN comes out ahead for most readers on the criteria we weight: 3 catalogued goals, Contested in US (FDA position 2022); widely sold as supplement; broadly available in EU, UK, Asia, oral dosing, with a Tier-A outcome catalogued. Low-Dose Naltrexone is the right call when one of the conditionals below applies.
- → If your priority is immune support, pick Low-Dose Naltrexone.
- → If your priority is pain modulation, pick Low-Dose Naltrexone.
- → If your priority is healthspan extension, pick NMN.
- → If your priority is energy and stamina, pick NMN.
Default choice: NMN. Wider use case, a Tier-A evidence outcome catalogued, and broader goal coverage. Reach for Low-Dose Naltrexone only if your priority sits squarely in the goals it owns above.
This verdict is generated from each compound's schema (goals, legal status, evidence outcomes, dosing route). It updates automatically as our compound data evolves; the deeper read sits on each individual compound page.
Common questions
What is the difference between Low-Dose Naltrexone and NMN?
Low-Dose Naltrexone and NMN differ in category (pharmaceutical vs supplement), mechanism, and typical dosing. See the side-by-side table for full details.
Which has a longer half-life, Low-Dose Naltrexone or NMN?
Low-Dose Naltrexone half-life is 4 hours; NMN half-life is 4 hours.
Can you stack Low-Dose Naltrexone with NMN?
Stack compatibility depends on mechanism overlap, legal status, and individual response. Check each compound page for specific interactions and contraindications before combining.
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