Everything you ever wanted to know about LDN fillers

[Guest guest]

I apologize in advance for the length of this post. I wrote it to

answer people's ongoing concern about LDN fillers, and I think it's

complete now. Please let me know if I've left anything out.

Okay, here it is, the whole story of … drumroll please…

LDN FILLERS!

If your LDN comes from a compounding pharmacy, and it arrives as a

liquid, then you're getting pure naltexone powder dissolved in

distilled water. This is probably the " purest " way to injest

naltrexone. You don't need to worry about fillers.

BUT -- If you get your LDN in any other form, you are injesting

filler.

A " filler " is an inert, inactive ingredient that accompanies

every dose of naltrexone that you take.

If you make your own LDN --

If you make LDN by crushing ReVia (pronounced REV-yah) or another

commercially manufactured 50mg naltrexone tablet, you are still

injesting filler, because each tablet is comprised of about 16%

Naltrexone and 84% filler.

What kind of filler is used in your tablet? This depends on the

manufacturer. Here are the main manufacturers:

1. Barr Labs – Barr manufactures naltrexone under the brand name

ReVia for the US and Canadian markets. This tablet contains 50mg

naltrexone, and these inactive ingredients: lactose monohydrate,

colloidal silicone dioxide, magnesium stearate, crospovidone,

microcrystalline cellulose, purified water, Opadry beige

(coloring). [information from Barr Labs phone representative.]

2. Bristol Myers Squibb – BMS manufactures naltrexone under the

brand name ReVia in markets other than the US and Canada. As of

2002, their 50 mg tablets contain 50 mg of naltrexone hydrochloride,

plus these inactive ingredients (filler): lactose, microcrystalline

cellulose, crospovidone, silicon dioxide, magnesium stearate, and

pale yellow Opadry (colouring). (Information from a 2002 leaflet by

Australian Prescription Products Guide.)

3. Mallinckrodt – makes a 50mg naltrexone pill called Depade.

This tablet contains 50mg naltrexone, plus these inactive

ingredients (filler): crospovidone, hydropropyl methylcellulose,

lactose monohydrate, magnesium stearate, microcrystalline cellulose,

polyethelene glycol, polysorbate 80, silicone dioxide, titanium

dioxide, yellow iron oxide, and red iron oxide. [information from

Mallinckrodt website.]

[Historical Note: The original ReVia was made by Dupont. The

inactive ingredients were: lactose, microcrystalline cellulose,

crospovidone, silicon dioxide, magnesium stearate, and pale yellow

Opadry (colouring). In 2001, Bristol Myers Squibb acquired DuPont

Pharmaceuticals. In April 2002, BMS sold the ReVia brand-name

rights in the US and Canada to Barr Laboratories. BMS continues to

market ReVia outside of the US and Canada.]

If your LDN is made by a compounding pharmacy –

Ask your pharmacist how it is made.

1. Some compounders make LDN by crushing commercially manufactured

50mg tablets and putting the powder into capsules. Because the

amount of powder that goes into each capsule is not enough to fill

the capsule, most pharmacies add additional filler. If this is how

you get your LDN, you can find out which commercially manufactured

tablet they are using, and what kind of additional filler your

pharmacist puts in.

2. Other compounders don't crush 50mg tablets; instead, they use

pure naltrexone powder (purchased in bulk from pharmaceutical

companies), which they mix with filler. From these pharmacists, you

CAN learn what kind of filler you are taking.

Here are some of the fillers used by these compounders:

-- LACTOSE: Lactose is a naturally occurring simple carbohydrate,

or sugar, found only in the milk of mammals. For this reason, it is

also commonly referred to as " milk sugar. "

Lactose has long been used as a soluble filler in the manufacture of

orally administered pharmaceuticals. It is safe, stable,

inexpensive, and has a fast dissolution rate. Pharmaceutical-grade

lactose powder is highly pure, specifically produced to meet

government standards of safety and purity.

Lactose is easily tolerated by most patients. However, if you are

lactose-intolerant (that is, if milk products give you nausea,

diarrhea, abdominal cramping, bloating, or flatulence), you might

want to try another filler.

Note: Dr Bihari asks his patients to use lactose, unless they have

an adverse reaction… not because he believes lactose is better

than other fillers, but because he began his study of LDN with

lactose, and he wants his records to be consistent.

-- ACIDOPHILOUS – (pronounced Ah-SID-uh-FILL-us) – is lactic

bacteria, or one-celled micro-organisms, essential in the digestive

tract for performing many functions necessary to promote immunity

and proper nutrition. It is used as a digestive aid and is sold over

the counter as a nutritional supplement. Acidophilus is sometimes

used as a treatment for diarrhea and constipation. It is

commercially available as powder, tablets, capsules or liquid.

Patients who are lactose intolerant sometimes switch to Acidophilus

filler in their LDN capsules.

-- AVICEL – a brand name for microcrystalline cellulose. Avicel

has been used safely and effectively for 35 years in the food,

pharmaceutical and specialty industries. It is virtually inert; it

is not absorbed into the system, and will not interfere or interact

with other nutrients, vitamins or minerals. Avicel is made of wood

which has been purified and powdered into extremely tiny particles --

between 0.000039 and 0.0001560 of an inch of pure fiber, with the

consistency of a very fine face powder

Avicel is the filler used by Skip's Pharmacy in Boca Raton. For

a fun history of Avicel, visit: " Let Us Have Nothing To Eat, "

http://www.uefap.co.uk/reading/exercise/kavaler/kavaler8.htm

-- CALCIUM CARBONATE – a mineral that occurs naturally in

limestone, marble and coral. Crushed to a fine, odourless powder,

it is a natural food additive, and the most common ingredient in

calcium supplements and antacids.

Calcium is absorbed by the small intestine and is used by the body

to build bone tissue. Calcium supplements are generally well

tolerated, but in some patients may cause constipation, bloating,

gas and flatulence.

Some people should not take calcium carbonate: People with kidney

stones, hypercalcemia, sarcoidosis, hyperparathyroidism,

hypervitaminosis D and cancer.

People taking calcium supplements are usually advised to take them

with food.

There has been some concern among LDN users that calcium carbonate

might be packed too tight in the capsule, which can cause a slow-

release reaction, rather than the desired fast-release.

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I hope this post is useful. Please let me know if I missed

anything.

-- Maureen