Version May 2024
| Medication* | Dose range¶ | Notes |
| Antihistamines | Variable depending on medication | No direct effect on pruritus except in urticaria; sedating antihistamines may be useful through their soporific effects |
| Antidepressants | Mirtazapine 7.5 to 15 mg at night | Useful in nocturnal pruritus, may cause increased weight and appetite |
| Paroxetine 10 to 40 mg per day | Consider in psychiatric patients with pruritus and paraneoplastic pruritus | |
| Fluvoxamine 25 to 150 mg per day | Consider in psychiatric patients with pruritus and paraneoplastic pruritus | |
| Sertraline 75 to 100 mg per day | Useful in cholestatic pruritus | |
| µ-opioid receptor antagonists | Naltrexone 12.5 to 50 mg per day | Useful in patients with cholestatic and CKD-associated pruritus; may cause nausea, vomiting and drowsiness; reverses analgesia and may precipitate acute withdrawal in patients receiving opioid analgesics |
| κ-opioid receptor agonist/µ-opioid receptor antagonist | Butorphanol 1 to 4 mg intranasally per day | Useful in nocturnal and intractable pruritus; may cause nausea and vomiting as well as drowsiness; may precipitate acute withdrawal in patients receiving opioid analgesics; some potential for abuse due to concomitant weak µ-opioid receptor agonist activity |
| Selective κ-opioid receptor agonist | Nalfurafine 2.5 to 5 micrograms per day | Useful in CKD-associated pruritus; may cause insomnia; approved in Japan only |
| Anticonvulsants | Gabapentin 100 to 3600 mg per day | Applies to both: useful in neuropathic pruritus, may cause drowsiness and weight gain; usually given in two to three divided daily doses; dose alteration for renal insufficiency may be needed |
| Pregabalin 150 to 300 mg per day | ||
| Substance P antagonist | Aprepitant 80 mg per day | Beneficial in pruritus associated with the Sézary syndrome; expensive |
| Thalidomide | 100 mg at night | Primarily used for prurigo nodularis |
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
