Gastroenterology

Gastroenterology

Volume 108, Issue 5, May 1995, Pages 1582-1588
Gastroenterology

The pruritus of cholestasis: Potential pathogenic and therapeutic implications of opioids

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    In case series, drug-induced hepatic dysfunction has been reported in up to 12% of cholestatic patients.45 Opioid antagonists, such as naltrexone, are important mediators of itch and have been studied as treatment for cholestatic pruritus.46–51 Naltrexone may be used at a dose of 50 mg/d, or nalmefene at 4 to 240 mg/d. Problems with opiate withdrawal–type reactions have been noted, however, and this risk should be reviewed with the patient.

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    In case series, drug-induced hepatic dysfunction has been reported in up to 12% of patients with cholestasis.37 Opioid antagonists, such as naltrexone, have been studied as treatment of cholestatic pruritus.38–43 Naltrexone may be used at a dose of 50 mg/day or nalmefene, 4 to 240 mg/day.

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Dr. Jone's current address is: Department of Gastrointestinal and Liver Diseases, Academic Medical Center, Melberdreef 9, 1105 AZ Amsterdam Zuidoost, The Netherlands.

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