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Dr Asit Kumar Mittal, Udaipur 21 January 2019

In recent years, there is an attempt to better understand mechanism of itch in systemic itch.
Disturbance in endogenous opioids both at the central and peripheral level is one of the proposed mechanisms.
Drugs-like gabapentin and pregabalin in low doses have shown maximum efficacy in itch of chronic kidney disease (CKD).
Antagonist such as naltrexone and agonist such as nalfurafine have shown efficacy in itch arising out of both kidney and liver disorders.
Other pharmacotherapies that have been attempted in hepatobiliary itch are rifampicin, cholestyramine and sertraline.
Ileal bile acid transporter inhibitors are some of the exciting new developments in treating hepatobiliary itch.

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