Role of intravenous naloxone in severe pruritus of acute cholestasis.
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Date
2009-09
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Abstract
Pruritus is a well-known manifestation of various cholestatic disorders. Increased opioidergic tone is one of the mechanisms
for this. This prospective, uncontrolled study was done
to determine the efficacy of intravenous naloxone in pruritus
of acute cholestasis. Twenty-two patients with severe pruritus
(based on visual analogue scale [VAS] score of 0–100 and
associated symptoms) were treated with intravenous naloxone
(0.4 mg every 8 hours) for at least 48 hours. Viral hepatitis
E was found to be the most common etiology for cholestatic
pruritus (n=12). Eighteen patients (81.8%) patients had significant
reduction in VAS after 48 hours of starting naloxone;
these patients also showed reduction in alkaline phosphatase
and gamma glutamyl transpeptidase. There was no side-effect
or ‘breakthrough’ phenomenon noted in any patient over
next 6 weeks. Naloxone is safe and efficacious in symptomatic improvement in cholestatic pruritus.
Description
Keywords
Cholestasis, naloxone, open-label study
Citation
Joshi Gunjan G, Thakur B S, Sircar Shohini, Namdeo Arvind, Jain Ajay K. Role of intravenous naloxone in severe pruritus of acute cholestasis. Indian Journal of Gastroenterology. 2009 Sept-Oct; 28(5): 180-182.