PMID: 9431714Feb 12, 1998Paper

Naltrexone: a case report of pruritus from an antipruritic

The Australasian Journal of Dermatology
J R Sullivan, A Watson

Abstract

Intense, generalized pruritus associated with mycosis fungoides was relieved using subcutaneous naloxone but intensified when changed to the new oral opioid antagonist, naltrexone. Rechallenge again led to worsening in pruritus. This unexpected adverse effect is surprising as naltrexone and naloxone are currently thought to work via similar opioid receptor binding. The worsening of the itch may have been due to adaptation in opioid receptor expression induced by prolonged naloxone therapy, possibly highlighting differential opioid receptor affinity between naltrexone and naloxone, or may have represented an idiosyncratic adverse reaction. Naltrexone and naloxone have been reported to reduce pruritus due to cholestasis, uraemia, morphine epidurals, and possibly atopic dermatitis and urticaria. Naltrexone has the convenience of oral administration and a longer half-life. The role of the opioid system and naltrexone in pruritus is reviewed.

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Citations

Feb 24, 2001·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·T C Puchner, J N Fink
Apr 13, 2002·Japanese Journal of Pharmacology·Takayuki MiyamotoYasushi Kuraishi
Jan 31, 2012·Journal of the American Academy of Dermatology·Kristen AhernBrian Poligone
Jul 20, 2011·Seminars in Cutaneous Medicine and Surgery·Judith HongMartin Steinhoff
May 14, 2010·Journal of the American Academy of Dermatology·Ngoc Quan PhanSonja Ständer
May 19, 2018·Journal of the European Academy of Dermatology and Venereology : JEADV·D J LewisM Duvic
Mar 25, 2019·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Dae Bo LeeWon-Myong Bahk

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