Buprenorphine and hepatic pruritus

Pruritus in cholestatic liver disease can be difficult to treat. It may be related to impaired excretion of large opioid peptides. Buprenorphine, a drug with partial opiate antagonist properties, was used in a double-blind trial of five patients with uncontrollable itching. One patient improved clinically, one patient had good relief from pruritus and three had intolerable side-effects. Buprenorphine may be of limited use in intractable pruritus.