RCH ADR Committee: Treatment of Opioid- induced Pruritis

The Adverse Drug Reactions (ADR) Committee would like to remind staff that opioid-induced pruritus should be managed with low dose naloxone in accordance with the Patient Controlled Analgesia (PCA) Attachment and Opioid Infusion Attachment.

Several Adverse Drug Reaction reports have been received by the ADR Committee where opioid-induced pruritus has been treated with an antihistamine. When antihistamines are used concurrently with opioids the risk of excessive sedation and respiratory depression is increased.

The pathophysiology of opioid-induced pruritus is not fully understood and current evidence suggests that the main pathway involves μ-opioid rather than histamine receptors. 


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