Apply topical agents, e.g. D.P.Lotion (no part-charge on prescription), Alpha-Keri™ lotion, 0.25-1% Menthol in aqueous cream.
Night sedation may be helpful.
Use emulsifying ointment or Pinetarsol instead of soap.
Biliary stenting may be the most effective management if appropriate.
UVB phototherapy may be helpful for uraemic itch.
Consider drug treatment
Anti-histamines, e.g. Promethazine HCl 10-25 mg nocte or a non-sedating alternative for daytime use. Cetirizine if there is liver involvement as it is not liver metabolised.
Cholestyramine (Questran Light™) ½ - 1 sachet BD/TDS for obstructive jaundice as it binds bile salts.
H2 Antagonist (acting via histamine receptors in the skin), e.g. Cimetidine 400 mg BD. (Note: check drug interactions.)
Steroids – particularly for lymphoma or other active malignancies.
Low dose Paroxetine (5 mg) – beware of nausea.
Rifampicin for chronic cholestasis.
NSAIDs, e.g. diclofenac.
Ondansetron has been reported to be helpful (beware of cost and constipation).
Information about this Canterbury DHB document (4134):