Nalfurafine hydrochloride  for the treatment of pruritus.
BACKGROUND
Severe pruritus associated with end-stage renal disease is a particularly troublesome complication, because no effective treatment has been established. However, based on the findings of a recent randomized controlled trial, nalfurafine hydrochloride was officially approved in Japan for the treatment of resistant pruritus in hemodialysis patients.


METHODS
This review is based upon a PubMed search and personal experience with nalfurafine hydrochloride. The pharmacokinetics and pharmacodynamics of nalfurafine hydrochloride are reviewed and its efficiency and potential adverse effects are discussed, mainly based on the findings of randomized controlled trials.


CONCLUSIONS
A recent long-term open trial showed that the effect of nalfurafine hydrochloride was enhanced by continuous, long-term administration. It will be of future interest to investigate its effect on excoriations, lichen simplex, prurigo nodularis and acquired perforating dermatosis (all caused by uremic pruritus), because it targets both the skin and the central nervous system. In clinical practice, it should be kept in mind that basic skin care with emollients and other topical drugs is essential for stopping the itch-scratch cycle, and the resultant skin barrier dysfunction.
Osaka University School of Medicine, Department of Regenerative Dermatology, 2-2, G2, Yamadaoka, Suita-shi, Osaka 5650871, Japan. inui@r-derma.med.osaka-u.ac.jp
Shigeki
S
Inui
D003879:Dermatologic Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D009019:Morphinans / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D011537:Pruritus / Q000188:drug therapy*; D017473:Receptors, Opioid, kappa / Q000819:agonists; D013141:Spiro Compounds / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*
D003879:Dermatologic Agents; D009019:Morphinans; D017473:Receptors, Opioid, kappa; D013141:Spiro Compounds; C111212:TRK 820