Which medications in the drug class Antipruritics are used in the treatment of Primary Biliary Cholangitis (Primary Biliary Cirrhosis)?

Updated: Nov 08, 2017
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

Antipruritics

Pruritus is often refractory to medical therapy and significantly impacts patients' quality of life. Antihistamines are first-line agents to relieve pruritus in early stages. Cholestyramine and colestipol are effective in sequestering bile salts in the enteric lumen. A 1- to 4-day delay is expected before itching remits.

Cholestyramine (Questran)

Should be administered 1 h before meals.

Rifampin (Rifadin, Rimactane)

Precise mechanism of action is unclear. May involve inhibition of bile acid uptake into hepatocytes and facilitation of excretion of dihydroxy and monohydroxy bile acids and toxic bile acids. Used in patients who are not responding to cholestyramine.

Colestipol (Colestid)

Forms a soluble complex after binding to bile acid, increasing fecal loss of bile acid–bound low-density lipoprotein cholesterol.


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