Drug-induced pruritus

Pruritus, especially chronic pruritus, has long been underestimated and leads to high psychological strain in the affected patients. Even today, in spite of receiving increased attention, the underlying etiology cannot always be identified. We review potential underlying pathologic mechanisms of drug-induced pruritus, focusing among others on current dermato-oncological medications in terms of their pruritogenic risks. Acute pruritus must be distinguished from chronic pruritus which lasts for a minimum of 6 weeks. There are various therapeutic approaches for drug-induced pruritus. As a first step, the drug causing the pruritus has to be identified; then the intake of that drug has to be ceased or modified. This may not always be possible, as in the case of chemotherapy agents. With regard to the demographic development of the population with increasing life expectancy and the resulting increasing polypharmacy, drugs will have to be taken into account as a possible cause for pruritus more often in the future. It would be desirable to routinely assess pruritus as a possible adverse effect in regulatory drug studies.