DRUG-INDUCED PRURITUS

Abstract

Drug-induced pruritus is a common problem in daily medical practice. Many drugs can cause pruritus after systemic or topical administration, but often the exact mechanism underlying the pathogenesis of itching caused by drugs remains unclear. Therefore, the diagnosis and treatment of drug-induced pruritus are challenging. In the present review, the current knowledge of the most common medications inducing itch with or without skin rash and their underlying mechanisms is summarized. Opioids can cause pruritus, especially if they are administered intrathecally. Some antineoplastic agents can frequently cause intense pruritus due to immune-related cutaneous reactions (immune checkpoint inhibitors) or via triggering hypersensitivity reactions (taxanes) in cancer patients. Recently, it was found that MAS-related G protein-coupled receptor X2 (MRGPRX2), expressed on mast cells in humans, is responsible for drug-induced non-histaminergic pruritus and pseudoallergic reactions.