Severe Itching in Patients With Acute Cholestatic Hepatitis B

Question
What is the safest antihistaminic to be used for severe itching in patients with acute cholestatic hepatitis B?

K. Hanna, MD Response from Bradley E. Chipps, MD, FCCP
Medical Director, Cystic Fibrosis Center, Capital Allergy & Respiratory Disease Center, and Associate Medical Director, Sleep Laboratory of Sutter Community Hospitals, Sacramento, California

For severe itching in acute cholestatic hepatitis B, the antihistamine fexofenadine has very high protein binding and low metabolism. Ninety percent of the drug is excreted unchanged. Therefore, this drug is in distinct difference with desloratadine, which has very slow metabolizers. African Americans may especially have significant accumulation of drug. Cetirizine also undergoes metabolism before excretion. It is my opinion that fexofenadine is the safest drug for itching in this clinical syndrome.

Posted 08/26/2003

Medscape Allergy & Clinical Immunology 3(2), 2003. © 2003 Medscape
This is a part of article Severe Itching in Patients With Acute Cholestatic Hepatitis B Taken from "Allegra Buy Fexofenadine" Information Blog