Group of drugs | Examples | Possible mechanism of pruritus | Frequency of pruritus |
Antiarrhythmic drugs | Amiodarone | Cholestatic liver injury | Case reports |
Antibiotics | Penicillins | Secondary to skin lesions or cholestatic liver injury | 2 to 20% |
Cephalosporins | Unknown or secondary to skin lesions | <2% |
Macrolides | Secondary to skin lesions or cholestatic liver injury | <0.3% |
Carbapenems | Cholestatic liver injury | Rare |
Monobactams | Secondary to skin lesions | Rare |
Quinolones | Unknown or secondary to skin lesions | 1 to 4% |
Tetracyclines | Unknown or cholestatic liver injury | 1 to 2% |
Lincosamides | Secondary to skin lesions or cholestatic liver injury | Rare |
Streptogramins | Secondary to skin lesions | 2.5% |
Metronidazole | Unknown or secondary to skin lesions | <5% |
Rifampin | Unknown | Case report |
Thiamphenicol | Unknown | <0.1% |
Trimethoprim-sulfamethoxazole | Secondary to skin lesions | 2 to 10% |
Cholestatic liver injury | Rare |
Antimalarials | Unknown, but genetic background is important; release of histamine or activation of mu-receptors were postulated | Up to 60 to 70% of Black Africans, uncommon in White population or Asian population |
Anticoagulants | Ticlopidine | Cholestatic liver injury | Case reports |
Fractionated heparins | Urticarial reaction | Case reports |
Antidiabetic drugs | Biguanides | Cholestatic liver injury | Case reports |
Sulfonylurea derivatives | Unknown | <5% |
Antiseizure medications | Carbamazepine, fosphenytoin, oxcarbazepine, phenytoin, topiramate | Secondary to skin lesions, allergic reaction | Rare |
Antihypertensive drugs | Angiotensin-converting enzyme inhibitors | Increase of bradykinin level or cholestatic liver injury or secondary to skin lesions | 1 to 15% |
Angiotensin II antagonists (sartans) | Cholestatic liver injury | Case reports |
Beta-adrenergic blockers | Secondary to skin lesions | Frequent, if administered transdermally |
Cholestatic liver injury | Rare |
Calcium channel blockers | Secondary to skin lesions or unknown | <2% |
Cholestatic liver injury | Case reports |
Methyldopa | Unknown or secondary to skin lesions | <2% |
Sildenafil | Cholestatic liver injury | Case report |
BRAF inhibitors | Vemurafenib | Unknown | 19% |
Cytokines, growth factors and monoclonal antibodies | Granulocyte-macrophage colony-stimulating factor | Unknown | Common |
Interleukin 2 | Direct pruritogenic effect of interleukin 2 | Very common |
Matuzumab | Unknown | <10% |
Lapatinib | Unknown or urticarial reaction | 3% |
Cytostatics | Chlorambucil | Secondary to skin lesions | Case reports |
Paclitaxel | Unknown or secondary to skin lesions | 10 to 14% |
Tamoxifen | Sebostasis/xerosis | 3 to 5% |
Epidermal growth factor inhibitors | Cetuximab | Unknown | 22% |
Erlotinib | Unknown | 18% |
Panitumumab | Unknown | 58% |
Hypolipidemic drugs | Statins | Unknown or secondary to skin lesions | 16% |
Monoclonal antibody to CTLA-4 | Ipilimumab | Unknown | 31% |
Plasma volume expanders | Hydroxyethyl starch (HES) | Deposition of HES in small peripheral nerves or in Schwann's cells of cutaneous nerves | 12.6 to 54% |
Psychotropic drugs | Tricyclic antidepressants | Cholestatic liver injury | Rare |
Selective serotonin reuptake inhibitors | Activation of peripheral serotonin receptors or secondary to skin lesions | Rare |
Neuroleptics | Cholestatic liver injury | Rare |
Others | Antithyroid agents | Cholestatic liver injury | Rare |
Nonsteroidal antiinflammatory drugs | Increased synthesis of leukotrienes | 1 to 7% |
Cholestatic liver injury | Rare |
Corticosteroids | Cholestatic liver injury | Very rare |
Sex hormones | Cholestatic liver injury | Rare |
Opioids | Centrally mediated process via mu-opioid receptor | 2 to 100% |
Inhibitors of xanthine oxidase | Secondary to skin lesions | 0.8 to 2.1% |