Opiate Itching

[DianeGam]

I and many of my patients are unable to take opiate medications due to intense, long acting itching all over. Antihistamines don't help. What are some alternative oral pain meds and what can be used to stop the itching?

[Minnie_Amma]

Dr. Diane, here's what I would do if I was a doctor. I would order up some doxepin, get the powder out the capsules, mix it with some distilled water in a spray bottle, and spray it on my left side.

For example, if my torso itches (belly + chest), and spray just my left side.

I would see if that works (titrating the ratio of dox/h2o, of course).

Disclaimer: this is not medical advice, don't even touch doxepin without under the direct supervision of an army of physicians. This post only represents what I would try, on myself, if I were a doctor.

[jemma116]

Have you or any of your patients had acupuncture to help with their pains?

I have been referred to have that done, but not had it yet.  

[jemma116]

I have experienced an itchy rash just in the area of the patch of the 5 microgram/hour Buprenorphine (BuTrans).  The "rashes" were bearable for the first 3 weeks.  One patch stays stuck on for a week.  The pain management consultant advised a much higher dose, but with my medical history of reactions to medications, my doctor has started me on the lowest dose to see if I will be OK with it. - obviously not.

This last patch that I have put on on Wednesday, has caused severe itching, pain and burning pins and needles in the area of the patch.  I could not tolerate it any longer and have had to take it off.  It was due to come off and a new one put on next Tuesday.  I have an appointment to see my doc on Monday.

I too take 10mg every morning of Ceterizine (antihistamine) that I was prescribed a few years ago for other reasons.  And that has not help with this "allergic" reaction to the opioid patch.

I have applied natural set yogurt which is helping to cool down the burning and the itching.  

The other thing I would suggest is to have a cool shower.  Calomine lotion or calomine based creams will help to ease the itching, as will the natural yogurt, but really not very good if the itching is all over the body.

Your patients are unfortunately going to have to stop taking the opiate medications.