Scalp Pruritus: Review of the Pathogenesis, Diagnosis, and Management

Table 3

Principal systemic medications for scalp pruritus.

Medication	Dosage	Adverse effects
Antihistamines
Chlorphenamine	4 - 16 mg/day orally	Drowsiness, dry mouth
Hydroxyzine	25 - 50 mg/day orally	Drowsiness, dry mouth
Diphenhydramine	25 - 100 mg/day orally	Drowsiness, dry mouth
Cetirizine	10 - 20 mg/day orally	Drowsiness, dry mouth
Loratadine	10 - 20 mg/day orally	Drowsiness, dry mouth
Fexofenadine	60 - 360 mg/day orally	Drowsiness, dry mouth
Levocetirizine	5 - 10 mg/day orally	Unusual drowsiness, dry mouth
Doxepin	25 - 100 mg/day orally	Drowsiness, dry mouth, prolonged; QT interval
Anticonvulsants
Gabapentin	100 - 1200 mg/day orally	Drowsiness, leg edema, constipation
Pregabalin	25 - 200 mg/day orally	Drowsiness, leg edema
Opioids
Naloxone	0.2 mg/kg/min intravenous daily, preceded by 0.4mg intravenous bolus over 24 hours	Hepatotoxicity, nausea and vomiting, insomnia
Naltrexone	12.5 - 50 mg/day orally	Hepatotoxicity, nausea and vomiting, abdominal pain, diarrhea
Butorphanol	1 - 4 mg inhaled at bedtime	Drowsiness, nausea and vomiting, dizziness
Antidepressants
Amitriptyline	10 - 150 mg/day orally	Drowsiness, dizziness, dry mouth, constipation
Paroxetine	10 - 40 mg/day orally	Insomnia, dry mouth, sexual dysfunction
Mirtazapine	7.5 - 15 mg/day orally	Drowsiness, weight gain, dry mouth
Miscellaneous
Cyclosporin A	3 - 5 mg/kg/day orally	Nephrotoxicity, hypertension
Thalidomide	100 - 200 mg/day orally	Teratogenic effect, peripheral neuropathy, drowsiness, constipation