Cholestatic pruritis

Cholestatic pruritus is secondary to obstruction of common bile duct and can be relieved by inserting an intra-ductal stent.

Treatment should be based upon the severity of the pruritus and the following approaches can be considered:

  • Warm baths and emollients
  • Topical antipruritic: Levomenthol (menthol) cream BP 0.5-2% may be helpful
  • Anti-histamine: consider a trial either at bed time or around the clock. Chlorphenamine 4mg TDS may be effective. Higher doses can be used but may precipitate coma or mask signs of encephalopathy in severe liver disease
  • Sertraline 50-100mg once daily
  • Other drugs include Rifampicin, Danazol and Naltrexone – please seek specialist advice


This Guide is intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.

Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.

While WMPCPS takes every care to compile accurate information , we cannot guarantee its correctness and completeness and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.