透析症例のかゆみに対するテルフェナジンの効果

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  • Effect of terfenadine on uremic itching in dialysis patients.

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Twenty patients (6 males and 14 females, mean age 58±13 years) with chronic renal insufficiency and who had been an dialysis for an average of 3.2±2.5 years complained of itchiness. They were treated with Terfenadine (TRILUDAN®) at a daily dosage of 120mg (given in two divided doses) for four weeks. An assessment of changes in itchiness and IgE before and after treatment was made.<br>Itchiness improved significantly (p<0.001). The improvement ratio was 80%, the safety ratio was 100%, and the usefulness ratio 80%. However, IgE showed no significant changes. Major metabolic of Terfenadine (M1) in the patients had a Cmax of 654.4±250.6ng/ml, tmax of 3.4±0.5 hr, t1/2 of 5.1±1.6 hr, and AUC0-24 of 6, 917±3, 519ng·hr/ml on non-dialysis days. On dialysis days, the Cmax was 670.5±124.5ng/ml, tmax 4.3±0.2 hr, t1/2 5.8±0.8 hr, and AUC0-24 7, 421±2, 236ng·hr/ml, Terfenadine clearance by dialysis was 20ml/min. Patients on CAPD showed a Cmax of 508.9±60.2ng/ml, tmax of 6.2±1.5 hr, t1/2 of 6.7±0.6 hr, and AUC0-24 of 6, 767±171ng·hr/ml.<br>The above results suggest that Terfienadine, an antiallergic agent, is useful in treating itching skin in patients on dialysis. It is necessary to consider lower doses since patients with renal insufficiency had higher Cmax and AUC0-24 values.

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