COMPARISON OF RIFAMPICIN WITH PHENOBARBITONE FOR TREATMENT OF PRURITUS IN BILIARY CIRRHOSIS
Abstract
The anti-pruritic effects of rifampicin (10 mg/kg) and phenobarbitone (3 mg/kg) were assessed in 22 patients with primary biliary cirrhosis in a crossover randomised clinical trial. Each agent was given for 14 days, with a 30-day washout period between treatments. 21 patients completed the course of rifampicin and 18 that of phenobarbitone; rifampicin was withdrawn from 1 patient when anaemia and renal failure developed, whereas 3 patients stopped taking phenobarbitone because of a rash and the 4th merely refused the drug. Rifampicin had a greater anti-pruritic effect than phenobarbitone. The symptom improved in 19 patients taking rifampicin and in 8 taking phenobarbitone, the degree of improvement being greater with rifampicin than with phenobarbitone. Pruritus disappeared in 9 patients receiving rifampicin, and three of them were free of itch when switching over to phenobarbitone. Both drugs were equally effective in inducing hepatic microsomal function but rifampicin has the additional effect of reducing cholestasis. Its anti-pruritic effect should be tested in long-term clinical trials.
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Several prospective randomised placebo-controlled trials have shown rifampicin to be effective in the management of cholestatic pruritus.
“Several prospective randomised placebo-controlled trials have shown rifampicin to be effective in the management of cholestatic pruritus.182–185”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [183]
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- Authors
- Bachs, L., Elena, M., Parés, A., Piera, C., & Rodés, J.
- Affiliations
- Hospital Clínic de Barcelona (ES)
- Universitat de Barcelona (ES)
- ORCID
- Parés, Albert
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 1989-03
- Volume
- 333
- Issue
- 8638
- Pages
- 574-576
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2088682754
- Cited by
- 231
- References
- 23
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 8 · 2023: 8 · 2022: 6 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 9 · 2017: 6 · 2016: 8 · 2015: 9 · 2014: 10 · 2013: 4 · 2012: 3
- FWCI
- 3.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Keywords
- rifampicin, phenobarbital, pruritus, primary biliary cirrhosis, antipruritic effect, cholestasis, drug-induced liver injury, anemia, renal failure
- MeSH terms
- Adult, Cholestasis, Clinical Trials as Topic, Drug Administration Schedule, Female, Humans, Liver Cirrhosis, Biliary, Microsomes, Liver, Middle Aged, Phenobarbital, Pruritus, Random Allocation, Rifampin, Severity of Illness Index
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