Relief of cholestatic pruritus by a novel class of drugs: 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists: effectiveness of ondansetron

Pain. 1995 Apr;61(1):33-37. doi: 10.1016/0304-3959(94)00145-5.


The objective of the present study was to determine whether ondansetron, a specific serotonin type 3 receptor antagonist (5-HT3), relieves cholestatic pruritus in patients resistant to conventional antipruritic therapy (antihistamines and cholestyramine). In a placebo-controlled study the acute effect of an intravenous injection of ondansetron (4 mg, 8 mg) or placebo (NaCl solution) was tested in 10 patients (41-66 years of age; 4 men, 6 women) with cholestatic itch. A successful treatment was assessed when the intensity of itch was reduced by 50% or more within 2 h after injection of ondansetron. Intensity of itch was determined by the patients on a visual rating scale from 0 to 10. Ondansetron reduced or abolished pruritus within 30-60 min after injection. A 50% reduction of the intensity of itch was observed up to 6 h after injection of 8 mg. The effect was reproducible in the same patient. In conclusion ondansetron is effective in the treatment of cholestatic itch. Serotonin may participate in the generation and/or sensation of cholestatic pruritus.

Publication types

  • Case Reports
  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Cholangitis, Sclerosing / complications
  • Cholestasis / complications*
  • Female
  • Humans
  • Liver Cirrhosis, Biliary / complications
  • Male
  • Middle Aged
  • Ondansetron / therapeutic use*
  • Pruritus / drug therapy*
  • Pruritus / etiology
  • Serotonin Antagonists / therapeutic use*


  • Serotonin Antagonists
  • Ondansetron