Patricia Pinto-Garcia, MD, MPH
Written by Nikki Javit, PharmD | Reviewed by Patricia Pinto-Garcia, MD, MPH
Published on September 1, 2023
Key takeaways:
Many things in life can make you feel itchy. Dry skin, environmental triggers, and certain health conditions can all cause itchiness. Some medications can too.
Opioids, antibiotics, and several blood pressure medications may tempt you to scratch your skin. Some cancer treatments are also notorious for this.
If you’re feeling itchy and it’s affecting your day-to-day life, you should talk with your healthcare provider. They can help you come up with a plan to manage your symptoms.
Table of contents
Blood pressure meds
Opioids
Antibiotics
Antidepressants
Statins
Cancer drugs
Heparin
Chloroquine
Seeking help
Bottom line
References
Ljupco/iStock via Getty Images
We all know how annoying itchy skin can be. It’s like having a tickle that won’t stop. And although it may just be uncomfortable, it can sometimes affect your quality of life. Battling the urge to scratch can seem impossible.
If you’re itching your skin more than usual, there are a few possible reasons why. For instance, certain medical conditions, environmental triggers, or irritants could be the cause. In some cases, medications could also be a culprit.
Here, we’ll cover eight medications that can cause you to feel itchy and how to manage it. Keep in mind that this list isn’t all inclusive.
BLOOD PRESSURE MEDICATIONS
There are several blood pressure drugs that cause itching.
Calcium channel blockers (CCBs) like amlodipine (Norvasc), beta blockers like atenolol (Tenormin), and hydrochlorothiazide are a few examples. Itchiness has also been reported with angiotensin-converting enzyme (ACE) inhibitors like lisinopril.
There’s some evidence that suggests itchiness caused by CCBs, beta blockers, and hydrochlorothiazide is due to skin inflammation. Itchiness from ACE inhibitors is likely due to the buildup of bradykinin (a natural protein in the body). Higher levels of this protein can cause swelling and itchiness.
Managing itchiness from blood pressure medications
If your itchiness is just an annoyance, you can try applying a cold compress to your itchy areas of skin. Anti-itch creams like pramoxine or hydrocortisone may also help if only a small area of skin is affected. Oral antihistamines like diphenhydramine (Benadryl) or loratadine (Claritin) are better if you feel itchy in several places, but they can cause drowsiness.
If your itchiness is severe or long-lasting, loop in your healthcare provider. They may recommend a different medication to lower your blood pressure.
Keep in mind: Don’t stop taking your blood pressure or heart medications without talking to your healthcare provider first. If you’re bothered by itchiness, your provider can help figure out if the medication — or something else — is at fault. They can also come up with a plan to manage it.
Opioids
Opioid medications, such as oxycodone (Roxicodone, OxyContin) and morphine (MS Contin), are strong pain-relieving medications. They can also trigger itchy skin.
Itchiness from opioids is likely triggered by the stimulation of mast cells, a type of immune cell. These cells release histamine, which is a chemical in your body that’s known for its role in causing allergy symptoms. It can also cause itchy skin.
Managing itchiness from opioids
If your symptoms are mild, you may be able to manage itchiness on your own. Antihistamines like diphenhydramine or loratadine work well for some people. Small skin care adjustments can also make a difference. For instance, bathing in warm water instead of hot water can soothe your skin. And avoiding irritants like preservatives, metals, and fragrances in skincare products can offer relief if you have sensitive skin.
If your itchiness is severe or won’t go away, talk to your healthcare provider. They may suggest switching to another pain medication.
But, if you’ve been taking your opioid medication for a while, don’t abruptly stop taking it without talking to your provider first. They can help you lower your dose over time to minimize any withdrawal symptoms.
Certain antibiotics
Several antibiotics can make you feel itchy, too. This includes sulfamethoxazole / trimethoprim (Bactrim) and penicillin antibiotics such as amoxicillin and amoxicillin / clavulanate (Augmentin). Azithromycin (Zithromax) and other macrolides are also on the list of antibiotics that cause itchiness.
Feeling itchy stems from the body’s response to the antibiotic, likely either through an allergic reaction or cholestasis (buildup of bile in body tissues).
Management itchiness from antibiotics
In most cases, itchiness from antibiotics is a temporary problem. These medications are taken for a short period of time.
But, you shouldn’t try to manage itchiness from an antibiotic on your own. Some people report being allergic to antibiotics, especially penicillin antibiotics and sulfa drugs. To be safe, you should contact your provider if you develop any new skin rashes after starting an antibiotic.
In milder cases, your provider may recommend applying a cool compress or hydrocortisone cream to the affected area. In more serious cases, they might suggest an antihistamine or an oral corticosteroid like prednisone. They’ll likely switch you to a different antibiotic, too.
Severe allergic reactions to antibiotics are rare, but possible. It’s recommended to go to the nearest emergency room if you suddenly have trouble breathing or experience facial, lip, or tongue swelling.
Certain antidepressants
Antidepressants are medications that treat depression and anxiety. Several antidepressants have been reported to cause itchiness. The exact way they do this isn’t clear.
Tricyclic antidepressants (TCAs), such as amitriptyline and nortriptyline (Pamelor), are one group of antidepressants that cause itchiness. But this isn’t unique to TCAs. Selective serotonin reuptake inhibitors like escitalopram (Lexapro), paroxetine (Paxil), and sertraline (Zoloft) have also been linked to this.
If excessive itchiness doesn’t go away or interferes with your quality of life, talk to your healthcare provider. They may switch you to a different antidepressant.
Statins like rosuvastatin
Statins are go-to treatments for lowering cholesterol. Rosuvastatin (Crestor), atorvastatin (Lipitor), and simvastatin (Zocor, FloLipid) are top examples.
Itchy skin has been reported among some people taking statins. This is likely because they slow down the body’s production of cholesterol, which can cause your skin to feel itchy. They can also make your skin feel drier.
If you notice that you feel itchy after starting a statin, a moisturizing cream containing hyaluronic acid, glycerin, or ceramides may help. If you live in a dry or cold climate, a humidifier is another option. Also, try to avoid irritants like fragrances and alcohol-based skin products.
But, if your itchiness doesn’t seem to go away with time, speak to your healthcare provider. An oral or topical corticosteroid may also be necessary. They may switch you to another cholesterol medication so you can continue receiving cholesterol support, too.
Some cancer medications
Chemotherapy medications kill cancer cells. But they can also harm normal, healthy cells. This can sometimes lead to itchiness. Other cancer treatments that may cause itchiness include targeted therapy drugs, immunotherapy medications, and radiation therapy.
Thankfully, itchiness from cancer treatments is often manageable. Antihistamines like diphenhydramine are a good starting point, especially if itching keeps you awake. You can also try soaking in oatmeal baths and avoiding topical products that contain alcohol or other irritants.
Depending on the cancer treatment(s) you’re receiving, your cancer care team can offer more personalized ways to manage itchiness.
Heparin
Heparin is a blood thinner that treats and prevents blood clots. It’s injected into a vein or under the skin by a healthcare provider.
Some people report feely itchy after receiving heparin. It’s not fully clear why heparin causes itchiness. It may be due to an allergic reaction that causes a skin reaction — the most common being itchy plaques at the injection site.
If you develop a rash after your heparin injection, tell your medical team right away. They can give you medications to manage your symptoms. But, if you notice a skin rash after you return home, call your healthcare provider. Go to the emergency room if you have a fast-spreading rash that’s accompanied by shortness of breath or facial swelling.
Anti-malaria medications like chloroquine
Anti-malaria medications like chloroquine, hydroxychloroquine (Plaqenil), and mefloquine treat malaria worldwide. They’re also a common cause of itchiness.
With chloroquine, this is usually reported as a stinging sensation that appears within a few hours of your dose. Hydroxychloroquine may cause a red, itchy rash within 4 weeks of starting it. Mefloquine has been linked to itchiness and a bumpy rash. Thankfully, these symptoms tend to resolve after stopping the treatment.
If your itchiness doesn’t go away or feels severe at any point, your provider may suggest trying a corticosteroid like prednisolone or an antihistamine like promethazine to calm your symptoms. Switching to another anti-malarial is an option, too.
When should you talk to a healthcare provider about itchiness from medications?
It’s a good idea to contact your healthcare provider any time your itchiness feels bothersome or doesn’t go away. They can help figure out whether your medication(s) may be at fault. They can also help you get your symptoms under control.
Milder cases of itchiness can usually be treated at home. But more serious spells of itching should be taken seriously. If your itchiness comes with a sudden rash, oozing, or blistering, you should let your provider know as soon as possible. These could be symptoms of a skin infection or allergic reaction. You should go to the emergency room if your itchiness is accompanied by shortness of breath or swelling in the face, throat, or tongue.
The bottom line
Common medications that cause you to feel itchy include opioid pain relievers, antibiotics, and heparin. There are also antidepressants and blood pressure drugs that cause itching.
If you think one of your medications is causing you to feel itchy, talk to your healthcare provider. They can find out if your symptoms are caused by the medication — or something different — and come up with a plan to manage it.
References
Aghahowa, S. E., et al. (2010). Chloroquine-induced pruritus. Indian Journal of Pharmaceutical Sciences.
American Cancer Society. (n.d.). Targeted therapy.
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