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About nalfurapine hydrochloride

It is suitable for the treatment of pruritus in patients with dialysis and chronic liver disease.

1. Psychiatric and neurological diseases: insomnia, dizziness, headache, irritability, hallucinations, dysarthria, and irritability.

2. Digestive system diseases: constipation, nausea, diarrhea, vomiting, loss of appetite, abdominal discomfort.

3. Skin and subcutaneous tissue diseases: worsening of itching, eczema, urticaria, erythema, and papules.

4. Systemic diseases: fatigue, edema.

Measures for dealing with side effects

1. Insomnia: Sleep less during the day, develop good sleeping habits, go to bed early and get up early, do not perform strenuous exercise before going to bed or drink coffee, strong tea and other drinks that can easily aggravate insomnia. You can drink a cup of hot milk or soak your feet before going to bed, which will help improve insomnia.

2. Dizziness: Pay attention to rest. When dizziness occurs, avoid standing or changing body position immediately to avoid falling. Try to stay in bed and rest. Avoid fatigue and heavy physical labor at ordinary times.

3. Headache: Enough rest should be ensured, and the diet should appropriately increase fruits, vegetables and meat. On the premise of providing sufficient nutrition, avoid dry stool and strain during defecation to avoid aggravating the headache. Emotions should be kept stable and irritability should be avoided.

4. Constipation: Eat more fresh fruits and vegetables to supplement fiber. Cellulose helps promote intestinal peristalsis and facilitate defecation. Drink more water to replenish moisture.

5. Nausea: Eat a light diet, avoid eating irritating foods, and drink plenty of water to avoid dehydration.

6. Diarrhea: Keep your abdomen warm and avoid eating raw or cold foods that can easily aggravate diarrhea. You can use antidiarrheal drugs as directed by your doctor.

7. Vomiting: Temporarily stop eating and drink plenty of warm water to replenish fluids.

8. Loss of appetite: Eat more of the food you like and eat smaller meals more often.

9. Eczema: Pay attention to keeping the local area clean and hygienic, wear loose and comfortable cotton clothes to reduce local friction, bathe frequently, and keep the local area dry after bathing.

10. Fatigue: Pay attention to rest and avoid strenuous exercise. Fatigue can be relieved through hot compress, massage and other methods.

11. Edema: Elevate the affected limb when resting, avoid standing for long periods of time, and reduce sodium intake in the diet.

1. Nafurapine hydrochloride may cause drowsiness, dizziness and other symptoms. Patients should not drive cars or other dangerous machine operations.

2. Endocrine dysfunction such as increased prolactin may occur after taking the drug. It is recommended to conduct timely examination.

3. If no effect occurs after taking nalfuraphine hydrochloride, it cannot be taken for a long time at will.

Usage and Dosage

The recommended dose of nalfuraphine hydrochloride is 2.5 μg, once a day, and needs to be taken after dinner or before going to bed. The maximum daily dose is 5 μg.

Drug purchasing channels

1. Hospital pharmacies: Nafurafine hydrochloride is currently on the market in China and can be purchased through hospital pharmacies.

2. Purchase abroad: You can go to Japan, South Korea and other countries to purchase by yourself or with relatives and friends, but in addition to the cost of the medicine, you also have to pay for round-trip travel expenses, etc., which is not cost-effective.

3. Formal overseas medical institutions: There are many professional overseas medical service institutions in China, which can also help purchase nalfuraphine hydrochloride. The drug can be obtained by mail, which is more convenient and fast.

Cost

1. Drug unit price

1. 2.5μg*14 tablets: The reference price of nalfurapine hydrochloride is about 470$ per box, with an average of 33.6$ per tablet.

2. 2.5μg*140 tablets: The reference price of nalfuraphine hydrochloride is about $4,250 per box, with an average of $30 per tablet.

2. Monthly cost of medication

1. 2.5μg*14 tablets: If you take 2.5μg*14 tablets, you need to take 30 tablets a month, which costs 1008$ a month.

2. 2.5μg*140 tablets: If you take 2.5μg*140 tablets, taking 30 tablets a month will cost you $900 a month.

3. Price after medical insurance

Nafuraphine hydrochloride is not included in China’s medical insurance and cannot be reimbursed by medical insurance. Therefore, there is no price after medical insurance reimbursement.

Effectiveness results

Research background

Stubborn pruritus in hemodialysis patients can significantly reduce their quality of life and is associated with poor life prognosis. Although multiple causes of refractory itching in these patients have been identified, no existing treatments have been proven to be sufficiently effective. To follow up and evaluate the safety and efficacy of nalfurapine hydrochloride in the treatment of refractory pruritus in hemodialysis patients in a study.

Research Methods

3762 hemodialysis patients with refractory pruritus were treated with oral nalfurapine hydrochloride.

Study results

Nafurafine hydrochloride was effective in 82.50% of patients within the first 12 weeks and 84.95% of patients during subsequent treatment periods until 1 year after the start of nalfrafine treatment. 10.69% of patients experienced adverse drug reactions. The most common adverse drug reactions were insomnia, constipation, drowsiness, dizziness, nausea and discomfort.

Study Conclusions

Oral nalfurapine hydrochloride (from 2.5 μg/day to a maximum of 5.0 μg/day) can safely and effectively treat refractory pruritus in hemodialysis patients in real-life clinical settings.

References:

Kozono H, Yoshitani H, Nakano R. Post-marketing surveillance study of the safety and efficacy of nalfurafine hydrochloride (Remitch® capsules 2.5 μg) in 3,762 hemodialysis patients with intractable pruritus. Int J Nephrol Renovasc Dis. 2018 Jan 15;11:9-24. doi: 10.2147/IJNRD.S145720. PMID: 29391822; PMCID: PMC5774492.

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