FDA (U.S.): Approved (2021, Korsuva) for moderate-to-severe pruritus associated with chronic kidney disease in adults on hemodialysis.
EMA (EU): Approved (2022, Kapruvia) for moderate-to-severe pruritus associated with chronic kidney disease in adults on hemodialysis.
0.5 micrograms/kg of dry weight intravenously at the end of each hemodialysis session, three times a week (FDA label 2021 / EMA 2022).
More drowsiness and dizziness with other central nervous system depressants (opioids, benzodiazepines, sedating antihistamines, gabapentinoids).
378 hemodialysis patients, 12 weeks. 49.1% with difelikefalin vs 27.9% with placebo improved by at least 3 points on the itch scale, with better itch-related quality of life. Diarrhea, dizziness, and vomiting were more frequent.
View the study (RCT) →It activates kappa opioid receptors on peripheral nerves and immune cells, which reduces the itch signal and inflammation. It barely enters the brain, so it carries little risk of central opioid effects.
In people
Information, not medical advice. Prescription or unapproved peptides should only be used under medical supervision.