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Difelikefalin is a synthetic peptide and selective kappa opioid receptor agonist with low central nervous system penetration. It is used to treat moderate to severe pruritus (itching) associated with chronic kidney disease in adults undergoing hemodialysis. Difelikefalin acts primarily on peripheral kappa opioid receptors located on sensory neurons and immune cells, reducing itch signals and exerting anti-inflammatory effects. Its hydrophilic structure limits its ability to cross the blood-brain barrier, minimizing central nervous system side effects and abuse potential compared to traditional opioids. The drug was developed as a peripherally restricted therapy for uremic pruritus in patients with chronic kidney disease[1][3][6][8].
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