From the Guidelines
Nifedipine, a dihydropyridine calcium channel blocker, is the first-line treatment for Raynaud's phenomenon due to its clinical benefit, low cost, and acceptable adverse effects. Medications for Raynaud's phenomenon primarily aim to improve blood flow and reduce symptoms.
Treatment Options
- Calcium channel blockers like nifedipine (10-30 mg daily) are typically the first-line treatment, working by relaxing blood vessels to improve circulation 1.
- For more severe cases, other options include phosphodiesterase inhibitors like sildenafil (20-40 mg as needed) 1.
- Intravenous iloprost should be considered for severe Raynaud's phenomenon following failure of oral therapy 1.
Key Considerations
- Treatment is typically long-term during cold seasons, and patients should combine medication with preventive measures like keeping extremities warm, avoiding triggers, and stopping smoking to maximize effectiveness.
- The choice of medication should be based on the severity of symptoms, patient tolerance, and potential side effects.
- Dihydropyridine-type calcium antagonists, usually oral nifedipine, should be used as first-line therapy for Raynaud's phenomenon 1.
Additional Therapies
- Topical nitroglycerin (apply to affected fingers 2-3 times daily) may be considered for acute relief of symptoms.
- Alpha-blockers such as prazosin (1-5 mg twice daily) may be used in certain cases, but their effectiveness is less well-established.
- Bosentan should be considered for reduction of number of new digital ulcers in systemic sclerosis, but its use in Raynaud's phenomenon is not well-established 1.
From the FDA Drug Label
1 INDICATIONS AND USAGE
(No text related to Raynaud's disease)
The FDA drug label does not answer the question.
From the Research
Medications for Raynaud's Disease
The following medications are used to treat Raynaud's disease:
- Calcium channel blockers, such as nifedipine and diltiazem, which are considered first-line therapy 2, 3, 4, 5, 6
- Topical nitrates, which can help to dilate blood vessels and improve blood flow 2, 5
- Phosphodiesterase 5 inhibitors, which can help to reduce symptoms of Raynaud's disease 2, 4
- Endothelin antagonists, which can help to improve blood flow and reduce symptoms 2, 5
- Prostaglandin analogues, which can help to improve blood flow and reduce symptoms, but are often limited by their parenteral route of administration 3, 4
- Botulinum toxin injection, which can help to reduce symptoms in some patients 2, 4
- Digital sympathectomy, which can help to improve blood flow and reduce symptoms in patients with severe digital ischemia 2, 4, 5
Specific Medications
Some specific medications that have been studied for the treatment of Raynaud's disease include:
- Nifedipine, which has been shown to be effective in reducing symptoms of Raynaud's disease 3, 6
- Diltiazem, which has been shown to be effective in reducing symptoms of Raynaud's disease, but may have fewer side effects than nifedipine 3, 6
- Bosentan, which has been shown to be effective in preventing future ulcers in patients with scleroderma 4
- Pentoxifylline, which has been shown to be mildly effective in reducing symptoms of Raynaud's disease 3, 5
- Naftidrofuryl, which has been shown to be useful in mild disease, with adverse effects like headache and flushing being less problematic 3
- Inositol nicotinate, which has been shown to be useful in mild disease, with adverse effects like headache and flushing being less problematic 3