How is Raynaud phenomenon treated in scleroderma?

Updated: Sep 09, 2019
  • Author: Sergio A Jimenez, MD, MACR, FACP, FRCP(UK Hon); Chief Editor: Herbert S Diamond, MD  more...
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Raynaud phenomenon can be treated with the following agents [45, 46, 165] :

  • Calcium channel blockers (increasing the dose to tolerance)
  • Prazosin
  • Prostaglandin derivatives (eg, prostaglandin E1)
  • Dipyridamole
  • Aspirin
  • Topical nitrates

Sildenafil, an inhibitor of phosphodiesterase 5 (PDE-5), has been approved for treatment of pulmonary hypertension. In addition, it has been shown to be effective and well tolerated in patients with Raynaud phenomenon. [166, 167, 168]

In the event of thrombosis and vascular flow compromise, a tissue plasminogen activator, heparin, and urokinase may be necessary. [169] In very severe cases, patients may benefit from intravenous iloprost or related prostanoids. Some patients may require pharmacologic cervical sympathectomy or surgical digital sympathectomy. [170, 171, 172]

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