Treatments and drugs

By Mayo Clinic Staff

Self-care and prevention steps, such as dressing in layers or wearing gloves or heavy socks, usually are effective in dealing with mild symptoms of Raynaud's. If these aren't adequate, however, medications are available to treat more-severe forms of the condition. The goals of treatment are to:

  • Reduce the number and severity of attacks
  • Prevent tissue damage
  • Treat any underlying disease or condition

Medications

Depending on the cause of your symptoms, medications may help treat Raynaud's. To widen (dilate) blood vessels and promote circulation, your doctor may prescribe:

  • Calcium channel blockers. These drugs relax and open up small blood vessels in your hands and feet. They decrease the frequency and severity of attacks in most people with Raynaud's. These drugs can also help heal skin ulcers on your fingers or toes. Examples include nifedipine (Adalat CC, Afeditab CR, Procardia), amlodipine (Norvasc) and felodipine (Plendil).
  • Alpha blockers. Some people find relief with drugs called alpha blockers, which counteract the actions of norepinephrine, a hormone that constricts blood vessels. Examples include prazosin (Minipress) and doxazosin (Cardura).
  • Vasodilators. Some doctors prescribe a vasodilator — a drug that relaxes blood vessels — such as nitroglycerin cream to your fingers to help heal skin ulcers. Your doctor may also prescribe vasodilator drugs that are commonly used to treat other conditions, but may effectively relieve the symptoms of Raynaud's. These drugs include the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra, Revatio), the antidepressant medication fluoxetine (Prozac, Sarafem), and a class of medication called prostaglandins.

You and your doctor may find that one drug works better for you than another. Some drugs used to treat Raynaud's have side effects that may require you to stop taking the medication. A drug may also lose effectiveness over time. Work with your doctor to find what works best for you.

Some medications actually can aggravate Raynaud's by leading to increased blood vessel spasm. Your doctor may recommend that you avoid taking:

  • Certain over-the-counter (OTC) cold drugs. Examples include drugs that contain pseudoephedrine (Chlor-Trimeton, Sudafed).
  • Beta blockers. This class of drugs, used to treat high blood pressure and heart disease, includes metoprolol (Lopressor, Toprol XL), nadolol (Corgard) and propranolol (Inderal, Innopran XL).
  • Birth control pills. If you use birth control pills, you may wish to switch to another method of contraception because these drugs affect your circulation and may make you more prone to attacks. Talk to your doctor before stopping the pill.

If you have questions about how best to manage Raynaud's, contact your doctor. Your primary care doctor may refer you to a physician who specializes in treating Raynaud's.

Surgeries and medical procedures

Sometimes in cases of severe Raynaud's, approaches other than medications may be a treatment option:

  • Nerve surgery. Nerves called sympathetic nerves in your hands and feet control the opening and narrowing of blood vessels in your skin. Sometimes it's necessary in cases of severe Raynaud's to cut these nerves to interrupt their exaggerated response. Through small incisions in the affected hands or feet, a doctor strips away these tiny nerves around the blood vessels. The surgery, called sympathectomy, may reduce the frequency and duration of attacks, but it's not always successful.
  • Chemical injection. Doctors can inject chemicals to block sympathetic nerves in affected hands or feet. You may need to have the procedure repeated if symptoms return or persist.
  • Amputation. Sometimes, doctors need to remove tissue damaged from a lack of blood supply. This may include amputating a finger or toe affected by Raynaud's in which the blood supply has been completely blocked and the tissue has developed gangrene. But this is rare.
Oct. 20, 2011