Materiały źródłowe

• #1 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  Raynaud phenomenon is an overactive vascular response to cold and emotional stress that results in cutaneous color changes and sensory symptoms in the digits. If nonpharmacologic interventions prove inadequate, then vasodilator agents are used. […] Nonpharmacologic interventions, ie, cold avoidance and stress management, are first-line for all patients. […] Calcium channel blockers are first-line drugs and should be titrated to the maximum tolerated dose before adding or switching to other agents. […] The goal of treatment should not be to eliminate Raynaud attacks completely but to improve quality of life and prevent ischemic complications. […] Cold avoidance and stress management are first-line therapies for preventing Raynaud attacks and must be part of any treatment strategy. […] For many patients, nonpharmacologic interventions are enough to decrease the severity and frequency of attacks. However, if Raynaud phenomenon continues to negatively affect quality of life, drug therapy can be added.

• #2 Raynaud Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499833/

  Treatment of Raynaud phenomenon aims at decreasing the frequency and severity of the attacks with prevention of tissue ischemia. Treatment response is measured by the Raynaud Condition Score (RCS). This scoring system looks at the quality of life, frequency and severity of attacks, and the effect of Raynaud phenomenon on an individual. […] Conservative medical management to prevent Raynaud phenomenon attacks is a lifestyle change. This includes avoiding exposure to cold, staying warm, avoiding stimulants, avoiding anxiety or emotional stress, and smoking cessation. […] If the patient fails to respond to only conservative therapy, then pharmacologic therapy with a vasodilating mechanism of action is used. Dihydropyridine calcium channel blockers (DHP CCBs) are the first-line pharmacologic treatment for Raynaud phenomenon. DHP CCBs include amlodipine and nifedipine.

• #2 Raynaud Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499833/

  If the patient fails to respond to DHP CCB therapy, a phosphodiesterase (PDE) inhibitor. It can be added to the current CCB therapy if partial treatment response is noted to the CCB. If there is no treatment response to the CCB, then the PDE inhibitor can be used as monotherapy. Sildenafil is started at a low dose, 20 mg daily, and then titrated depending on response over a period of 4 to 6 weeks with a maximum dose of 20 mg 3 times a day. […] Alternative therapy to treatment failure using CCB and PDE inhibitor is topical nitrates, such as nitroglycerin, which is a direct vasodilator. Typically, 2% nitroglycerin ointment is used and applied to affected Raynaud phenomenon areas. […] If tissue ischemia is present in the digits and symptoms are severe, then intravenous infusion of prostaglandin is used. Different intravenous prostaglandins include iloprost, epoprostenol, treprostinil, and alprostadil. Prostaglandin functions as a strong vasodilator and also prevents platelet cell aggregation.

• #2 Raynaud Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499833/

  Bosentan blocks endothelin-1 vasoconstrictive effect. This is used in recurrent digit ulceration in CTD, such as systemic sclerosis. Surgery to remove the particular sympathetic nerves that cause vasoconstriction, also known as sympathectomy, can be used in severe, refractory cases. […] In the setting of secondary Raynaud phenomenon and history of ischemic ulceration, low dose aspirin 81 mg should be used daily. If there is aspirin intolerance or contraindication, clopidogrel, or dipyridamole can be used instead.

• #3 Raynaud’s disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/raynauds-disease/symptoms-causes/syc-20363571

  Treatment of Raynaud’s disease depends on how bad it is and whether you have other health conditions. […] Symptoms of secondary Raynaud’s usually appear around age 40. That’s later than symptoms appear for primary Raynaud’s. […] If secondary Raynaud’s is severe, reduced blood flow to fingers or toes could cause tissue damage. But that’s rare. […] A completely blocked blood vessel can lead to skin sores or dead tissue. This can be difficult to treat. Rarely, very bad untreated instances might require removing the affected part of the body. […] To help prevent Raynaud’s attacks: Bundle up outdoors. When it’s cold, wear a hat, scarf, socks and boots, and two sets of mittens or gloves. Thermal underwear might help. A coat with cuffs that close around mittens or gloves helps protect the hands from cold air. […] Warm your car. Run your car heater for a few minutes before driving in cold weather. […] Take care indoors. Wear socks. To take food out of the refrigerator or freezer, wear gloves, mittens or oven mitts. Some people find it helpful to wear mittens and socks to bed during winter.

• #4 Raynaud’s disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/raynauds-disease/diagnosis-treatment/drc-20363572

  Dressing for the cold in layers and wearing gloves or heavy socks usually can help mild symptoms of Raynaud’s. Medicines can treat more-serious symptoms. The goals of Raynaud’s treatment are to: […] Depending on the cause of symptoms, medicines might help. Medicines used to treat people with Raynaud’s disease may include: […] Surgery or shots might be needed to treat serious Raynaud’s. […] Nerve surgery. Nerves in the hands and feet control opening and narrowing of blood vessels in skin. Cutting these nerves stops those responses. […] Chemical injection. Shots of numbing medicines or onabotulinumtoxinA (Botox) can block nerves in affected hands or feet. Some people need to have this more than once if symptoms remain or return.

• #5 Raynaud’s Syndrome: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/9849-raynauds-phenomenon

  Treatment depends on the severity of your condition and whether you have the primary or secondary form. Treatment goals include: […] For many people, lifestyle changes are enough to manage their condition. These include: […] However, if you have severe symptoms, you may need medication. Your provider may prescribe one or more of the following medications: […] If you have severe Raynauds and other treatment methods dont work, your provider may recommend a procedure called a sympathectomy. A sympathectomy temporarily blocks or cuts tiny nerves near your affected blood vessels. This prevents the nerves from sending signals that make your blood vessels get too narrow. The procedure should relieve your symptoms for one or two years, but you may need it again in the future.

• #6 Raynaud’s Phenomenon

  https://rheumatology.org/patients/raynauds-phenomenon

  Raynauds can be managed with both lifestyle modifications and medications. Patients can use mittens/gloves, thick socks, and insertable warmers to help keep their hands and feet warm. Stress reduction and smoking cessation are also recommended to help decrease Raynauds attacks. Medications such as calcium channel blockers (amlodipine, nifedipine, felodipine, and others) and angiotensin-receptor blockers increase blood flow to the fingers and toes. For patients with more severe symptoms or who have developed complications such as ulcers, other medications can be used including sildenafil or prostacyclins. […] Wear warm, protective clothing like socks, boots, mittens or gloves in the fall and winter. In the summer months, avoid keeping the temperature of the AC too low. Wear oven mitts or gloves when taking food out of the freezer or refrigerator. Exercise regularly as this can boost healthy circulation and try to decrease stressful triggers. If symptoms occur, rewarm your body, place hands under the armpits, wiggle fingers and toes, run fingers or toes under warm (not hot) water, or massage the hands and feet.

• #7 Raynaud’s Disease & Syndrome: Symptoms, Causes, Treatment

  https://www.webmd.com/arthritis/raynauds-phenomenon

  These steps can also help you control your condition: […] Don’t smoke, and stay away from secondhand smoke, too. It can make your blood vessels close up, which lowers your skin temperature. […] Itll boost your circulation. If you have secondary Raynauds, check with your doctor before you try an outdoor workout in cold weather. […] Keeping it under control could help cut the number of attacks. […] Don’t go straight from a chilly space to a warm space. Also, avoid the frozen food section of the grocery store as much as possible. […] Wear layers, gloves, and heavy socks. Buy chemical warmers for your pockets, gloves, and socks. […] Decongestants with phenylephrine, diet pills, migraine medications with ergotamine, herbal medications with ephedra, and the blood pressure medication clonidine (Catapres) can all narrow your blood vessels. […] Or, run warm water over them when you feel an attack starting.

• #7 Raynaud’s Disease & Syndrome: Symptoms, Causes, Treatment

  https://www.webmd.com/arthritis/raynauds-phenomenon

  Treatment goals include preventing Raynauds episodes or limiting them when they do happen. You can focus on keeping your hands and feet warm and dry, controlling stress, and getting regular exercise. […] Your doctor might ask you to avoid some drugs, including over-the-counter cold medicines that contain pseudoephedrine. They can make your symptoms worse by causing your blood vessels to narrow. […] If you have secondary Raynauds, your doctor might prescribe medicines to control your blood pressure and relax your blood vessels. If you get sores on your skin as a result, you might need to apply a cream that contains one of these drugs. These include: […] If your condition doesnt improve after these steps and youre at risk of severe problems, such as losing parts of your fingers or toes, your doctor might consider surgery. These procedures involve cutting the nerves to the blood vessels in your skin to limit how much they open and close. The doctor might also inject drugs into your hands or feet to block those nerves.

• #8

  https://www.podiatry.care/Raynauds-Disease-Treatment-By-Top-Podiatrists

  In mild forms of Raynaud’s disease, the simplest treatment is to protect the hands, and feet from cold exposure. […] Since cold is the cause of the vasospasm, preventing exposure to cold will prevent the spasm from occurring. […] This may require insulated boots and thick warm socks in colder climates. […] Dressing in layers, with new polyester liners and new insulating materials may be helpful. […] Cigarette smoking contains nicotine, which is known to cause vasospasm. […] Discontinuation of cigarette smoking will be a definite benefit for the individual with Raynaud’s disease. […] In more severe cases, or in those with recurrent episodes, medications are available to help relax the arterial smooth muscle. […] Medications that have been used successfully in some individuals include nitroglycerin, phenoxybenzamine, prazosin, nifedipine, pentoxyphylline, and guanethidine. […] These medications are only available by prescription, and patients must be monitored for potential side effects.

• #9 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  Raynaud phenomenon is an overactive vascular response to cold and emotional stress that results in cutaneous color changes and sensory symptoms in the digits. If nonpharmacologic interventions prove inadequate, then vasodilator agents are used. […] Nonpharmacologic interventions, ie, cold avoidance and stress management, are first-line for all patients. […] Calcium channel blockers are first-line drugs and should be titrated to the maximum tolerated dose before adding or switching to other agents. […] The goal of treatment should not be to eliminate Raynaud attacks completely but to improve quality of life and prevent ischemic complications. […] Cold avoidance and stress management are first-line therapies for preventing Raynaud attacks and must be part of any treatment strategy. […] For many patients, nonpharmacologic interventions are enough to decrease the severity and frequency of attacks. However, if Raynaud phenomenon continues to negatively affect quality of life, drug therapy can be added.

• #9 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  Calcium channel blockers are first-line agents for both primary and secondary Raynaud phenomenon that does not adequately respond to nonpharmacologic interventions. […] When calcium channel blockers do not adequately control symptoms, phosphodiesterase type 5 (PDE5) inhibitors can be added or substituted. […] Patients who have an unsatisfactory response to calcium channel blockers with or without PDE5 inhibitors can try topical nitrates, available as sustained-release transdermal patches, tapes, creams, gels, and ointments. […] Overall, we move to other options only in patients with persistent symptoms that impair quality of life, or in patients with recurrent digital ischemic lesions that have not responded to calcium channel blockers and PDE5 inhibitors or nitrates, either alone or in combination.

• #9 Treating Raynaud phenomenon: Beyond staying warm | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/84/10/797

  For many patients with primary or secondary Raynaud phenomenon, nonpharmacologic interventions are all that are required to decrease the frequency of attacks and improve quality of life. The goal should not be to eliminate attacks completely, as aggressive drug treatment may cause more harm than benefit. From our perspective, the goals of treatment should be to improve quality of life and prevent ischemic complications. […] Pharmacologic therapies should be added only if attacks remain poorly controlled with incapacitating symptoms, or if the patient has digital ischemic ulcers. Calcium channel blockers are first-line therapy, given proven efficacy and low cost, and should be titrated to the maximum tolerated dose before adding or substituting other agents.

• #10 Raynaud Syndrome – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/peripheral-arterial-disorders/raynaud-syndrome

  Treatment of uncomplicated cases includes avoidance of cold, biofeedback, smoking cessation, and, as needed, vasodilating calcium channel blockers (eg, nifedipine) or prazosin. […] Treatment of primary Raynaud syndrome involves avoidance of cold, smoking cessation, and, if stress is a triggering factor, relaxation techniques (eg, biofeedback) or counseling. Medications are used more often than behavioral treatments because of convenience. Vasodilating calcium channel blockers (eg, extended-release nifedipine 60 to 90 mg orally once a day, amlodipine 5 to 20 mg orally once a day, felodipine 2.5 to 10 mg orally twice a day, or isradipine 2.5 to 5 mg orally twice a day) are most effective, followed by prazosin 1 to 5 mg orally once a day or twice a day. Topical nitroglycerine paste, pentoxifylline 400 mg orally twice or 3 times a day with meals, or both may be effective, but no evidence supports routine use. Beta-blockers, clonidine, and ergot preparations are contraindicated because they cause vasoconstriction and may trigger or worsen symptoms.

• #10 Raynaud Syndrome – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/peripheral-arterial-disorders/raynaud-syndrome

  Treatment of secondary Raynaud syndrome focuses on the underlying disorder. Calcium channel blockers or prazosin is also indicated, given as above for primary Raynaud syndrome. Antibiotics, analgesics, and, occasionally, surgical debridement may be necessary for ischemic ulcers. Low-dose aspirin may prevent thrombosis but theoretically may worsen vasospasm via prostaglandin inhibition. IV prostaglandins (alprostadil, epoprostenol, iloprost) appear to be effective and may be an option for patients with ischemic digits. However, these drugs are not widely available, and their role is yet to be defined. […] Cervical or local sympathectomy is controversial; it is reserved for patients with progressive disability unresponsive to all other measures, including treatment of underlying disorders. Sympathectomy often abolishes the symptoms, but relief may last only 1 to 2 years.

• #11 Treatment of Raynaud phenomenon: Initial management – UpToDate

  https://www.uptodate.com/contents/treatment-of-raynaud-phenomenon-initial-management

  Treatment of Raynaud phenomenon: Initial management […] Initial treatment includes patient education and general measures taken by the patient to prevent and treat attacks. In severe cases, treatment may include pharmacologic interventions and/or sympathetic blockade to prevent and treat digital ischemia. […] The goals of therapy are to improve quality of life and to prevent tissue loss (ie, ulceration, gangrene). At least a moderate reduction in the intensity of attacks and the prevention of tissue loss are achievable in most patients. […] All patients should be educated about the potential causes of a Raynaud attack as well as the nonpharmacologic measures to help prevent and terminate an episode. These nonpharmacologic measures include avoidance of provoking factors such as cold temperature and vasoconstricting drugs, smoking cessation (when applicable), and other measures discussed further below.

• #11 Treatment of Raynaud phenomenon: Initial management – UpToDate

  https://www.uptodate.com/contents/treatment-of-raynaud-phenomenon-initial-management

  Pharmacologic measures include initial pharmacologic therapy with calcium channel blockers. If patients are unable to tolerate or receive preferred initial therapy, alternatives include phosphodiesterase type 5 inhibitors, topical nitrates, angiotensin II receptor blockers, and selective serotonin reuptake inhibitors. […] Inadequate response to calcium channel blockers or alternative agents may require a combination of calcium channel blockers with another agent. […] Monitoring response to therapy includes routine follow-up and assessment of refractory or progressive ischemia.

• #12 Raynaud’s Phenomenon: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/raynauds-phenomenon/diagnosis-treatment-and-steps-to-take

  The goals of treatment for Raynauds phenomenon are to: […] For most people with Raynauds phenomenon, avoiding getting cold prevents attacks and keeps symptoms under control. But if this is not enough, medications and, in some cases, surgical procedures can help. […] Secondary Raynauds phenomenon is more likely to be serious and to need more aggressive therapy, such as prescription medications. […] While there are no medications approved by the U.S. Food and Drug Administration for Raynauds phenomenon, medications that have been approved for other conditions are routinely used to treat it. […] If you have severe Raynauds phenomenon, your doctor may recommend a procedure called a sympathectomy to destroy the nerves that trigger blood vessel narrowing in the affected areas. […] In serious cases, repeated attacks can lead to skin sores or gangrene (death and decay of tissue).

• #12 Raynaud’s Phenomenon: Diagnosis, Treatment, and Steps to Take

  https://www.niams.nih.gov/health-topics/raynauds-phenomenon/diagnosis-treatment-and-steps-to-take

  If this happens, the person may need to be admitted to the hospital for a few days for imaging studies and intravenous medications to rapidly improve blood flow and to treat infection. […] Wound care services may be needed. […] In rare cases, the person may need surgery to remove dead tissue and provide pain relief.

• #13 Prescribed drug treatments | SRUK

  https://www.sruk.co.uk/raynauds/raynauds-treatments/prescribed-treatments/

  Sometimes natural and over-the-counter therapies are not enough and it is necessary to take prescription medications. The below treatments help improve circulation and your Raynaud’s attacks should improve, or the length between attacks should improve. This sort of medication can also treat and help to prevent skin ulcers on your fingers and toes know as digital ulcers. […] These drugs relax and open small blood vessels in your hands and feet, decreasing the frequency and severity of attacks in most people with Raynaud’s. These drugs can also help heal digital ulcers. Examples include nifedipine (Afeditab CR, Procardia), amlodipine (Norvasc), felodipine (Plendil) and Diltiazem. […] Some doctors prescribe a drug that relaxes blood vessels (vasodilator), such as nitroglycerin cream applied to the base of your fingers to help heal skin ulcers. Some vasodilators commonly used to treat other conditions, including the high blood pressure drug losartan (Cozaar), the erectile dysfunction medication sildenafil (Viagra, Revatio), the antidepressant medication fluoxetine (Prozac, Sarafem), and a class of medications called prostaglandins, may relieve the symptoms of Raynaud’s.

• #13 Prescribed drug treatments | SRUK

  https://www.sruk.co.uk/raynauds/raynauds-treatments/prescribed-treatments/

  These help relax blood vessels. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance in your body that narrows your blood vessels and releases hormones that can restrict blood vessels. […] 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).

• #14 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  Pharmacologic options for secondary Raynaud phenomenon include calcium channel blockers and prostacyclin analogues. Other agents may be considered; however, in a meta-analysis of interventions for secondary Raynaud phenomenon by Huisstede et al, solid evidence for therapies beyond calcium channel blockers and the prostacyclin analogue iloprost was lacking. […] Calcium channel blockers are the class of drugs most widely used for treatment of Raynaud syndromespecially the dihydropyridines (eg, nifedipine, nicardipine), which are the most potent vasodilators. […] Nifedipine is the customary first choice. The usual dosage is 30-120 mg of the extended-release formulation taken once daily. Start with the lowest dose and titrate up as tolerated. If adverse effects occur, decrease the dosage or use another agent, such as nicardipine, or a non-dihydropyridine calcium channel blocker such as such as diltiazem.

• #14 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  Topical calcium channel blockers promote healing of digital ulcers in these patients. […] Other medications that have been studied in Raynaud phenomenon include the following: Topical nitroglycerin (1% or 2%), Iloprost (prostaglandin analog), Selective serotonin reuptake inhibitors (SSRIs), Phosphodiesterase-5 enzyme inhibitors (sildenafil, tadalafil, vardenafil), Losartan, Bosentan (endothelin receptor antagonist) Orphan drug for treating new digital ulcers in patients with systemic sclerosis, Botulinum toxin injection, N-acetylcysteine In patients with systemic sclerosis and digital ulcers. […] Topical nitroglycerin (1% or 2%) has been found to help if applied locally. Side effects include headache and dizziness. […] Improvement in Raynaud phenomenon has been reported in patients treated with the SSRIs fluoxetine, sertraline, and escitalopram. However, exacerbation of Raynaud phenomenon has also been reported with SSRI treatment.

• #14 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  Botulinum toxin injection, typically in the vicinity of the palmar digital neurovascular bundle, has been used in both primary and secondary Raynaud syndrome. Improvement in symptoms and healing of digital ulcers has been reported. […] In one study, some patients derived long-term benefit from a single treatment, whereas in patients with systemic sclerosis, repeat treatments were administered after an average of 6 months. […] Critical digital ischemia, which is more likely to occur in secondary Raynaud phenomenon, necessitates aggressive management. It is considered a medical emergency that requires hospitalization. Warm temperature and bed rest are used to decrease trauma and activity and to control pain. Local infiltration of lidocaine or bupivacaine at the base of the involved digits decreases sympathomimetic input, reduces ischemic pain, and improves blood flow.

• #14 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  In patients with rapidly advancing ischemia, anticoagulant therapy may be necessary. No algorithms or studies exist for the use of heparin. Intravenous iloprost, alprostadil, or epoprostenol can be used if anticoagulant therapy fails or if the ischemia rapidly worsens. Failure of all these therapies might warrant surgical intervention with distal digital sympathectomy and arterial reconstruction. […] While treatment is proceeding, further workup for underlying conditions must be performed. Conditions to consider include vasculitis, thrombosis, and atherosclerosis.

• #14 Raynaud Phenomenon Treatment & Management: Approach Considerations, Nonpharmacologic Therapy, Pharmacologic Therapy

  https://emedicine.medscape.com/article/331197-treatment

  Therapy for secondary Raynaud phenomenon must be tailored to the underlying disorder. If the disorder is associated with occupational or toxic exposure, the patient should avoid the inciting environment. […] Patients with hyperviscosity syndromes and cryoglobulinemia improve with treatments that decrease the viscosity and improve the rheologic properties of their blood (eg, plasmapheresis). Unfortunately, patients with Raynaud phenomenon associated with autoimmune disorders do not usually respond well to therapy. Hepatitis B, hepatitis C, and Mycoplasma infections need to be addressed, if present. […] Patients with secondary Raynaud phenomenon should also use lifestyle measures. However, these patients are more likely to require pharmacologic therapy than are patients with primary Raynaud phenomenon.

• #15 Raynaud’s

  https://www.nhs.uk/conditions/raynauds/

  If you have Raynaud’s and your symptoms are very bad or getting worse, a GP may prescribe a medicine to help improve your circulation. For example, you may be offered nifedipine, which is used to treat high blood pressure. […] Some people need to take this medicine every day. Others only use it to prevent Raynaud’s, for example, during cold weather. […] A GP may arrange tests if they think Raynaud’s could be a sign of a more serious condition, such as rheumatoid arthritis or lupus.

• #16 Raynaud’s Disease (Causes, Symptoms and Treatment)

  https://patient.info/doctor/raynauds-phenomenon-pro

  Management of primary Raynaud’s disease […] Self-help measures include smoking cessation, avoiding exposure to cold, and using gloves or electrically heated mittens in winter. […] Topical agents such as topical glyceryl trinitrate have shown to result in digital vasodilatation. […] Calcium-channel blockers are most widely used in the treatment of Raynaud’s phenomenon, promoting relaxation of vascular smooth muscle cells and leading to vasodilatation. […] A Cochrane review found low to moderate quality evidence that calcium-channel blockers may be useful in reducing the frequency, duration, and severity of attacks. […] Intravenous prostaglandins, such as intravenous iloprost, have been shown to reduce the frequency and severity of attacks. […] Surgical intervention may be considered for severe and disabling symptoms, including arterial reconstruction and peripheral sympathectomy. […] Optimal management of the underlying cause can alleviate the symptoms of secondary Raynaud’s disease, but many cases do not respond well despite treatment.

• #17 Management of Raynaud’s disease/phenomenon – Primary Care Notebook

  https://primarycarenotebook.com/pages/dermatology/treatment-of-specific-complications/management-of-raynauds-diseasephenomenon

  the European League Against Rheumatism recommends prostaglandins in patients who do not have any improvement with calcium channel blockers. […] intravenous ilopros has shown to reduces the frequency and severity of attacks. […] oral sildenafil has been reported to decrease in the frequency and severity of attacks. […] trials have shown that losartan reduces the frequency and severity of attacks to a greater extent than nifedipine but there is lack of sufficient evidence. […] the European League Against Rheumatism recommends in patients with refractory symptoms to treatment with calcium channel blockers and prostaglandins. […] a pilot study of 53 patients showed that fluoxetine reduces the severity and frequency of attacks compared with nifedipine in primary Raynauds phenomenon. […] Surgical interventions can be considered in certain patients with severe and disabling symptoms. These include: arterial reconstruction, peripheral sympathectomy, embolectomy, ulcer debridement, a combination of techniques (1).

• #18 Raynaud syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Raynaud_syndrome

  Angiotensin receptor blockers, such as Losartan, or ACE inhibitors may aid blood flow to the fingers, and some evidence shows that angiotensin receptor blockers (often losartan) reduce frequency and severity of attacks, and possibly better than nifedipine. […] The prostaglandin iloprost is used to manage critical ischemia and pulmonary hypertension in Raynaud’s phenomenon, and the endothelin receptor antagonist bosentan is used to manage severe pulmonary hypertension and prevent finger ulcers in scleroderma. […] In severe cases, an endoscopic thoracic sympathectomy procedure can be performed. […] A more recent treatment for severe Raynaud’s is the use of botulinum toxin. […] Evidence does not support the use of alternative medicine, including acupuncture and laser therapy.

• #19 Raynaud’s phenomenon | Causes, symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/raynauds-phenomenon/

  There are several ways to help ease the symptoms of Raynauds phenomenon. Many of these are things you can do in your day-to-day life, but there are also a number of medications that may help. […] A number of drugs can be prescribed for Raynauds phenomenon. Most of these work by making the blood vessels wider. […] Examples include nifedipine and amlodipine. These are in groups of drugs known as calcium channel blockers. […] Unfortunately, theres no drug that will act only on the blood vessels in the fingers and toes, so these medications may also cause side effects such as skin flushing of the face, headaches or dizziness. This is because the drugs increase blood flow elsewhere. However, many people experience no side effects from the drugs and find them very useful. […] Losartan and ACE inhibitors are more commonly used to treat high blood pressure, but they can also help control symptoms of Raynauds. These drugs also relax blood vessels and stop them from narrowing.

• #19 Raynaud’s phenomenon | Causes, symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/raynauds-phenomenon/

  A drug called fluoxetine can help improve circulation. Fluoxetine can also be used to treat depression. This is an entirely different use and if youve been prescribed it for Raynauds, it doesnt mean your doctor thinks youre depressed. […] In severe cases almost always in cases of secondary Raynauds some treatments may be given as a drip directly into a vein, otherwise known as an intravenous injection. These intravenous drugs act directly on the blood vessels and cause them to open up. The most commonly used intravenous drug for this condition is iloprost. […] Another family of drugs used to treat severe Raynauds are the phosphodiesterase inhibitors (foss-fo-dye-ess-tur-aze in-hib-e-turs), which include sildenafil trade name Viagra. These are drugs that can treat a number of conditions, including high blood pressure in the blood vessels supplying the lungs and erectile dysfunction. They can help with Raynauds because they improve blood flow around the body. […] Its important you talk to your doctor if youre planning for a baby, if you become pregnant, or if you want to breastfeed when on any of these drugs.

• #20 Raynaud’s disease: Treatment, causes, and symptoms

  https://www.medicalnewstoday.com/articles/176713

  There is no cure for Raynauds disease, but there are ways to manage symptoms. […] For mild forms of Raynauds disease, covering exposed skin before leaving the house can help. If an attack occurs, soaking the affected parts in warm, not hot water can ease symptoms and prevent them from worsening. […] For moderate to severe cases, medication may be necessary. These may include: Alpha-1 blockers: These can counter the effect of norepinephrine, which constricts blood vessels. Examples include doxazosin and prazosin. […] Dihydropyridine calcium channel blockers: These relax the smaller blood vessels of the hands and feet. Examples include amlodipine, nifedipine, and felodipine. […] Topical nitroglycerin ointment: Applying creams near the affected area may relieve symptoms. […] Other vasodilators: These dilate the veins, easing symptoms. Examples include losartan, sildenafil (Viagra), fluoxetine (Prozac), and prostaglandin.

• #21 New Outpatient Raynaud Treatment Saves Fingers and Toes < Yale School of Medicine

  https://medicine.yale.edu/news-article/treating-threatened-digit-loss-due-to-raynaud-phenomenon/

  In a new outpatient treatment at Yale, epoprostenol infusions are safely given to patients whose fingers and toes are damaged by severe Raynaud phenomenon, also known as Raynauds phenomenon, to prevent amputation. […] But the medication epoprostenol, administered intravenously, can prevent or treat these ulcers and gangrene by relaxing blood vessels and improving circulation. […] The treatment is used as a last resort in patients who have autoimmune disease and acute circulatory problems, that have not responded to standard medical therapy, explains Vaidehi Chowdhary, MD, associate professor of medicine and clinical chief (rheumatology, allergy and immunology). […] Epoprostenol is now given by the Saint Raphael Hospital Outpatient Infusion Therapy (HOIT) team. […] Now that the outpatient treatment is in place, Yale researchers are assessing its effectiveness by administering a newly developed patient questionnaire specifically for Raynaud phenomenon and using a handheld digital camera to capture images of patients finger nailfold capillaries.

• #22 Battling the Chill: How to Treat Raynaud’s Disease

  https://www.hackensackmeridianhealth.org/en/healthu/2025/03/26/battling-the-chill-how-to-treat-raynauds-disease

  Treatment for Raynauds Disease depends on how severe your condition is, says Dr. Broder. She adds that treatment also depends on whether the cause is physical or pathological. Some options for treating Raynauds include: […] Calcium Channel Blockers These medications relax and widen blood vessels, improving blood flow. […] Vasodilators A group of medications called vasodilators can help widen blood vessels by relaxing the muscles in their walls. This allows blood to flow more easily, lowering blood pressure and improving circulation. Be aware that some of these medications are used to lower blood pressure. They can cause side effects if you have normal or low blood pressure. […] Botox Injections Botox isnt just for cosmetic purposes. If you have a severe case of Raynauds, it can help block nerve reactions. You may need more than one round of injections before seeing improvements. […] Nerve Resection Surgery Nerve resection surgery can help stop nerve responses. This procedure is not always effective. Dr. Broder cautions you should only consider it as a last resort.

• #23 Warming Cold Hands: A New Treatment for Raynaud’s Syndrome

  https://blog.radiology.virginia.edu/new-treatment-for-raynauds-syndrome/

  UVA Health is one of the first hospitals in the country to offer a revolutionary treatment technique for severe Raynauds syndrome. […] Image-guided botox injections performed by radiologists can help fight against the symptoms of Raynauds disease for up to 6 months. […] For some time now, Botox injections have been performed as a treatment for severe Raynauds syndrome. […] At UVA Health, specially trained musculoskeletal radiologists now use ultrasound-guidance as a new technique for these injections, making the procedure more precise while attempting to reduce the chances of complications. […] When injected into the hands or feet of patients with Raynauds disease, it acts to decrease the shrinkage of blood vessels which may help heal skin ulcers and lessen the painful symptoms associated with this disorder.

• #23 Warming Cold Hands: A New Treatment for Raynaud’s Syndrome

  https://blog.radiology.virginia.edu/new-treatment-for-raynauds-syndrome/

  Patients have found improvement in symptoms of Raynauds syndrome for up to 6 months after their Botox injections. This safe, relatively simple procedure is revolutionizing treatment for Raynauds disease. […] If you or a loved one is dealing with severe symptoms of known or suspected Raynauds Disease, ask you care provider about image-guided Botox injections performed by UVA Radiologists.

• #24 Raynaud’s Phenomenon Disease Causes, Symptoms, Treatment, Medications, Prevention

  https://www.medicinenet.com/raynauds_phenomenon/article.htm

  Severe RP can lead to gangrene and the loss of digits from a lack of blood supply. With severe disease, nerve surgery called „sympathectomy” is sometimes considered. In this procedure, to prevent blood-vessel spasm, the nerves that stimulate the constriction of the vessels (sympathetic nerves) are surgically interrupted. Usually, this is performed during an operation that is localized to the sides of the base of the fingers at the hand. Through small incisions, the tiny nerves around the blood vessels are stripped away. This procedure is referred to as digital sympathectomy.

• #25

  https://link.springer.com/article/10.2165/00003495-199652050-00006

  Initial management for mild disease should focus on support and advice regarding avoidance of known precipitating factors, including vasospastic drugs. […] Simple vasodilators like naftidrofuryl, inositol nicotinate and possibly pentoxifylline (oxpentifylline) are useful in mild disease, with adverse effects like headache and flushing being less problematic. The gold standard of Raynauds phenomenon treatment is nifedipine, a calcium channel antagonist/blocker. […] Useful, enhanced benefit is also achieved by combination therapy with vasodilators. […] Newer treatments include the prostaglandin analogues which are effective but disadvantaged by their parenteral route of administration, and lack of licence in some countries. […] Lumbar sympathectomy retains its important role in the treatment of Raynauds phenomenon involving the lower limbs. […] Satisfactory symptomatic relief is now possible for many patients with Raynauds phenomenon and this should certainly be the aim for all patients seeking medical help.

• #26 Pediatric Raynaud Phenomenon Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1355650-treatment

  Patients with Raynaud phenomenon (RP) should avoid situations and stressors that aggravate the disease (eg, vibration, cold exposure, digital trauma). […] Patients should avoid medications and drugs that aggravate the disease (eg, smoking, cocaine, other medications listed above). […] Patients need to adequately cover themselves in cold weather by covering core areas (head, trunk) and extremities using hats, layers, mittens, thick socks, and boots. […] Digital wounds should be carefully treated and monitored. Clean wounds twice daily with soap and water, cover with a topical antibiotic ointment (eg, bacitracin, mupirocin [Bactroban]) and then with a light bandage. […] Systemic antibiotics may be required if the infection worsens. Digital ulceration should be treated in a similar fashion.

• #26 Pediatric Raynaud Phenomenon Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1355650-treatment

  Biofeedback was reported to enable a pediatric patient to raise her digit temperature by 12o C and to aid some adult patients. […] Auricular electroacupuncture was reported to decrease the frequency and severity of attacks in primary Raynaud phenomenon patients in an uncontrolled study. […] Low-level laser irradiation has also been reported to significantly reduce the frequency and severity of attacks in primary Raynaud phenomenon and secondary Raynaud phenomenon compared with sham irradiation. […] Botulinum toxin injection, typically in the vicinity of the palmar digital neurovascular bundle, has been used in both primary and secondary Raynaud syndrome. Improvement in symptoms and healing of digital ulcers has been reported. […] Surgical care is needed for serious morbidity problems, including the following: Debridement of necrotic tissue, including infected wounds and osteomyelitis, may be necessary.

• #26 Pediatric Raynaud Phenomenon Treatment & Management: Medical Care, Surgical Care, Consultations

  https://emedicine.medscape.com/article/1355650-treatment

  Different surgical techniques have been used to improve Raynaud phenomenon symptoms, including balloon angioplasty, venous or arterial grafting, and digital or thorascopic sympathectomy. […] Sympathectomy may be required for intractable ischemia not responsive to medical treatment. […] No specific diet recommendations are necessary. […] Supplements such as fish oil and evening primrose have been reported to be beneficial in limited studies, but additional trials are needed for better evaluation of the effectiveness of these products. […] Patients should carefully monitor symptoms in situations that may precipitate an episode. […] If the patient is involved in winter sports, limiting the duration of continuous cold exposure, wearing layers, and using hand warmers may help. […] Patients who participate in activities that may result in digital injury (eg, skateboarding, mountain biking) should wear protective gloves to minimize abrasions and deeper injuries.

• #27 Treatment for Raynaud’s Phenomenon | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/raynauds-phenomenon/treatment.html

  If you have Raynaud’s that is caused by another disease, your doctor can treat that disease. This may relieve your symptoms. […] There is no cure for Raynaud’s that occurs on its own (primary Raynaud’s). But you may be able to control it by avoiding the things that trigger it. […] If you can’t control your symptoms with these steps, your doctor may give you medicine such as calcium channel blockers. This may increase blood flow to your hands and feet and relieve symptoms. […] Some alternative treatments, such as herbal supplements and biofeedback training, have shown promise in treating Raynaud’s. But they haven’t been shown to work for everyone. Talk with your doctor if you’re interested in trying any of these.

• #28 Raynaud’s Phenomenon Information & Treatment

  https://www.columbiadoctors.org/health-library/condition/raynaud-s-phenomenon/

  If you have Raynaud’s that is caused by another disease, your doctor can treat that disease. This may relieve your symptoms. […] There is no cure for Raynaud’s that occurs on its own (primary Raynaud’s). But you may be able to control it by avoiding the things that trigger it, such as cold or stress. […] If this doesn’t work, your doctor may give you medicine such as calcium channel blockers. This may increase blood flow to your hands and feet and relieve symptoms. […] Some alternative treatments, such as herbal supplements and biofeedback training, have shown promise in treating Raynaud’s. But they haven’t been shown to work for everyone. Talk with your doctor if you’re interested in trying any of these.

• #29 Classical Conditioning Raynaud’s Therapy – Raynaud’s Association

  https://www.raynauds.org/2019/09/26/classical-conditioning-raynauds-therapy/

  Promising recent scientific research in classical conditioning therapy indicates that Raynauds patients may be able to train themselves to avoid the painful spasms that occur when theyre exposed to cold temperatures. […] Could Raynauds patients be conditioned so that when they encountered cold, their hand circulation opened up? […] The good news is that the answer is yes. He and many other researchers have found that improvements in circulation can be trained. […] The Hamlet method is simple. A person sits in a warm room with warm hands. The person then moves into a cold place (ideally 32F) for ten minutes. […] All subjects had measurable improvement in finger temperatures of at least 2 degrees Fahrenheit when exposed to cold. […] For at least 50% of patients, calcium channel blocker drugs are helpful, possibly reducing the motivation to commit to the training. In support of classical conditioning, however, there are two great benefits. First, it does not require drugs, as it relies on reconditioning a bodys natural responses. Secondly, classical conditioning avoids the ongoing expense and potential side effects of prescription drugs.

• #30 Natural treatments for Raynaud’s phenomenon | EBSCO Research Starters

  https://www.ebsco.com/research-starters/complementary-and-alternative-medicine/natural-treatments-raynauds-phenomenon

  In a seventeen-week, double-blind, placebo-controlled trial of thirty-five people with Raynauds, fish oil (taken at a dose that provided a total of 3.96 grams (g) of eicosapentaenoic acid and 2.64 g of docosahexaenoic acid daily) reduced reaction to cold among those with primary Raynauds disease, but it did not seem to help those with Raynauds caused by other illnesses. […] The herb Ginkgo biloba has been found to increase circulation in the fingertips, and therefore it has been proposed as a treatment for Raynauds. […] A ten-week, double-blind, placebo-controlled trial of twenty-two people with primary Raynauds found that the use of ginkgo at the very high dose of 120 milligrams three times daily reduced the number of Raynauds attacks. […] One small double-blind study found suggestions that evening primrose oil might help primary or secondary Raynauds. […] A small double-blind trial tested the effects of a single dose of two g of vitamin C on Raynauds caused by scleroderma and found no benefit. […] Finally, evidence suggests that biofeedback is, at most, no more than marginally effective for Raynauds; the same is true of acupuncture.

• #31 Raynaud’s Syndrome Treatment | LENS Neurofeedback | Marin | San Francisco | Mill Valley

  https://echoneurotherapy.com/condition-treated/raynauds-syndrome/

  Echo Neurotherapy provides medication-free treatment for chronic cold hands and feet. Raynaud’s Syndrome occurs when the brain overreacts and reduces adequate circulation to the extremities. EchoNeuro treatment protocols combined with LENS Neurofeedback restore better circulation after the first and subsequent treatments. […] LENS Neurofeedback is a non-invasive treatment that accelerates neuroregeneration of brain receptors and neural pathways to support optimal blood circulation throughout the body. […] Most clients feel the benefits after the first treatment, with steady improvement in just a few sessions. […] Often, a single neurofeedback treatment relieves Raynaud’s symptoms. Several treatment sessions are generally necessary to fully solidify the desired results. Treatments typically restore optimal circulation, greater endurance, mental clarity, and emotional resilience.

• #32 The Description and Treatment of Raynaud’s Disease/Phenomenon

  https://www.uspharmacist.com/article/the-description-and-treatment-of-raynauds-diseasephenomenon

  However, patients with secondary disease, in whom structural damage to the vessel wall is pronounced and fixed, would not be expected to respond as well to CCBs as patients suffering primarily from vasospasm (primary Raynaud’s). […] An excellent review of the use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in the treatment of Raynaud’s was recently published. […] The phosphodiesterase type 5 (PDE-5) inhibitors have demonstrated efficacy in the treatment of Raynaud’s symptoms in several case reports and clinical trials. […] For severe cases of secondary Raynaud’s, usually associated with scleroderma, several studies and case reports have supported the use of either the oral endothelin receptor antagonist bosentan or the IV administration of the synthetic prostacyclin (PGI2) analogue iloprost.

• #33 Raynaud Disease | Riley Children’s Health

  https://www.rileychildrens.org/health-info/raynaud-disease

  Raynaud disease is the tendency of cold temperatures and anxiety to trigger spasms in the arteries of the arms and legs, which causes skin discoloration and discomfort. […] Your child’s doctor will prescribe the course of treatment best suited to his or her specific case of Raynaud. Treatment may include one or more of the following: […] Anti-inflammatory medicines may be used to reduce inflammation associated with the condition. […] Vasodilators relax the blood vessels, helping to reduce the spasms of the blood vessels that occur with Raynaud’s. […] Nitroglycerin paste. Your child’s rheumatologist may suggest applying nitroglycerin paste to the affected areas to open up the blood vessels, which stimulates flushing and warmth and better blood flow to the skin. […] Calcium channel blockers relax and open the small blood vessels in your child’s hands and feet, which decreases the frequency and severity of Raynaud attacks. […] Your child’s doctor will perform blood tests to diagnose the condition. […] Raynaud disease is treated with medicines such as anti-inflammatory medicines, vasodilators, nitroglycerin paste, calcium channel blockers and alpha blockers.

• #34 Raynaud’s Disease Clinic – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/medicine/rheumatology-inflammation-immunity/services/raynauds-disease-clinic

  Avoiding use of beta blockers, usually used to treat high blood pressure, which slows the heart rate and reduces blood flow to the extremities. […] For patients who dont respond well to the above medications, there may be investigational drug options drugs that are allowed to be used in clinical trials. […] Surgery […] For patients who are at risk of losing their fingers, plastic surgeon Christian E. Sampson, MD, offers of a variety of surgical techniques. One such innovative technique is to remove the sheath of nerves surrounding the hands blood vessels, thereby eliminating the nerves responsible for triggering vasospasms.

• #35 Students see an Opportunity to treat Raynaud’s Phenomenon Symptoms with Blue Light | Medical School

  https://med.umn.edu/iem/news/students-see-opportunity-treat-raynauds-phenomenon-symptoms-blue-light

  A multidisciplinary team of undergraduate students develop a potential new pathway to treating the disabling symptoms of Raynauds phenomenon and disease. […] Saliterman suspected that blue light could be a potential treatment. […] The phototherapy device became a portable instrument that could produce low-level light at a specific wavelength and power density to modulate a signaling pathway of the microvascular structures. […] The team received a utility patent (U.S. 11,865,357) for the light-based treatment devices and methods on January 9, 2024. […] An Experimental Phototherapy Device for Studying the Effects of Blue Light on Patients with Raynauds Phenomenon.

Zobacz więcej