This site/blog explains everything about Raynaud's Phenomenon in normal human language,
no sophisticated and scientific words, but everything discussed here have a scientific base.

This blog is created, in the hope that it will help the people affected by this disease.
Kindly use "Index" for a better experience. (Given on right hand side.)

Thursday, January 19, 2012

Raynaud's Treatment

There are several treatment options for Raynaud's.
Treatment options depends on the type of Raynaud's present condition.
For Primary Raynaud's, if it is sever, then medications can be prescribed by the doctor.
(We will discuss madicines in depth, after this intro.)
But most of the times when it is not sever, treatment of primary Raynaud's focuses on avoiding triggers.
This applies to both primary, and secondary.

Secondary Raynaud's is usually treated by taking care of the underlying problem.

There are three major categories of treatment for both the Raynaud's.

The first is obviously General Care / Precautions.

It has been observed that the effects of Raynaud's can be decreased
just by taking precautions and care, without the aid of medication for Raynaud's.
This is also known as home treatment. ( I wonder why.)
I have discussed about General Care, and Precautions with depth in my three previous posts,
Don'ts For the Patients of Raynaud's Phenomenon,
Do's For The Patients of Raynaud's Phenomenon,
and Skin Protection For Raynaud's Phenomenon.

The second option is drug therapy, which also can be called as medication.

But medication is recommended only in severe cases that too only prescribed by a doctor.
(Do not attempt to take medicines on your own.)

I have explained about most of the medicines which are good and bad for us, in my other post: Drug Theropy.

In very severe cases surgery is the third option.
There are two different surgeries that can be performed regarding Raynaud's.
One should leave this up to doctor, the task of choosing which kind of surgery to perform.

Warm Regards,
Kiran Nayak :-)

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Drug Theropy

            Treatment for Raynaud's phenomenon may include prescription medicines that dilate blood vessels. According to most of the doctors, calcium channel blockers (Nifedipine1) is the safest drug for us. It reduces the frequency and severity of the Raynaud's attacks. It has the usual common side effects of headache, flushing, and ankle edema; but these are not typically of sufficient severity to stop the treatment. Nifedipine also help heal skin ulcers on the fingers and toes.

            To cut the chase,
            Positive medicines for us:
  • Calcium Channel Blockers: nifedipine (Procardia) or amlodipine (Norvasc).
  • Alpha Receptor Blockers: prozosin (Minipres) or doxazosin (Cardura). These drugs counteract a neurochemical called norepinephrine, which causes blood vessels to narrow in response to stress or temperature change. But side effects are observed with long term use.
  • For skin ulcers: nonspecific vaso-dilators such as nitroglycerinpe paste is useful.
  • Vaso-dilators: fluoxetine (Prozac),  phosphodiesterase inhibitors such as cilostazol (Pletal), pentoxifylline (Trental), and sildenafil (Viagra); and an angiotensin II receptor antagonist (used for blood pressure control), losartan (Cozaar).


        A more recent treatment for severe Raynaud's is the use of Botox. The 2009 article studied 19 patients ranging in age from 15 to 72 years with severe Raynaud's phenomenon of which 16 patients (84%) reported pain reduction at rest. 13 patients reported immediate pain relief, 3 more had gradual pain reduction over 1–2 months. All 13 patients with chronic finger ulcers healed within 60 days. Only 21% of the patients required repeated injections. A 2007 article describes similar improvement in a series of 11 patients. All patients had significant relief of pain.
There is some evidence that Angiotensin II receptor antagonists (often Losartan) reduce frequency and severity of attacks, and possibly better than nifedipine. But this is not 100% confirmed yet.

            Alpha-1 adrenergic blockers such as prazosin can be used to control Raynaud's vasospasms under supervision of a health care provider.

            In a study published in the November 8, 2005 issue of Circulation, sildenafil (Viagra) improved both microcirculation and symptoms in patients with secondary Raynaud's phenomenon resistant to vasodilatory therapy. According to the scientist's report: "In the present study, capillary blood flow was severely impaired and sometimes hardly detectable in patients with Raynaud's phenomenon. Sildenafil led to a more than 400% increase of flow velocity."

            Fluoxetine, a selective serotonin reuptake inhibitor, and other antidepressant medications may reduce the frequency and severity of episodes if caused mainly by psychological stress.

            Aggravating Medicines (To Be Avoided):

            Avoid aggravating medications such as vasconstrictors, which cause the blood vessels to narrow. Vasoconstrictors include beta-blockers, many cold preparations, caffeine, narcotics, some migraine headache medications that contain ergotamine, some chemotherapeutic drugs, and clonidine, a blood pressure medication. Some studies also associate the use of estrogen with Raynaud’s phenomenon.

     1Brand names included in this fact sheet are provided as examples only, and their inclusion does not mean that these products are endorsed by any government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

Warm Regards,
Kiran Nayak :-)

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