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In general, drugs known as vasodilators are used to control the symptoms of RP. Vasodilators relax blood vessels to improve circulation and prevent ischemic problems such as pain and ulceration. Examples include:

• Calcium channel blockers - These drugs reduce contraction of muscles and blood vessels. They have also shown to be effective in reducing the frequency of RP episodes. Examples include:

  • nifedipine (Procardia; Adalat)
  • diltiazem (Cardizem; Dilacor XR)
  • amlodopine (Norvasc)
  • isradipine (Dynacirc)

• Angiotensin II receptor blockers - These drugs block the constriction of blood vessels and reduce the severity and frequency of RP episodes. Examples include:

  • losartan (Cozaar)
  • eprosartan (Teveten)
  • valsartan (Diovan)
  • irbesartan (Avapro)
  • olmesartan medoxomil (Benicar)
  • telmisartan (Micardis)

• Prostacyclins - These drugs are effective for dilating blood vessels, reducing viscosity (thickness) of the blood, and promoting healing of the linings of the blood vessels. The most widely studied drug in this class for the treatment of RP is Iloprost, which can be administered either intravenously (IV) or orally. Studies have shown that the IV route of administration of Iloprost is more effective for controlling the symptoms of RP than the oral route. Other prostacyclin drugs that are currently being investigated for the treatment of RP include:

  • alprostadil (Prostaglandin E-1)
  • epoprostenol (Flolan)
  • treprostinil (Remodulin)

• Pentoxifylline - This drug improves circulation by reducing viscosity of the blood so that it flows more easily through the small capillaries.

• Nitrates - Nitrates such as nitroglycerin are powerful vasodilators that may sometimes be prescribed to treat patients with RP. Nitrates work by relaxing the smooth muscle around blood vessels causing the blood vessels to dilate (widen). A topical gel containing nitric oxide was found to improve circulation in the hands and arms of patients with RP. The side-effects of nitrates, including dizziness, nausea, rapid heartbeat, and blurred vision, may limit the use of nitrates in some patients with RP.