Medications That Cause And Treat Raynaud's Phenomenon

In our latest question and answer, the pharmacist discusses medications known to cause Raynaud's phenomenon and ones used for treatment.

Jan 21, 2018

Colddeadfingers asked

Are any of the following drugs/additives known to cause or suspected of causing Raynaud's? Trimethroprim (antibiotic), Codeine Phosphate,  5htp, paracetamol,  Tonic Water (containing Quinine)

Answer

Raynaud's phenomenon (or syndrome) is a disorder in which there is a lack of vascular blood flow to the extremities caused by a response to certain stimuli including:

  • Cold temperatures
  • Emotional stress
  • Certain Medications

Raynaud's may also be a secondary symptom caused by certain disease states such as multiple sclerosis and lupus.

The exact cause of Raynaud isn't known but symptoms can include blue/white extremities as well as numbness and tingling. The most often recommended treatment of Raynaud's is simply avoiding triggers such as cold temperatures or medications/substances that cause vasoconstriction, which can worsen symptoms.

Medications That Can Cause Raynaud Phenomenon

Below are some well known medications, based on reported data, that can trigger symptoms of Raynaud's phenomenon:

  • Alcohol
  • Caffeine
  • Nicotine
  • Psuedoephedrine
  • Sympathomimetics (e.g. Adderall, Phentermine)
  • Strattera (Atomoxetine)
  • Catapres (Clonidine)
  • Benadryl (Diphenhydramine)
  • Certain hormonal therapies (e.g. Premarin)
  • Duragesic (Fentanyl)
  • Lopid (Gemfibrozil)
  • Ritalin (Methylphenidate)
  • Aldomet(Levodopa)
  • Phenylephrine
  • Mirapex (Pramipexole)
  • Imitrex (Sumatriptan)
  • Theophylline
  • Narcotics (such as codeine)
  • Beta Blockers (although data isn't conclusive)

Source: NEJM, DRUGS


Medications Used To Treat Raynaud Phenomenon

When avoiding triggers of Raynaud's phenonenon isn't possible or working to eliminate symptoms, often times, medication is used. These drugs include:

  • Calcium Channel Blockers
  • Minipress (Prazosin)
  • ACE-Inhibitors (e.g. enalapril)
  • Fluoxetine
  • Nitroglycerin ointment
  • Antioxidants
  • L-Arginine
  • Aspirin
  • Pentoxifylline 

It is important to note that the above are not complete lists but cover the most common causative agents and medications used for treatment. If you are having symptoms, please reach out to your doctor to try and identify the primary cause and potential therapies.

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