Initial treatment of Raynaud phenomenon

* Frequency of follow-up will vary based on individual patient and environmental factors (eg, winter or colder weather conditions). Reassessment of symptoms does not need to be done in person (eg, via phone call). Some patients may require more frequent visits (eg, 2 to 4 weeks) with a more rapid escalation of therapy, whereas others with stable symptoms may follow up less frequently (eg, 3 to 6 months). Refer to UpToDate content on assessment of response to therapy during follow-up.
¶ Refer to UpToDate for alternative options for patients unable to tolerate or receive preferred initial therapy with CCB for RP.
Δ In patients with progressive symptoms, it is important to consider alternative diagnoses and address reversible causes or treatable aggravating or comorbid conditions before proceeding with additional interventions.
◊ The choice of adding one agent over another depends on the side effect profile and whether there are additional benefits for other comorbidities. The combination of PDE type 5 inhibitors and topical nitrates should be avoided due to increased risk of hypotension. Refer to UpToDate content on combination therapy for RP.