Some Drug Classes Can Cause Raynaud's Disease

Patients taking drugs from certain classes should be educated about an alarming side effect.

A recent literature review published in the British Journal of Clinical Pharmacology identified 12 total drug classes that can cause Raynaud’s disease, a syndrome in which blood vessels constrict more than normal in response to cold temperatures or stress. The resultant lack of blood flow can cause numbness and pain.

In rare cases, blood circulation to fingers and toes can permanently diminish, leading to deformities. In very extreme, untreated cases, amputation may be necessary.

Drug-induced Raynaud’s is a “probably underestimated drug event,” the review authors hypothesized.

“Careful monitoring must be made and, if possible, alternative therapies that do not alter peripheral blood flow should be considered,” they advised.

Pharmacists should alert patients taking the following common drugs about the potential for this side effect.

1. Cancer Drugs

Drugs used during chemotherapy have long been linked to Raynaud’s.

Specifically, cisplatin and bleomycin were most likely to induce the phenomenon, the researchers found.

Additionally, evidence suggests “a possible involvement of tyrosine kinase inhibitors,” such as imatinib (Gleevec), dasatinib (Sprycel), and sorafenib (Nexavar), which may be linked “through an unknown mechanism,” the authors wrote.

2. Beta-Blockers

Like chemotherapy agents, beta-blockers have long been associated with Raynaud’s because they slow heart rate and lower blood pressure, the researchers noted.

3. Migraine Medications

Migraine medications that contain ergotamine or sumatriptan have been associated with vasoconstriction and subsequently Raynaud’s.

According to the National Heart Lung and Blood Institute (NHLBI), the following risk factors may also play role in a patient’s odds of developing Raynaud’s:

• Gender
• Age
• Family history
• Living in cold temperatures
• Having certain diseases and conditions that can directly damage the arteries or nerves that control arteries, such as rheumatoid arthritis or lupus
• Exposure to workplace chemicals, such as vinyl chloride
• Smoking