Nifedipine and alpha1-adrenergic blockade in Raynaud's phenomenon

The efficacy of nifedipine and prazosin in the treatment ofRaynaud's phenomenon was assessed in a prospective double-blindrandomized cross-over trial in 15 patients. Each patient receivedone week of nifedipine 20 mg TID, one week of prazosin 1 mgTID, and 2 weeks of placebo. Nifedipine was shown to be effectivein reducing both the frequency and the severity of Raynaud'sphenomenon, whereas prazosin was ineffective. Before initiationof therapy in the 15 patients, pressor responses to the intravenousalpha₁-agonist phenylephrine were assessed in the basal state,30 min after 20 mg oral nifedipine, and 30 min after 1 mg oralprazosin; the shift to the right of the log dose-vasopressorresponse curves to phenylephrine was similar with nifedipineand prazosin.