Stepwise therapy for Raynaud phenomenon
| Step 1 | Cold avoidance |
| Emotional regulation | |
| Step 2 | Dihydropyridine calcium channel blocker in maximum tolerated dose |
| Phosphodiesterase type 5 (PDE5) inhibitor substituted for or added to a calcium channel blocker | |
| Step 3 | Topical nitrate (contraindicated in a patient already taking a PDE5 inhibitor due to risk of hypotension) |
| Prazosin | |
| Fluoxetine | |
| Pentoxifylline | |
| Atorvastatin | |
| For acute digital crisis | Calcium channel blocker plus topical nitrate or calcium channel blocker plus PDE5 inhibitor |
| Intravenous prostacyclin | |
| Localized digital sympathectomy |