2.6.4 Peripheral vasodilators and related drugs

General guidance

• Most serious peripheral vascular disorders are due to occlusion of vessels, either by spasm or sclerotic plaques. Lifestyle changes especially smoking cessation and exercise training are the most important measures in the medical management of such conditions.
• Low dose aspirin should be given as cardiovascular prophylaxis to such patients.
• The use of naftidrofuryl may produce beneficial improvements in pain-free walking distance. However, its long- term use should only be considered if significant improvement has been noted following a planned review after 306 months after starting treatment.
• Other agents such as inositol, pentoxifylline (oxpentifylline) and cinnarizine have not been established as being effective and should not therefore be used.
• Management of Raynauds Syndrome includes avoidance of exposure to cold and stopping smoking. Drug therapy with nifedipine, naftidrofuryl or inositol nicotinate should only be considered for more severe symptoms.

Recommended drugs

Intermittent Claudication

Naftidrofuryl £

Raynauds Syndrome

Nifedipine £

Naftidrofuryl £

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary

Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low

Peripheral arterial disease - cilostazol, naftidrofyryl oxalate, pentoxifylline and inositol nicotinate - NICE TAG TA223