NHS Dudley Health Economy Medicines Formulary
Home > 2 Cardiovascular system > 2.6 Nitrates, calcium-channel blockers, and other antianginal drugs > 2.6.4 Peripheral vasodilators and related drugs

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

1.1 Naftidrofuryl oxalate is recommended as an option for the treatment of intermittent claudication in people with peripheral arterial disease for whom vasodilator therapy is considered appropriate after taking into account other treatment options. Treatment with naftidrofuryl oxalate should be started with the least costly licensed preparation.

1.2 Cilostazol, pentoxifylline and inositol nicotinate are not recommended for the treatment of intermittent claudication in people with peripheral arterial disease.

1.3 People currently receiving cilostazol, pentoxifylline and inositol nicotinate should have the option to continue treatment until they and their clinicians consider it appropriate to stop.


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