treatment of patients with RP
- Step 1: make sure to institute general measures such as heat conservation and cold protection. Counsel regarding the need for tobacco cessation. Consider stopping potential offending medications (e.g., beta-blockers) if medically feasible. If general measures are not effective, use medications. Try to use only during cold months.
- Step 2: start nifedipine XL 30 mg/day, amlodipine 5 mg/day, or diltiazem (Cardizem CD, Dilacor XR) 120 mg/day. If no response in 1 week, increase dose and continue to titrate subsequently every 2 weeks until maximum dose (nifedipine XL 180 mg/day, amlodipine 20 mg/day, Cardizem CD 360 mg/day, or Dilacor XR 480 mg/day) or side effects develop.
- Step 3: add topical nitrates, sildenafil or prazosin.