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Medications for Scleroderma

Here are the basics about each of the medicines below. Only common problems with them are listed.
Medicines cannot cure scleroderma. They can only manage symptoms.

Over-the-counter Medicines

Prescription Medicines

Disease-modifying Antirheumatic Drugs (DMARDs)
These drugs are given to try to slow the disease. They work by suppressing the immune system.
Non-biological DMARDs may include methotrexate and cyclophosphamide. Biologic DMARDs may include antithymocyte globulin, imatinib, or rituximab
Some problems may be:
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Some NSAIDs are available as over-the-counter medicines. This is given as a prescription to deliver a higher dosage. NSAIDs help ease inflammation, swelling, and joint pain.
Some problems may be:
  • Stomach upset
  • Stomach ulcers
  • Gastrointestinal bleeding
  • Kidney damage
  • Liver inflammation
  • Confusion
Corticosteroids
Corticosteroids are strong anti-inflammatory medicines. They are given to ease swelling, inflammation, and joint pain.
Short-term problems may be:
  • Problems sleeping
  • Lack of hunger
  • Mood swings
  • High blood pressure
  • High blood sugar, especially in people with diabetes
Long-term problems may be:
  • Weakening of the immune system and a higher risk of infections
  • Thinning, weak bones—osteoporosis
  • Cataracts, glaucoma
  • Stomach upset
  • Swelling in the hand, face, and legs
  • Easy bruising
  • Gastritis
Calcium-channel Blockers
Calcium-channel blockers can ease symptoms of Raynaud phenomenon by relaxing blood vessels. This allows better blood flow through the fingers, toes, and the tip of the nose. There will be less skin discoloring, numbness, and tingling. They can also lower the risk of sores or ulcers on the fingertips.
Calcium-channel blockers may also be given to treat high blood pressure.
Problems may be:
  • Low blood pressure
  • Constipation
  • Nausea
  • Lightheadedness
  • Headache
  • Swelling
Vasodilators
These medicines are used for Raynaud phenomenon that is not helped by other methods. They are also used to heal sores on the fingers and to treat pulmonary hypertension.
May include bosentan, ambrisentan, or sildenafil
Problems may be:
  • Liver damage
  • Blood pressure changes
  • Deadly pulmonary artery pressure changes
Blood Pressure Medicines
Blood pressure medicines are given to lower high blood pressure.
May include angiotensin-converting enzyme (ACE) inhibitors or calcium-channel blockers.
Problems may be:
  • Flushing of the skin
  • Cough
  • Headaches
  • Nausea
  • Jaw pain
  • Fainting
Prostanoids
Prostanoids are given to improve blood flow.
Problems may be:
  • Low blood pressure
  • Dry mouth
  • Cough
  • Lightheadedness
  • Diarrhea or constipation
Antibiotics
Antibiotics may be given to help treat diarrhea. This is often caused by an overgrowth of bacteria in the small intestine.
Problems may be:
  • Nausea
  • Vomiting
  • Antibiotic allergic reaction
  • Sun sensitivity
H-2 Blockers
H-2 blockers help ease acid production in the stomach. They may be given to help with heartburn and indigestion.
Problems may be:
  • Lightheadedness
  • Confusion
  • Headache
  • Diarrhea
Proton Pump Inhibitors
Proton pump inhibitors ease acid production in the stomach. They may be given to help with heartburn, indigestion, and problems swallowing.
Problems may be:
  • Lightheadedness
  • Headache
  • Diarrhea
Gastrointestinal Stimulants
These medicines are given to improve problems swallowing.
Problems may be:
  • Heart rhythm problems
  • Diarrhea
  • Stomach upset, cramping
  • Headache
  • Lightheadedness
  • Sleepiness

Over-the-Counter Medicines

Antacids
Antacids work to balance acidity in the stomach. They are given to ease heartburn and indigestion
Problems may be:
  • Diarrhea
  • Constipation

References

Kowal-Bielecka O, Fransen J, et al. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2017 Aug;76(8):1327-1339.
Localized scleroderma. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/localized-scleroderma. Accessed August 12, 2020.
Scleroderma. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/Health%5FInfo/Scleroderma/default.asp. Accessed August 12, 2020.
Systemic sclerosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/systemic-sclerosis. Accessed August 12, 2020.
What is scleroderma? Scleroderma Foundation website. Available at: http://www.scleroderma.org/site/PageServer?pagename=patients%5Fwhatis#.WEhnf02QzIV. Accessed August 12, 2020.

Revision Information

  • Reviewer: EBSCO Medical Review Board James P. Cornell, MD
  • Review Date: 03/2020
  • Update Date: 08/12/2020
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