Scleroderma has no known cure — there is no treatment to stop the
overproduction of collagen. Your doctor may recommend a number of
medications to make it easier for you to live with scleroderma by
treating its symptoms. Your doctor may also suggest treatments to deal
with complications of scleroderma that may affect various organs.
Doctors often treat localized scleroderma with therapies such as
moisturizers or corticosteroid medications that you apply to your skin.
Corticosteroid medications impede your body's ability to make substances
that can cause inflammation.
If the condition involves a lot of body area or an arm or a leg, your
doctor may prescribe systemic drugs to try to halt the progression of
the disease. Treatment of systemic scleroderma may be with drugs that
improve blood flow, promote esophagus and bowel function, preserve
kidney function and control high blood pressure.
dilate blood vessels and promote circulation, your doctor may prescribe:
These medications help relax blood vessel muscles, and some slow
your heart rate. They include amlodipine (Norvasc), diltiazem (Dilacor,
Tiazac), nifedipine (Adalat, Procardia) and verapamil (Calan,
These medications prevent muscle contractions in smaller arteries
and reduce the effects of naturally occurring body chemicals that
narrow blood vessels. Alpha blockers include doxazosin (Cardura).
enzyme (ACE) inhibitors.
ACE inhibitors help relax your blood vessels by blocking the
formation of a natural chemical inside your body that narrows blood
vessels. These medications include captopril (Capoten), benazepril (Lotensin),
lisinopril (Prinivil, Zestril), ramipril (Altace) and enalapril (Vasotec).
These medications act in a manner similar to that of ACE inhibitors,
but they block the action of the chemical instead of the formation
of the chemical itself. They include losartan (Cozaar).
Aspirin reduces your blood's clotting action and helps keep your
blood vessels open. The coating on the aspirin prevents the release
and absorption of the aspirin until the pill reaches your
Creams containing nitroglycerin also may help promote circulation.
Joint stiffness and pain
doctor may prescribe anti-inflammatory medications such as aspirin,
nonsteroidal anti-inflammatory drugs (NSAIDs) or low-dose
Often, along with NSAIDs, doctors prescribe certain medications called
disease-modifying antirheumatic drugs (DMARDs). These medications seem
to do their job by having an effect on immune systems that have gone out
of control. No one knows for sure how DMARDs work.
Common DMARDs include:
Originally developed as a treatment for malaria, this drug has
relatively few side effects. Apart from hydroxychloroquine's
apparent ability to affect the way immune cells work, scientists
don't completely understand how it helps tame the disease process.
Similar to other DMARDs, penicillamine can reduce inflammation, but
you must be patient. Its full effect may require many months to
develop. However, its beneficial effects may be longer lasting.
Because of a relatively high incidence of adverse reactions to this
drug and studies casting doubt on its effectiveness, its use has
declined in recent years.
Another class of medications, immunosuppressants, is able to tame
out-of-control immune systems. Some of these drugs are cytotoxic,
meaning they attack and eliminate cells associated with the disease.
Some immunosuppressants your doctor may prescribe include:
This drug does its job by affecting cells that are responsible for
some of the pain, inflammation and joint swelling that accompany
scleroderma. Trials have shown conflicting results regarding the
effectiveness of methotrexate in treating scleroderma.
This extremely potent medication works by damaging cells' genetic
information. In particular, it kills lymphocytes that are part of
autoimmune disease. Cyclophosphamide may be used to treat lung
scleroderma has affected your esophagus and you're experiencing
heartburn, your doctor may suggest prescription medications that
decrease stomach acid production. These medications include H-2 receptor
blockers and proton pump inhibitors. Prescription-strength H-2 receptor
blockers include nizatidine (Axid), famotidine (Pepcid), cimetidine (Tagamet)
and ranitidine (Zantac). Proton pump inhibitors include lansoprazole (Prevacid),
omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex)
and esomeprazole (Nexium). Your doctor may also suggest antibiotics,
special diets and medications that improve your gut's ability to
Kidney complications and high blood pressure
best way to prevent kidney complications is to control high blood
pressure. To accomplish this, your doctor may prescribe ACE inhibitors
or angiotensin II receptor blockers.
doctor may prescribe the oral medication bosentan (Tracleer) if you have
moderately severe pulmonary hypertension. This medication may improve
your ability to exercise and may slow the progression of pulmonary
hypertension. However, pregnant women shouldn't take this drug. Side
effects may include liver damage.
Skin-related (cutaneous) symptoms
Doctors sometimes prescribe minocycline (Minocin, Dynacin) to control
the cutaneous symptoms of scleroderma, although no studies have
addressed its long-term effectivenesss.
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