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Sildenafil Pulmonary Hypertension Dose

Sildenafil Pulmonary Hypertension Dose

What is sildenafil?

Sildenafil is an oral medication called a phosphodiesterase-5 (PDE5) inhibitor approved for the treatment of pulmonary arterial hypertension (PAH) in World Health Organization (WHO) Group 1 patients. The goal of this therapy is to improve exercise ability and delay clinical worsening. Research studies showing the effectiveness of the medication included mostly patients with symptoms that were rated as WHO Functional Class II-III.Sildenafil is marketed as Revatio® for PAH and was approved by the United States Food and Drug Administration (FDA) in 2005. Sildenafil is also marketed as Viagra® which is FDA-approved for the treatment of erectile dysfunction but not for the treatment of PAH.

How does sildenafil work?

PDE5 is a substance produced in the lungs and other parts of the body that breaks down another substance called cyclic guanosine monophosphate (GMP). Cyclic GMP causes the blood vessels (arteries) to relax and widen. Sildenafil decreases the activity of PDE5, so that more cyclic GMP is available for the blood vessels inside the lungs. This leads to relaxation, or widening, of those vessels. Relaxing and widening of the blood vessels in the lungs decreases the pulmonary blood pressure to the heart and improves its function. This reduces blood pressure in the lungs which generally results in the ability to be more active. Research studies have verified this improvement.

How is sildenafil supplied?

Revatio is only available as a round, white 20 mg pill, to distinguish it from Viagra®, which is a blue diamond-shaped pill.

Revatio injection is supplied as a single-use vial containing 10 mg (12.5 mL) of sildenafil.

How can a patient obtain sildenafil?

Sildenafil must be prescribed by a physician, and insurance approval must be obtained prior to starting therapy. It is carried by most retail and specialty pharmacies, including Accredo Health Inc., Aetna Specialty Pharmacy, CVS Caremark, Cigna Tel-Drug, CuraScript, Kaiser Permanente Specialty Pharmacy, Precision Rx, Walgreens Specialty Pharmacy (Medmark) and WellCare.

Will insurance pay for sildenafil?

It is expected that most health insurance plans will pay part of the cost of this medication. However, some plans still leave patients with a high out-of-pocket responsibility.Depending on your insurance type, you may be eligible for assistance from the company that manufactures your therapy or from a non-profit charitable assistance organization.

Sildenafil is generally well tolerated. The most frequent side effects are:

  • Nose bleeds
  • Headache
  • Upset stomach and heartburn
  • Flushing of the skin
  • Difficulty sleeping
  • Worsening shortness of breath
  • Nasal congestion
  • Fluid retention
  • Nausea and diarrhea
  • Pain in the extremity (arm or leg)
  • Temporary muscle aches
  • Fever
  • Numbness
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