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sildenafil

Generic Revatio
Used for Pulmonary Hypertension

Sildenafil (Revatio) is used to treat pulmonary arterial hypertension (PAH) in children and adults. It improves your ability to exercise and can help prevent PAH from getting worse.

Reviewed by:Last reviewed on May 31, 2021
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What is Sildenafil (Revatio)?

What is Sildenafil (Revatio) used for?

  • Pulmonary arterial hypertension (PAH)

How Sildenafil (Revatio) works

Sildenafil (Revatio) is a phosphodiesterase 5 (PDE-5) blocker that relaxes blood vessels in the lungs. This allows blood to flow better and lowers the blood pressure in the lungs. Your heart is able to pump better, your body gets more oxygen, and you should be able to breathe and exercise more easily.

PDE-5 blockers also relax blood vessels in other parts of the body to increase blood flow, which is why they are also used for erectile dysfunction.

Drug facts

Common BrandsRevatio, Liqrev
Drug ClassPDE-5 inhibitor
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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Side effects of Sildenafil (Revatio)

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Headaches (46%)
  • Indigestion (13%)
  • Flushing (10%)
  • Nosebleed (9%)
  • Diarrhea (9%)
  • Trouble breathing (7%)
  • Trouble sleeping (7%)
  • Muscle pain (7%)
  • Redness (6%)
  • Fever (6%)

Less Common Side Effects

  • Runny nose
  • Stomach irritation
  • Sinus inflammation
  • "Pins and needles" sensation

Sildenafil (Revatio) serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Erection lasting for more than 4 hours
  • Vision loss
  • Hearing loss

Source: DailyMed

The following Sildenafil (Revatio) side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Bladder pain

burning feeling in the chest or stomach

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

cloudy or bloody urine

dizziness

increased frequency of urination

indigestion

pain on urination

stomach upset

tenderness in the stomach area

Rare

Abnormal vision

anxiety

behavior change similar to drunkenness

bleeding of the eye

blurred vision

bone pain

breast enlargement

chest pain

chills

cold sweats

confusion

convulsions (seizures)

cool and pale skin

deafness or hearing loss

decrease in amount of urine or the frequency of urination

decreased vision

difficulty in concentrating

dizziness or lightheadedness, especially when getting up suddenly from a lying or sitting position

double vision

drowsiness

dry eyes

dry mouth

dryness, redness, scaling, or peeling of the skin

excessive hunger

eye pain

fainting or faintness

fast, irregular, or pounding heartbeat

feeling of something in the eye

fever or chills

headache (severe or continuing)

increase in the size of the pupil

increased sweating

increased thirst

lower back or side pain

migraine headache

nausea (severe or continuing)

nervousness

nightmares

numbness of the hands

painful, swollen joints

prolonged, painful erection of penis

redness, burning, or swelling of the eyes

redness, itching, or tearing of the eyes

restless sleep

seeing shades of colors differently than before

sensitivity to light

shakiness

skin lesions with swelling

skin paleness

skin rash, hives, or itching

skin ulcers

slurred speech

sore throat

sudden weakness

swelling of the face, hands, feet, or lower legs

trouble breathing

twitching of the muscles

unusual feeling of burning or stinging of the skin

unusual tiredness or weakness

vision changes

vision loss, temporary

Incidence not known

Blindness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Aches or pains in the muscles

bloody nose

diarrhea

difficult or labored breathing

flushing

headache

pain or tenderness around the eyes and cheekbones

redness of the skin

sneezing

stomach discomfort following meals

stuffy or runny nose

trouble sleeping

unusually warm skin

Rare

Abdominal or stomach pain

abnormal dreams

anxiety

clumsiness or unsteadiness

cough

diarrhea or stomach cramps (severe or continuing)

difficulty in swallowing

ear pain

increased amount of saliva

increased skin sensitivity

lack of coordination

loss of bladder control

mental depression

nausea

numbness or tingling of the hands, legs, or feet

rectal bleeding

redness or irritation of the tongue

redness, soreness, swelling, or bleeding of the gums

ringing or buzzing in the ears

sensation of motion, usually whirling, either of one's self or of one's surroundings

sexual problems in men (continuing), including failure to experience a sexual orgasm

sleepiness

sores in the mouth and on the lips

tense muscles

trembling and shaking

vomiting

waking to urinate at night

worsening of asthma

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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Pros and cons of Sildenafil (Revatio)

Pros

  • A first choice for treating PAH
  • Helps prevent worsening of PAH if given with epoprostenol
  • Also available as an oral liquid and an injection
  • Available as a generic
  • Safe to use if you have kidney problems

Cons

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Pharmacist tips for Sildenafil (Revatio)

pharmacist
  • Sildenafil (Revatio) can be taken with or without food. Taking it with food may help prevent upset stomach.
  • Separate your doses by 4 to 6 hours. Taking your doses too close together can raise your risk of side effects.
  • The oral liquid (suspension) is good for 60 days either at room temperature or in the fridge. Make sure to shake it well for at least 10 seconds before using. Be sure to use a medication dose cup, spoon, or syringe to measure out your dose. Using household teaspoons might cause you to take the wrong amount of sildenafil (Revatio).
  • Seek medical attention right away if you have an erection that lasts for more than 4 hours or sudden changes in vision or hearing, since these can lead to permanent problems.
  • Sildenafil (Revatio) contains the same active ingredient as Viagra, which is used for male erectile dysfunction (ED). Do not take sildenafil (Revatio) together with Viagra or any other treatments for erectile dysfunction (PDE-5 inhibitors) as this raises your risk of serious side effects.
  • Talk to your provider if you're taking a nitrate medication for your heart or chest pain. Sildenafil (Revatio) can cause dangerously low blood pressure if you take it with a nitrate, and you might have to be switched to another medication.
  • Headache is a common side effect of taking sildenafil (Revatio). Let your provider know if it doesn't go away or if it is severe.
faq-icon

Common questions about Sildenafil (Revatio)

Both Viagra and sildenafil (Revatio) contain the same active ingredient: sildenafil. However, Viagra is FDA-approved to treat erectile dysfunction, whereas sildenafil (Revatio) is FDA-approved to treat pulmonary arterial hypertension (PAH). The strengths and dosages used to treat each condition are different.

Sildenafil (Revatio) reaches peak levels in the blood about 1 to 2 hours after each dose, though it may be a couple of months before the full benefits of the medication kick in. In studies, people taking sildenafil (Revatio) started to see noticeable improvements in exercise ability after about 4 weeks.

Sildenafil (Revatio) is not FDA-approved to treat erectile dysfunction. Though it contains sildenafil, the same active ingredient as Viagra, the strength and dose are different from those used for erectile dysfunction. Take the medication that you're prescribed to make sure that you're getting the right dose for your health condition. It is possible to have a prolonged erection after taking sildenafil (Revatio).

Yes. Sildenafil (Revatio) is available by prescription only. Pulmonary arterial hypertension (PAH) is a serious heart and lung problem that should be closely managed by a medical specialist.

Take sildenafil (Revatio) 3 times day and separate the doses by 4 to 6 hours. Taking it more frequently can raise your risk of side effects. There is usually no benefit to taking more than 20 mg 3 times a day, though some medical specialists will recommend higher strengths (still taken 3 times a day).

Both sildenafil (Revatio) and sildenafil (Liqrev) are oral suspensions of the same generic medication and used to treat pulmonary arterial hypertension (PAH). But sildenafil (Revatio) is FDA-approved to treat both children and adults, sildenafil (Liqrev) is marketed to treat adults only. Talk to your provider to see which one is right for you.

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Risks and warnings for Sildenafil (Revatio)

Sildenafil (Revatio) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

DEATH IN CHILDREN

In one clinical study, children who took higher doses of sildenafil (Revatio) for PAH were more likely to die after about 1 year. Sildenafil (Revatio) is not recommended for long-term use in children.

LOW BLOOD PRESSURE

  • Risk factors: Taking medications for high blood pressure | Blood pressure that is already low | Dehydration | Problems with the heart pumping blood to the body | Blood pressure problems due to nerve problems

Sildenafil (Revatio) relaxes your blood vessels, which can make your blood pressure drop too low. If you take medications that lower blood pressure, make sure to check your blood pressure regularly while taking this medication. Let your provider know if your blood pressure goes lower than usual or if you feel symptoms like dizziness, lightheadedness, or chest pain that doesn't go away.

SERIOUS LUNG DISEASE

Although rare, sildenafil (Revatio) can cause a serious type of lung condition called pulmonary veno-occlusive disease, which can cause fluid build-up in the lungs. If your PAH symptoms get worse, breathing becomes difficult when you lie down, or if you develop a cough that doesn't go away, seek medical help right away.

NOSEBLEEDS

  • Risk factors: PAH due to connective tissue disease | people also taking blood thinners like warfarin

Sildenafil (Revatio) can cause nosebleeds. This is more likely to happen if you take blood thinners like warfarin. Seek medical attention if you have a nosebleed that you are unable to stop. Let your provider know if you have a bleeding disorder or stomach ulcer before starting sildenafil (Revatio).

VISION LOSS

  • Risk factors: History of eye nerve problems such as "crowded disc" or non-arteritic anterior ischemic optic neuropathy (NAION) | Age over 50 | Diabetes | High blood pressure | Heart disease | High cholesterol | Smoking

Though rare, sildenafil (Revatio) can cause you to lose your eyesight or have permanent eye damage. Go to the emergency room or call your provider immediately if you suddenly notice changes in your vision in one or both eyes. This may be a sign of a serious eye condition called non-arteritic anterior ischemic optic neuropathy (NAION).

HEARING LOSS

There have been reports of people having permanent hearing loss while taking sildenafil (Revatio). This may happen along with ringing in the ears (tinnitus) and dizziness. Go to the emergency room or call your provider immediately if you notice changes in your hearing in one or both ears.

DANGEROUS INTERACTION

Sildenafil (the active ingredient in sildenafil (Revatio)) is also marketed as Viagra to treat erectile dysfunction. Do not take sildenafil (Revatio) with other PDE-5 inhibitors as this may cause dangerous drops in blood pressure and increased side effects. Other PDE-5 inhibitors include: tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra).

PROLONGED ERECTION

  • Risk factors: Peyronie's disease | Cavernosal fibrosis | Sickle cell anemia | Certain blood cancers

There have been reports of men having an erection lasting more than 4 hours while on sildenafil (Revatio). This is rare but if it's not treated in time, it can cause permanent damage to your penis, including permanent impotence. Get medical help immediately if this happens.

SICKLE CELL CRISIS

  • Risk factors: Sickle cell disease

People with pulmonary hypertension due to sickle cell disease are more likely to have a sickle cell crisis if they take sildenafil (Revatio). If you have PAH due to sickle cell disease, talk to your provider before taking sildenafil (Revatio).

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Sildenafil (Revatio) dosage

The average cost for 30 tablets of 20mg of Sildenafil (Revatio) is $9.81 with a free GoodRx coupon. This is 94.52% off the average retail price of $179.00.
bottle of oral suspensionBottle of oral suspension
DosageQuantityPrice as low asPrice per unit
112ml of 10mg/ml1 bottle$35.22$35.22
tabletTablet
DosageQuantityPrice as low asPrice per unit
20mg30 tablets$9.81$0.33

Typical dosage for Sildenafil (Revatio)

Take 10 mg or 20 mg by mouth 3 times a day.

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Interactions between Sildenafil (Revatio) and other drugs

Sildenafil (Revatio) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Sildenafil (Revatio). Please note that only the generic name of each medication is listed below.

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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What are alternatives to Sildenafil (Revatio)?

There are a number of medications that your doctor can prescribe in place of Sildenafil (Revatio). Compare a few possible alternatives below.
Sildenafil (Revatio)
Used for:
  • Pulmonary arterial hypertension (PAH)
$9.81Lowest GoodRx priceView prices
Used for:
  • Pulmonary arterial hypertension (PAH)
$14.75Lowest GoodRx priceView prices
Used for:
  • Pulmonary arterial hypertension (PAH)
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