sildenafil
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.
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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
What are the side effects of Sildenafil (Revatio)?
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%)
Other Side Effects
- Runny nose
- Stomach irritation
- Sinus inflammation
- "Pins and needles" sensation
Serious Side Effects
- Erection lasting for more than 4 hours
- Vision loss
- Hearing loss
Source: DailyMed
The following 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
behavior change similar to drunkenness
bleeding of the eye
blurred vision
bone pain
breast enlargement
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
dryness, redness, scaling, or peeling of the skin
excessive hunger
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 ulcers
slurred speech
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
difficult or labored breathing
flushing
headache
pain or tenderness around the eyes and cheekbones
redness of the skin
stomach discomfort following meals
stuffy or runny nose
trouble sleeping
unusually warm skin
Rare
Abdominal or stomach pain
abnormal dreams
clumsiness or unsteadiness
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
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.
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
Often causes headaches
Has to be taken 3 times a day
Can't be used if you take nitrates like Isordil, Imdur, or nitroglycerin
Should not be used with erectile dysfunction medications like sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), or avanafil (Stendra)
Pharmacist tips for Sildenafil (Revatio)
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.
Frequently asked questions about Sildenafil (Revatio)
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What are the 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).
Sildenafil (Revatio) dosage forms
Typical dosing for Sildenafil (Revatio)
Take 10 mg or 20 mg by mouth 3 times a day.
Interactions between Sildenafil (Revatio) and other drugs
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.
- Amprenavir
- Amyl Nitrite
- Atazanavir
- Boceprevir
- Cobicistat
- Darunavir
- Erythrityl Tetranitrate
- Fosamprenavir
- Indinavir
- Isosorbide Dinitrate
- Isosorbide Mononitrate
- Lopinavir
- Molsidomine
- Nelfinavir
- Nitroglycerin
- Nitroprusside
- Pentaerythritol Tetranitrate
- Propatyl Nitrate
- Riociguat
- Ritonavir
- Saquinavir
- Telaprevir
- Tipranavir
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.
- Cannabis
- Ceritinib
- Clarithromycin
- Conivaptan
- Dihydrocodeine
- Duvelisib
- Fluconazole
- Fosnetupitant
- Idelalisib
- Itraconazole
- Ivosidenib
- Larotrectinib
- Lefamulin
- Lorlatinib
- Lumacaftor
- Nefazodone
- Netupitant
- Simeprevir
- Telithromycin
- Voriconazole
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.
- Alfuzosin
- Bosentan
- Bunazosin
- Ciprofloxacin
- Delavirdine
- Doxazosin
- Erythromycin
- Etravirine
- Ketoconazole
- Moxisylyte
- Nebivolol
- Prazosin
- Rifapentine
- Silodosin
- Tamsulosin
- Terazosin
- Trimazosin
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Pulmonary arterial hypertension (PAH)
Pulmonary arterial hypertension (PAH)
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