Pulmonary arterial hypertension (PAH) (WHO Group I) to improve exercise ability and delay clinical worsening, in patients who are temporarily unable to take oral Revatio.
Give by IV bolus inj. 10mg 3 times daily.
Phosphodiesterase type 5 inhibitor (cGMP-specific).
Concomitant organic nitrates.
Pulmonary veno-occlusive disease: not recommended. PAH secondary to sickle cell anemia. Underlying conditions that could be affected by vasodilatory effects (eg, concomitant antihypertensive therapy, BP<90/50, fluid depletion, severe left ventricular outflow obstruction, autonomic dysfunction). Retinitis pigmentosa. Anatomical penile deformation. Predisposition to priapism. Severe renal or hepatic impairment. Active peptic ulcer. Bleeding disorders. Elderly. Pregnancy (Cat.B). Nursing mothers.
See Contraindications. Hypotension with nitrates. Concomitant potent CYP3A4 inhibitors (eg, ketoconazole, itraconazole, ritonavir): not recommended. Potentiated by inhibitors of CY3A4 or CYP2C9, or cimetidine; may need dose adjustment. Antagonized by CYP3A4 inducers (eg, rifampin), bosentan; may need to adjust dose. Concomitant α-blockers (eg, doxazosin) may cause symptomatic hypotension (monitor BP). Potentiates bleeding risk with Vit. K antagonists. Concomitant Viagra or other PDE5 inhibitors: not recommended.
Epistaxis, headache, GI upset, flushing, insomnia, erythema, dyspnea worsened, rhinitis, sinusitis, myalgia, pyrexia, paresthesia; hypotension, vision or hearing loss, priapism.
Hepatic (CYP3A, CYP2C9).
Fecal (primary), renal.
Tabs (YES); Inj (NO)