Revatio (sildenafil) is a medicine used to treat pulmonary arterial hypertension (PAH). PAH is a serious condition where the blood pressure in the arteries supplying the lungs is abnormally high, putting strain on the right side of the heart.

Sildenafil is the same active ingredient as Viagra (used for erectile dysfunction), but Revatio is prescribed at a lower dose specifically for the lungs. It belongs to a class called PDE5 inhibitors (phosphodiesterase type 5 inhibitors). It works by relaxing and widening the blood vessels in the lungs, reducing the pressure the right heart must pump against.

Revatio is used to improve exercise capacity and slow the progression of PAH.

Take one 20 mg tablet three times daily, approximately 4 to 6 hours apart. It can be taken with or without food.

Do not stop taking Revatio without speaking to your PAH specialist. PAH can worsen rapidly if treatment is stopped.

Take the missed dose as soon as you remember. If it is nearly time for your next dose, skip and continue your schedule. Never take two doses at once.

Seek urgent medical attention. Signs of overdose include severe low blood pressure, dizziness, fainting, and visual disturbances.

• Store below 25°C
• Keep in the original packaging
• Keep out of reach of children

Very common side effects:

• Headache
• Flushing (warmth and redness of the face)
• Nausea
• Low blood pressure
• Vision changes: temporary, including colour tinge (particularly blue or green), sensitivity to light, or blurred vision
  
  

Common side effects:

• Nasal congestion
• Dyspepsia (indigestion)
• Diarrhoea
  
  

Serious side effects:

• Sudden hearing loss or tinnitus: stop taking Revatio and seek urgent medical attention
• Non-arteritic ischaemic optic neuropathy (NAION): a rare condition causing sudden vision loss. Seek urgent eye care if you experience sudden vision changes
  
  

Blood pressure is monitored regularly during treatment.

Several critical interactions exist:

• Nitrates (GTN spray, isosorbide mononitrate): absolutely contraindicated in combination. The combination causes a severe and potentially fatal drop in blood pressure
• Other PDE5 inhibitors (tadalafil, vardenafil): do not take more than one PDE5 inhibitor at a time
• Ritonavir and other HIV protease inhibitors: dramatically increase sildenafil levels, raising the risk of serious side effects. Tell your specialist you are on Revatio before any change to your HIV medicines
• Alpha-blockers (prazosin, doxazosin): can cause significant low blood pressure when combined
  
  

Tell every doctor and pharmacist you see that you are taking Revatio. This is important especially in emergency situations.

Is Revatio the same as Viagra?

Yes, they contain the same active ingredient, sildenafil, but at different doses. Viagra comes in 25, 50, and 100 mg doses for erectile dysfunction. Revatio is prescribed at 20 mg three times daily specifically for pulmonary arterial hypertension. The two products have different approved uses. Do not take Viagra in addition to Revatio, and never share or substitute one for the other without medical advice.

Why can't I take nitrates with Revatio?

PDE5 inhibitors like sildenafil and nitrates both lower blood pressure through related mechanisms. When taken together, the combined effect on blood pressure is dramatically greater than either drug alone, potentially causing a severe, rapid drop in blood pressure that can lead to fainting, organ damage, or death. If you are prescribed nitrates for heart disease and a doctor wishes to prescribe Revatio for PAH, your cardiologist and PAH specialist will need to carefully review and manage this.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.