The generic drug sildenafil is available for both indications.
Sildenafil has been approved by the US Food and Drug Administration (FDA) for the treatment of ED in adults and PAH in adults and children aged one year and older.³ ⁴ In ED, sildenafil indirectly promotes the activity of nitric oxide, a compound naturally released during sexual stimulation that increases blood flow to the genitalia.
European Review for Medical and Pharmacological Sciences. FDA approves intravenous formulation of Pfizer’s Revatio (sildenafil) for the treatment of pulmonary arterial hypertension. Revatio - sildenafil citrate tablet, film coated; Revatio - sildenafil citrate injection, solution; Revatio - sildenafil citrate powder, for suspension [package insert]. Retinal toxicity of long term overdose of sildenafil citrate: A case report. What to discuss with your doctor before starting sildenafil We make it easy to take part.
Sildenafil is a prescription drug belonging to a class of drugs known as phosphodiesterase type 5 (PDE5) inhibitors. PDE5 enzymes regulate the signaling pathway in the normal physiological processes related to blood flow. They bind to and activate receptors located in the arteries of the lungs and the corpus cavernosum of the penis. PDE5 inhibitors prevent the binding of these enzymes to their target receptors. This inhibition initiates a series of metabolic events resulting in the relaxation of smooth muscle in the blood vessel walls, allowing the vessels to dilate and increasing the flow of blood to those areas.¹ ² Sildenafil is sold under the brand name Viagra for the treatment of erectile dysfunction (ED), while prescriptions for pulmonary arterial hypertension (PAH) are for the brands Revatio and Liqrev. Because the drug relies on nitric oxide, it will not trigger spontaneous erections.
The drug works similarly in PAH to improve blood flow through the arteries bringing blood from the heart to the lungs.
| Parameter | Value | Description | Notes |
|---|---|---|---|
| Absorption time | 30-60 minutes | Time to reach peak plasma levels | Faster onset compared to tablets |
| Peak plasma concentration | 150-200 ng/mL | Max systemic concentration | Varies per dose and individual |
| Half-life | 4-5 hours | Time to reduce concentration by half | Helps determine dosing intervals |
| Bioavailability | 40-50% | Fraction reaching systemic circulation | Slightly variable across patients |
It allows these vessels to dilate, counteracting the high pressures that prevent healthy blood flow to the lungs in PAH.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Kamagra Polo | 100mg | 60 + 4 Pills | 189.39€ 180.37€ | |
| Viagra Generic | 50mg | 60 + 4 Pills | 83.93€ 79.93€ | |
| Viagra Generic | 100mg | 30 + 4 Pills | 60.91€ 58.01€ | |
| Viagra Generic | 50mg | 20 Pills | 40.52€ 38.59€ | |
| Kamagra Polo | 100mg | 84 + 4 Pills | 244.49€ 232.85€ | |
| Viagra Generic | 100mg | 180 + 8 Pills | 199.37€ 189.88€ | |
| Kamagra Polo | 100mg | 12 Pills | 60.21€ 57.34€ | |
| Viagra Generic | 200mg | 180 + 10 Pills | 277.56€ 264.34€ | |
| Kamagra Oral Jelly | 100mg | 30 + 5 Sachets | 136.20€ 129.71€ | |
| Viagra Generic | 200mg | 30 + 2 Pills | 83.07€ 79.11€ | |
| Kamagra Soft Tabs | 100mg | 60 + 4 Pills | 180.59€ 171.99€ | |
| Kamagra Soft Tabs | 100mg | 20 Pills | 79.79€ 75.99€ | |
| Viagra Generic | 100mg | 90 + 6 Pills | 129.02€ 122.88€ |
Sildenafil has been used off-label for treating female sexual arousal disorder and high-altitude sickness, but these uses are not US FDA-approved.⁵ Sildenafil is available as a tablet, an oral suspension, and a liquid for intravenous injection.⁶ Tablets are available in the following dosing strengths (generic, Viagra, Revatio): The oral suspension is formulated in one concentration (generic, Revatio, Liqrev): The solution for injection is available in one strength (generic, Revatio): The dosage for sildenafil varies
If you take a large amount of Revatio, the side effects can be more severe. There have been a few reports of high doses of sildenafil causing eye damage or liver damage with long-term use. Call Poison Control at 1-800-222-1222 or your healthcare team if you think you’ve taken too much Revatio. If you have severe or life-threatening symptoms, get medical help right away by calling 911 or going to the nearest ER. There are ways to save on Revatio, which is available as a brand-name and generic medication.
GoodRx can help you navigate between GoodRx coupons, copay savings cards, and patient assistance programs to save money on your prescription. Save with GoodRx: Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a 30-day supply of brand-name Revatio at an exclusive cash price of about $850. An equivalent supply of the generic may cost as little as $11.70. Save with a copay savings card: If you have commercial insurance, you may be eligible to pay $0 per month for Revatio 20 mg tablets using a copay savings card from the manufacturer. Save with a patient assistance program: If you’re uninsured or underinsured, you may be eligible for a patient assistance program that offers the medication free of charge. with the indication being treated.⁷ For ED, the recommended adult dosing options for sildenafil (generic, Viagra) are as follows: An initial dose of 50mg once a day as needed, and it can be taken 30 minutes to four hours before sexual activity (recommended one hour prior) An initial dose of 50mg once a day as needed, and it can be taken 30 minutes to four hours before sexual activity (recommended one hour prior) The dose
may be adjusted up or down based on effectiveness and tolerance The dose may be adjusted up or down based on effectiveness and tolerance Maximum dosing frequency is once per day Maximum dosing frequency is once per day These are the adult dosing recommendations for the treatment of PAH (generic, Revatio, Liqrev): An initial oral dose of 20mg three times daily, spaced 4–6 hours apart An initial oral dose of 20mg three times daily, spaced
Revatio sildenafil cenforce (sildenafil) is a medication that manages pulmonary arterial hypertension (PAH) in adults and children. Revatio is available as oral tablets, an oral liquid suspension, and an injection. The typical dosage of Revatio for PAH in adults is 20 mg by mouth 3 times a day, with a maximum dosage of 80 mg 3 times a day. For children, typical dosages are based on body weight, with dosages ranging from 10 mg to 40 mg by mouth 3 times a day. Revatio dosages do not need to be adjusted for health conditions.
But your dosage may be adjusted if you take an interacting medication. But don’t double up on doses to make up for a missed one. There are ways to save on both brand-name Revatio and the lower-cost generic, including with a GoodRx coupon. Sildenafil - sildenafil citrate injection, solution [package insert]. Sildenafil-associated hepatoxicity: A review of the literature. 4–6 hours apart A maximum oral dose of 240mg per day A maximum oral dose of 240mg per day Pediatric dosing is based on age and weight Pediatric dosing is based on age and weight Injections are administered by a medical professional in a healthcare setting Injections are administered by a medical professional in a healthcare setting Your prescriber will adjust your sildenafil dose according to the recommendations for your condition and your unique needs.
But with Revatio, no dosage changes are needed for people who have liver or kidney problems. However, Revatio can interact with other medications. So your prescriber may need to adjust your Revatio dosage if you start or stop certain medications. Examples include carbamazepine (Tegretol), phenytoin, and rifampin. Make sure to share your current medication list with your healthcare team so they can screen for potential interactions.
If you forget to take a dose of Revatio, take the missed dose as soon as you remember. But if it’s close to the time you are scheduled to take your next dose, skip the missed one and stick with your usual medication schedule. Don’t take an extra or double dose of Revatio to make up for a missed dose. If you accidentally take an extra dose of Revatio, you may experience side effects such as headache, upset stomach, and flushed skin. But in most cases, taking an extra dose isn’t likely to cause serious health problems. Sildenafil can produce an erection within 30 minutes.
| Drug Class | Potential Effect | Clinical Note |
|---|---|---|
| Nitrates | Severe hypotension | Absolute contraindication |
| Alpha-blockers | Increased risk of hypotension | Use with caution |
| CYP3A4 inhibitors (e.g., ketoconazole) | Increased sildenafil levels | Dose adjustment needed |
| Other vasodilators | Enhanced vasodilatory effects | Monitor blood pressure |
Its duration of action can last up to 18 hours. One study found the median time to onset of an erection was 27 minutes, with the shortest time to action at 12 minutes and the longest at 70 minutes.⁸ ⁹ Sildenafil is not suitable for everyone, and some people may need to take additional measures to ensure they can use the drug safely.
Below, we cover what you should know about typical Revatio dosages for PAH. Brand-name and generic Revatio come in several different dosage forms. Which dosage form you use may depend on your age and whether you have trouble swallowing pills. The oral forms can be taken with or without food. 10 mg/mL oral liquid suspension (also available as the brand-name product Liqrev) 10 mg/mL oral liquid suspension (also available as the brand-name product Liqrev) Liqrev comes as an oral liquid suspension that’s already mixed.
Revatio and sildenafil liquid suspensions come as a powder that needs to be mixed. Your pharmacist will do this for you prior to dispensing your medication. Tell your pharmacy if you receive it as a powder that’s not mixed. Once opened, Liqrev lasts up to 90 days at room temperature. Once mixed, Revatio and sildenafil suspensions last up to 60 days at room temperature or in the refrigerator. Inform your doctor if you¹⁰ ¹¹ ¹² Have had an allergic reaction to sildenafil or a similar drug Have had an allergic reaction to sildenafil or a similar drug Are taking nitrate-based drugs for chest pain (Nitrostat, Isordil) or for recreational use (“poppers”) Are taking nitrate-based drugs for chest pain (Nitrostat, Isordil) or for recreational use (“poppers”) Have a history of priapism (a painful, prolonged erection) Have a history of priapism (a painful, prolonged erection) Have had a
Good to know: Sildenafil is also the active ingredient in Viagra, a popular medication used to treat erectile dysfunction (ED). But the dose of sildenafil for PAH is different from the dose for ED. The typical Revatio dosage for adults is 20 mg by mouth three times a day. Your prescriber may increase your dose to a maximum of 80 mg three times a day if needed, based on your symptoms and how you tolerate the medication. The injectable version of Revatio is typically given in a healthcare setting.
It’s reserved for situations where you can’t take the oral formulations for a period of time. The usual dose is 10 mg given into a vein (IV) 3 times a day. Revatio is approved for use in children 1 year and older. The usual Revatio dosage for children (age 1 to 17) depends on their body weight: 20 kg (44 lbs) or less: 10 mg by mouth 3 times a day 20 kg (44 lbs) or less: 10 mg by mouth 3 times a day 20 kg (44 lbs) to 45 kg (99 lbs): 20 mg by mouth 3 times a day 20 kg (44 lbs) to 45 kg (99 lbs): 20 mg by mouth 3 times a day 45 kg (99 lbs) or more: 20 mg by mouth 3 times a day, up to a maximum of 40 mg 3 times a day 45 kg (99 lbs) or more: 20 mg by mouth 3 times a day, up to a maximum of 40 mg 3 times a day With some medications, dosages may need to be adjusted based on liver or kidney function. This is because the liver and kidneys are often responsible for breaking down medications. heart attack or stroke Have had a heart attack or stroke Or if you have any of the following medical conditions: Sickle cell disease, multiple myeloma, and leukemia Sickle cell disease, multiple myeloma, and leukemia Vision loss related to non-arteritic anterior ischemic optic neuropathy (NAION) and other eye conditions Vision loss related to non-arteritic anterior ischemic optic neuropathy (NAION) and other eye conditions These lists may be incomplete, and other conditions may affect your body’s handling of sildenafil.