Treating Pulmonary Arterial Hypertension with Sildenafil Citrate

Pulmonary Arterial Hypertension (PAH) is a type of high blood pressure that affects the blood vessels in the lungs and the right side of the heart. In this condition, the tiny blood vessels in the lungs become narrowed, blocked, or even destroyed. The symptoms of PAH include breathlessness on exertion and then at rest, fatigue, dizziness, chest pressure or pain, swelling in the ankles and legs, and palpitations.

Sildenafil Citrate is an oral drug belonging to a phosphodiesterase-5 (PDE5) inhibitor class of drugs approved for the treatment of PAH. The goal of prescribing this drug to PAH patients is to improve their exercise ability and delay clinical aggravation.

Sildenafil Citrate is sold under the brand name Revatiofor PAH and was approved by the FDA in 2005. It is also sold under the brand name Viagra, which is approved by the FDA for the treatment of erectile dysfunction (ED) but not for the treatment of PAH.

PDE5 is an enzyme that is produced in the lungs and other parts of the body, including the male reproductive organ. It breaks down another substance known as cyclic guanosine monophosphate (GMP). cGMP causes the blood vessels to relax and widen, improving blood flow.

Sildenafil Citrate decreases the function of PDE5 to stop the degradation of cGMP that is available for the blood vessels in the lungs. This causes relaxation and widening of those blood vessels, which eventually reduces the blood pressure in the lungs to the heart, resulting in the ability to be more active physically. Clinical studies have proven this improvement with the drug.

The drug is generally well tolerated. However, some people may experience mild side effects such as a runny nose, a headache, upset stomach or heartburn, facial flushing, or nasal congestion.

With Sildenafil Citrate, there is a reduction in blood pressure due to the relaxation of the blood vessels. So, caution must be used in patients who have low blood pressure issues, or whose blood pressure is less than 90/50 mmHg. Your physician may ask you to measure and monitor your blood pressure regularly during the course of treatment.

Taking medications such as nitrates or alpha-blockers along with sildenafil citrate can cause a significant drop in blood pressure. So, the use of this PAH drug with nitrates and alpha-blockers is contraindicated.

Please note that the safety and efficacy of sildenafil citrate in children with PAH has not been established. So, it is not advised to children. Check with your pediatrician if you have any doubts about your child having the symptoms of PAH.

Studies have evaluated sildenafil citrate in both men and women with pulmonary arterial hypertension. No differences in adverse effects have been reported between men and women. Although men experience erections, studies have not shown any improvement in sexual function in women with sildenafil citrate.

Comments are closed