Pulmonary hypertension:

Indications for: REVATIO

Pulmonary arterial hypertension (PAH) (WHO Group I) in adults to improve exercise ability and delay clinical worsening. PAH (WHO Group I) in pediatric patients to improve exercise ability and, in pediatric patients too young to perform standardized exercise testing, pulmonary hemodynamics thought to underlie improvements in exercise.

Adult Dosage:

≥18yrs: 20mg three times daily. May titrate dose to a max of 80mg three times daily, if needed, based on symptoms and tolerability.

Children Dosage:

<1yr: not established. 1–17yrs (≤20kg): 10mg three times daily; (20–45kg): 20mg three times daily; (>45kg): 20mg three times daily. Based on experience in adults, may titrate dose to a max of 40mg three times daily for patients >45kg, if needed, based on symptoms and tolerability.

REVATIO Contraindications:

Concomitant organic nitrates, riociguat.

REVATIO Warnings/Precautions:

Pulmonary veno-occlusive disease: not recommended. PAH secondary to sickle cell anemia (risk of vaso-occlusive crisis). 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). Risk of non-arteritic anterior ischemic optic neuropathy; monitor for sudden vision loss. Retinitis pigmentosa: not recommended. Anatomical penile deformation. Predisposition to priapism. Severe hepatic impairment. Active peptic ulcer. Bleeding disorders. Elderly. Pregnancy. Nursing mothers.

REVATIO Classification:

Phosphodiesterase type 5 inhibitor (cGMP-specific).

REVATIO Interactions:

See Contraindications. Hypotension with nitrates. Concomitant strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, ritonavir): not recommended. Antagonized by moderate to strong CYP3A4 inducers (eg, bosentan).

Adverse Reactions:

Headache, dyspepsia, flushing, pain in limb, myalgia, back pain, diarrhea; priapism, hypotension, vision or hearing loss.


Hepatic (CYP3A, CYP2C9).

Drug Elimination:

Fecal (~80%), renal (13%).

Generic Drug Availability:

Tabs (YES); Susp, inj (NO)

How Supplied:

Tabs—90; Susp—112mL (w. bottle adapter, oral syringe); Single-use vial (12.5mL)—1