Pulmonary Arterial Hypertension Medications
Phosphodiesterase Type 5 Inhibitors: Sildenafil (Revatio®), Tadalafil (Adcirca®)
Your medicine is called _________________________________
Sildenafil (Revatio®), and/or tadalafil
(Adcirca®) are used to treat a condition
called Pulmonary Arterial Hypertension
(PAH). These are medicines are taken by
mouth (orally). They work by causing blood
vessels in the body to open up or “dilate”.
Dilating blood vessels helps to decrease the
overall pressure in the blood vessels.
Decreasing pressure in the pulmonary
arteries helps to decrease the amount of
work that the right side of the heart has to do
to pump blood through the rest of the body.
It may help delay or prevent heart failure.
Both men and women with PAH can use this
type of medicine as long as they have no
other medical reasons that would prevent
them from using it.
If any of the information in this leaflet
causes you special concern or if you want
more information about your medicine and
its use, check with your doctor, pharmacist
Remember to keep this and all other
medicines out of the reach of children.
Never share your medicines with other
Before using this medicine
Tell your doctor, pharmacist or nurse if you
▪ Are allergic to any medicine, either
prescription or nonprescription (OTC).
▪ Are taking any other prescription or
nonprescription (OTC) medicine
especially nitrates (such as
nitroglycerin, isosorbide mononitrate
or dinitrate); alpha-blockers,
itraconazole; ketoconazole; rifampin..
▪ Have any other medical problems,
mainly heart disease, angina (chest
pain), uneven heartbeats, a stomach
ulcer, a bleeding disorder, and eye
disease called retinitis pigmentosa,
sickle cell anemia, multiple myeloma,
leukemia, or liver disease, low blood
pressure, or high blood pressure.
▪ Have had a stroke or heart attack
within the past 3 to 6 months.
Proper use of this medicine
Take this medicine exactly as directed by
your doctor. Do not take more of them. Do
not take them more often than directed by
It is best not to take these medicines with a
high fat meal or snack because dietary fat
can delay the absorption of the medicine
into your blood and decrease the amount of
medicine that is absorbed overall.
Precautions while Using this
There can be many causes for an increase in
pulmonary artery pressure, therefore your
doctor should do a complete medical exam
and take a complete history before you take
The combination of sildenafil and nitrate
medicines (often used to treat chest pain)
can cause a rapid drop in blood pressure.
They must not be taken together or in the
same day. Alpha-blockers should also be
avoided when using this medicine.
If you have chest pain and seek medical help
for the chest pain, make sure that you or
someone else tells everyone involved in
your care that you take daily sildenafil or
tadalafil for treatment of pulmonary arterial
Usual adult dose of this medicine
1. Revatio® - 20 mg three times daily
up to 80mg three times daily
2. Adcirca® – 40mg once daily
Possible side effects of this medicine
Call your doctor right away if you notice
any of these side effects.
▪ Allergic reaction: itching or hives;
swelling in your face, hands, or mouth;
tingling in your mouth or throat; chest
tightness; trouble breathing that was
not present before therapy began.
▪ Painful or prolonged erection for more
than 4 hours.
▪ Blurred vision, vision loss, or vision
▪ Decreased hearing or ringing in the
▪ Sudden changes in how you see colors
mainly seeing a blue or green haze.
▪ Chest pain, especially if it spreads to
your jaw or arm.
▪ Fast, pounding, or uneven heartbeat.
▪ Lightheadedness or fainting.
▪ Shortness of breath that was not
present before therapy began,
numbness or weakness, sudden or
severe headache, problems with speech
Side effects that most often do not require
These side effects may go away during
treatment, but if they persist or bother you,
check with your doctor, pharmacist or nurse
before stopping the medicine:
▪ Flushing (warmth or redness in your
face, neck, arms or upper chest)
▪ Stuffy or runny nose, dry mouth
Other side effects not listed above may also
occur in some patients. If you notice any
other effects, check with your doctor,
pharmacist, or nurse.
This patient education document was created using
the MICROMEDEX System and may contain Thomson
MICROMEDEX proprietary information. Your health
care team may have given you this information as
part of your care. If so, please use it and call if you
have any questions. If this information was not given
to you as part of your care, please check with your
doctor. This is not medical advice. This is not to be
used for diagnosis or treatment of any medical
condition. Because each person’s health needs are
different, you should talk with your doctor or others on
your health care team when using this information. If
you have an emergency, please call 911. Printed
12/2015 by the University of Wisconsin Hospitals and
Clinics Authority, Department of Nursing. Reviewed
by the Department of Pharmacy. HF#6716