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Revatio (sildenafil citrate)

Prescription Required.

Product of Canada.

Shipped from Canada.

Prescription Required.Product of Canada.Shipped from Canada.

What is Revatio (Sildenafil Citrate)?

Revatio (sildenafil citrate) is a phosphodiesterase type 5 inhibitor that is used to treat pulmonary arterial hypertension in adult patients. It is available as a tablet that is taken three times per day to improve a patient’s ability to engage in exercise and delay the decline of their condition.

How is Revatio Used?

This medication comes in the form of a tablet that is ingested orally three times per day, with or without food.

Storage

This medication should be stored at room temperature, ranging between 68°F (20°C) and 77°F (25°C). If necessary, this medication may be exposed to temperatures now lower than 59°F (15°C) and no higher than 86°F (30°C).

Keep this medication out of the reach of children at all times.

Uses

Revatio is prescribed for the treatment of pulmonary arterial hypertension in adult patients, a condition that involves high blood pressure levels between the lungs and the heart.

How Does Revatio Work?

This medication works by relaxing the blood vessels in the patient’s lungs, reducing the blood pressure in the lungs, allowing the blood to flow more easily, and thereby allowing the heart and lungs to work together more efficiently to provide oxygen to the body.

Dosage

This medication comes in tablet form with a strength of 20 mg.

The most common recommended dosage of this medication is 20 mg, taken three times per day with a period of about six hours between each dose. Higher dosages of this medication have not been associated with any improvement in a patient’s condition.

Overdose

If an overdose is suspected or has occurred, the patient’s doctor or local Poison Control Center should be contacted as soon as possible. If severe side effects of an overdose occur, such as breathing difficulties or loss of consciousness, emergency medical attention should be sought immediately.

Side Effects

The most common side effects of using this medication are as follows:

  • achy muscles
  • back pain
  • coughing
  • diarrhea
  • fever
  • flushing
  • flu-like symptoms
    • cough
    • fever
    • sore throat
    • sudden fatigue
  • headache
  • indigestion
  • nausea
  • nosebleeds
  • pain in one’s extremities
  • sleep difficulties

Some of the following side effects may also occur when using this medication and should be discussed with your doctor as soon as possible:

  • blurry vision
  • shortness of breath
  • sudden loss of hearing
  • sudden decrease in hearing
  • temporary loss of memory

Patients that experience any of the following serious side effects should stop using the medication and immediately seek out emergency medical attention:

  • chest pain
  • erection that lasts for more than four hours
  • heart attack symptoms
    • chest pain
    • chest pressure
    • nausea
    • pain that spreads through the arm and shoulder
    • sweating
    • vomiting
  • seizures
  • severe allergic reaction symptoms
    • breathing difficulties
    • hives
    • skin rash
    • swelling of the throat, tongue, lips, or face
  • severe skin reaction
    • blisters
    • peeling
    • rash with fever
    • rash that covers a significant portion of the body
    • rash that spreads rapidly
  • signs of bleeding in the lungs
    • bloody fluid oozing from the respiratory tract and nose
    • bluish coloration in the skin and lips
    • rapidly worsening breathing difficulties
  • stroke symptoms
    • loss of coordination
    • pain or numbness in the legs or arms
    • severe or sudden headache
    • slurring of speech that comes on suddenly
    • unexplained weakness
    • vision changes
  • vision changes (e.g., sudden loss of vision, sudden decrease in vision)

Warnings & Precautions

Bleeding

Patients with a history of bleeding conditions or bleeding disorders should inform their physician of this aspect of their medical history before beginning treatment with this medication, as Revatio may make it difficult to stop bleeding or cause it to take longer to inhibit any bleeding that occurs.

Blood Pressure Changes

This medication can cause some individuals to experience a significant and sudden drop in blood pressure. Those who are using additional medications to manage their high blood pressure levels are at an increased risk of this occurring. Patients currently being treated for hypertension that are using additional blood pressure medications should inform their physician before beginning treatment with this medication.

Blood Vessel and Heart Problems

Patients with an irregular heartbeat, chest pain, hypotension, hypertension, or a recent history of abnormal heart rhythm, stroke, or a heart that occurred within the past six months should inform their doctor of these conditions before beginning treatment with Revatio. This medication is associated with an increased risk of worsening of certain blood vessel and heart problems in some individuals.

Erections and Other Conditions

Patients with leukemia or sickle cell anemia or that have had a previous history, including an erection lasting for more than four hours, should inform their doctor of these conditions before beginning treatment with this medication.

Grapefruit

Patients using this medication should not consume grapefruit or grapefruit juice as this can result in high levels of the medication remaining present in the patient’s bloodstream, which can result in significant adverse effects.

Hepatic Function

Impaired hepatic function may impact the safety and efficacy of this medication. Patients with a history of liver problems or impaired liver function should inform their physician of this aspect of their medical history before beginning treatment with this medication. Individuals with severely impaired hepatic function should not be prescribed this medication.

Lung Conditions

Patients with pulmonary veno-occlusive disease, a certain type of hypertension that affects the lungs, should avoid using this medication. Those who have been diagnosed with this condition or that suddenly begin to experience symptoms such as rapid breathing, chest pain, shortness of breath, or a sudden cough should discuss this with their physician before beginning treatment with Revatio.

Nitrate Use

Revatio should never be mixed with any medication that includes nitrates. Mixing this medication with nitrates can result in a sudden, life-threatening drop in a patient’s blood pressure that may be fatal. Patients using this medication should avoid any medications that include nitrates, such as nitroglycerin patches, sprays, or tablets. This also includes “poppers” (amyl nitrate) and isosorbide dinitrate. A sudden drop in blood pressure due to mixing these medications may result in fainting spells, dizziness, stroke, or a heart attack.

Pediatric Patients

It has not been determined if this medication is effective or safe for use in those below the age of 18 years old.

Penile Deformations

Patients with certain penile anatomical deformations will require close monitoring during their use of this medication. This includes deformations such as Peyronie’s disease, cavernosal fibrosis, and angulation.

Pregnancy and Breastfeeding

This medication is not recommended for use during pregnancy unless it has been determined that the benefits of its use outweigh the potential risks. Patients that become pregnant while using this medication should inform their prescribing physician immediately.

Revatio may be capable of passing through breast milk and affecting a breastfed child. Patients that desire to breastfeed should discuss the potential risks of doing so with their prescribing physician.

Prostate Medications

Certain medications that are prescribed to treat prostate issues may result in dangerous drops in a patient’s blood pressure when combined with Revatio. If you are currently using any medications to manage certain prostate conditions, including alpha-blockers, please inform your physician before beginning treatment with this medication.

Vision Problems

Patients using this medication may experience a temporary or permanent partial or complete loss of vision. Any significant changes in vision or loss of vision in either or both eyes should be reported to your prescribing physician as soon as possible.

If a patient has a medical history including retinitis pigmentosa, non-arteritic anterior ischemic optic neuropathy (NAION), or a temporary or permanent decrease in vision or vision loss in either or both of their eyes should inform their doctor of this aspect of their medical history before beginning treatment with this medication.

Drug Interactions

Speak to your doctor about any medications or herbal supplements you are currently taking before beginning treatment with this medication. Discuss any concerns you may have with your doctor or a trusted pharmacist.

The following substances and medications are known to interact with Revatio:

  • alcohol
  • alfuzosin
  • aliskiren
  • alpha-agonists
  • alpha-blockers
  • alprostadil
  • amlodipine
  • amyl nitrate “poppers”
  • angiotensin-converting enzyme inhibitors (ACEIs)
  • angiotensin receptor blockers (ARBs)
  • apalutamide
  • aprepitant
  • atazanavir
  • atenolol
  • atorvastatin
  • “-azole” antifungals
  • beta-adrenergic blockers
  • bosentan
  • calcium channel blockers
  • candesartan
  • captopril
  • carbamazepine
  • ciprofloxacin
  • clarithromycin
  • clonidine
  • cobicistat
  • conivaptan
  • dasabuvir
  • dasatinib
  • deferasirox
  • diltiazem
  • diuretics
  • doxazosin
  • dronedarone
  • efavirenz
  • enalapril
  • enzalutamide
  • erythromycin
  • etravirine
  • fluconazole
  • furosemide
  • grapefruit juice
  • guanfacine
  • hepatitis C antivirals
  • HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs)
  • HIV protease inhibitors
  • hydralazine
  • hydrochlorothiazide
  • imatinib
  • indinavir
  • irbesartan
  • isosorbide dinitrate
  • isosorbide mononitrate
  • itraconazole
  • ivacaftor
  • ketoconazole
  • levodopa
  • losartan
  • lovastatin
  • lumacaftor
  • macrolide antibiotics
  • methyldopa
  • mifepristone
  • mitotane
  • modafinil
  • nevirapine
  • nifedipine
  • nilotinib
  • nitrates
  • nitroglycerin
  • ombitasvir
  • paritaprevir
  • phenobarbital
  • phenytoin
  • phosphodiesterase inhibitors
  • pramipexole
  • prazosin
  • primidone
  • propranolol
  • ramipril
  • rifabutin
  • rifampin
  • riociguat
  • ritonavir
  • saquinavir
  • sarilumab
  • selegiline
  • siltuximab
  • simvastatin
  • sotalol
  • “-statin” anticholesterol medications
  • stiripentol
  • John’s wort
  • sunitinib
  • tacrolimus
  • tadalafil
  • tizanidine
  • tocilizumab
  • triamterene
  • tyrosine kinase inhibitors
  • vardenafil
  • verapamil
  • voriconazole
  • water pills

Alternative Medications

For patients who are unable to take this medication or are experiencing significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed:

  • ambrisentan (Letairis)
  • bosentan (Tracleer, Safebo)
  • isosorbide dinitrate
  • macitentan (Opsumit)
  • tadalafil (Adcirca)
  • Treprostinil (Remodulin)

Frequently Asked Questions

Revatio is a medication prescribed to treat pulmonary arterial hypertension and improve the blood flow between the patient’s heart and lungs.

This medication improves pulmonary arterial hypertension by widening the patient’s blood vessels, and this will help to improve a patient’s ability to engage in exercise as well as decrease the rate at which their physical condition declines over time.

Patients should take this medication exactly as prescribed by their physician. Typically, this medication is taken three times per day, with about six hours between each dose.

Some of the most common side effects associated with this medication include shortness of breath and hypotension. Side effects that should immediately be reported to your physician include changes in vision, changes in hearing, erections that last multiple hours, and heart-related issues such as an irregular heartbeat, stroke, and heart attack.

The most important information about this medication is that patients should never mix Revatio with nitrates or guanylate cyclase stimulator medications due to the high risk of a dangerous drop in blood pressure occurring.

You should not take this medication if you are allergic to any of its ingredients, have unstable angina, have severe low blood pressure, have vision issues caused by blood flow-related nerve damage, have pulmonary hypertension that is due to sickle cell anemia, are taking any nitroglycerin or additional nitrate medications, have severely impaired liver function, have an irregular heartbeat, or have had a heart attack or stroke in the recent past. Additionally, you should not take this medication if you are currently using riociguat, ritonavir, itraconazole, or ketoconazole.

Patients should not mix this medication with nitroglycerin, other nitrate medications, itraconazole, ketoconazole, riociguat, or ritonavir. Please refer to the comprehensive list above for additional medications that may affect the safety and efficacy of Revatio or be impacted by the effects of using this medication.

This medication works by widening the patient’s blood vessels to improve their blood flow and blood pressure levels.

This medication comes in tablet form at a strength of 20 mg.

The recommended and most common dose of this medication is 20 mg, taken three times per day with about six to eight hours in between those doses.

This medication may be taken with or without food.

If the patient has missed a dose of this medication, it should be taken as soon as they remember. However, if the next scheduled dose is approaching soon, the missed dose should simply be skipped, and the patient should proceed with their usual dosing schedule. Patients should not take a double dose of this medication to compensate for a dose being skipped.

Patients should discontinue their use of the medication and seek emergency medical attention if they experience any of the following side effects: vision changes, severe skin reaction, severe allergic reaction, stroke symptoms, heart attack symptoms, seizures, chest pain, evidence of bleeding in the lungs, or an erection that lasts for longer than four hours.

The active ingredient in Revatio is sildenafil citrate. The inactive ingredients present in this medication include the following: triacetin, lactose monohydrate, titanium dioxide, hypromellose, magnesium stearate, croscarmellose sodium, anhydrous dibasic calcium phosphate, and microcrystalline cellulose.

Consuming grapefruit or grapefruit juice can result in higher levels of the medication being present in your blood and result in serious side effects. Individuals using Revatio should not consume grapefruit or grapefruit juice.

This medication should be stored at room temperature between the temperatures of 68°F (20°C) and 77°F (25°C). This medication may be exposed to temperatures as low as 59°F (15°C) or as high as 86°F (30°C).