About sildenafil for pulmonary arterial hypertension

Hypertension artérielle pulmonaire (HTAP) is a condition where there is too high a blood pressure in the arteries which supply blood to your lungs from your heart. The arteries become narrowed so your heart has to work harder to pump blood to your lungs.

Sildenafil relaxes the muscles in the walls of the arteries, allowing the blood vessels to become wider. This reduces the pressure in the arteries and allows blood to flow more easily through them. In turn, this increases the supply of blood to your lungs and improves your ability to do physical activities. Sildenafil will be prescribed for you by a doctor who is a specialist.

Another brand of sildenafil tablets called Viagra® is used by men for a completely different condition called erectile dysfunction. There is another medicine leaflet called Sildénafil pour la dysfonction érectile which gives more information about this.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking sildenafil it is important that your doctor knows:

• Si vous êtes enceinte ou si vous allaitez.

• If you have any other heart or blood vessel disease.

• If you have low blood pressure.

• If you have a condition which causes bleeding, such as a stomach ulcer.

• If you have had an eye condition causing loss of vision.

• Si vous avez des problèmes avec le fonctionnement de votre foie, ou des problèmes avec le fonctionnement de vos reins.

• If you have had a stroke or a heart attack.

• If you have any disease, injury or deformity of your penis.

• If you have sickle cell disease.

• If you have ever had bone marrow cancer or leukaemia.

• If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines. It is important that your doctor knows if you are using a nitrate medicine to treat angina pain, or if you are using a recreational drug called a 'popper'.

• Si vous avez déjà eu une réaction allergique à un médicament.

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack, along with any information you have been given by your hospital. The manufacturer's leaflet will give you more information about Revatio® and will provide you with a full list of the side-effects which you may experience from taking it.

• Take sildenafil exactly as your doctor tells you to. The usual dose for adults is one 20 mg tablet three times daily (6-8 hours apart), but your doctor will tell you what dose is right for you. Try to take your doses at the same times of day each day, as this will help you to remember to take the tablets regularly.

• Swallow the tablet with a drink of water. You can take sildenafil either before or after food.

• If you forget to take a dose, take it as soon as you remember. Try to take the correct number of doses each day but do not take two doses at the same time to make up for a missed dose.

• If you are giving sildenafil liquid medicine to your child, shake the bottle well before you measure out the dose. Use the oral dose syringe provided in the pack to give the correct dose. The mixture will have been made up freshly by your pharmacy when it is supplied to you. Store the bottle in a refrigerator. It will keep for four weeks.

Instructions for using the dosing syringe with Revatio® oral suspension

1. Shake the bottle well for at least 10 seconds.

2. Remove the bottle cap and make sure the plastic adaptor is fitted into the top of the open bottle.

3. Insert the tip of the dosing syringe into the adapter.

4. Retournez la bouteille (avec la seringue connectée) à l'envers.

5. Tirez doucement le piston de la seringue afin que la solution remplisse la seringue jusqu'à la marque correspondant à votre dose.

6. Turn the bottle the correct way up again and remove the syringe from the bottle.

7. Put the tip of the syringe into your (or your child's) mouth and gently push the plunger so that the liquid is released.

• Try to keep your regular appointments with your doctor so your progress can be checked.

• Do not drink grapefruit juice while you are on sildenafil. This is because a chemical in grapefruit juice is thought to increase the amount of sildenafil in your bloodstream. This makes side-effects more likely.

• Each time you collect a new supply of tablets from your pharmacy, check to make sure that the tablets look to be the same as you have had before. There is another brand of sildenafil tablets available for a different condition and these are not suitable for you. If you are unsure about your supply, please ask your pharmacist to check the tablets for you.

• Treatment with sildenafil for PAH is usually long-term. Continue to take the tablets unless you are advised otherwise by your doctor. Stopping treatment suddenly can cause problems, so if it becomes necessary for you to stop taking sildenafil, your doctor may want you to reduce your dose gradually.

• Women with pulmonary hypertension should avoid becoming pregnant as pregnancy can lead to serious worsening of your condition. Women of childbearing potential must use effective contraception during treatment with sildenafil. Speak with your doctor about which contraceptive methods are suitable for you.

• If you are due to have an operation or some other medical treatment, it is important that you tell the person carrying out the treatment that you are on sildenafil.

• If you buy any medicines 'over the counter', always check with a pharmacist that they are suitable for you to take with sildenafil.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with sildenafil. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to sildenafil, please speak with your doctor or pharmacist for further advice.

• Gardez tous les médicaments hors de la portée et de la vue des enfants.

• Conserver dans un endroit frais et sec, à l'abri de la chaleur et de la lumière directes.

• If you have been given liquid medicine, this will have been made up by the pharmacy and lasts for four weeks stored in a fridge. Make sure you check the expiry date on the bottle and do not use it after this date.