Revatio 20 mg is another Sildenafil Citrate-containing drug from the eminent pharmaceutical company, Pfizer. Besides Viagra, the company manufactures Revatio, although this particular drug is not for erectile dysfunction (ED), but primarily for pulmonary hypertension. Although the Sildenafil Citrate content of Revatio and Viagra are the same thing, Pfizer is marketing Revatio solely for pulmonary hypertension and not for ED. However, Revatio remains efficacious for ED since the Sildenafil content of the drug is effective for ED management and is therefore used to treat ED .
Erectile dysfunction is caused by a number of factors which is able to alter how the blood flows to the tissues of the penis during sexual stimulation. A number of factors such as heart disease, chronic high blood pressure, endocrinal disorders, medicine side effects, lifestyle factors, and other factors are known to influence the presence of ED in patients . Drugs such as Revatio, which contain Sildenafil Citrate are effective in restoring erectile function in patients with ED. Sildenafil Citrate, however, is not only intended for ED and pulmonary hypertension, but also in various conditions such as prostatic hyperplasia’s urinary retention symptoms, pregnancy maintenance, female fertility, and even considered for the management of Reynaud’s disease and other peculiar conditions .
The drug Revatio belongs to the drug class of PDE5/phosphodiesterase type 5 inhibitors, along with Tadalafil (Cialis for ED and Adcirca for pulmonary hypertension), and Vardenafil (Levitra). The mechanism of action of these drugs is the same although they vary a bit when it comes to their chemical structure.
Revatio is available in several forms, such as pills, tablets, ftb, suspension, liquids, and injections. There are different strengths of the product, as Revatio is available in adult and pediatric doses.
The company Pfizer is one of the world’s largest and the world’s first pharmaceutical companies . The company has its headquarters set in New York, in the US, but it massively supplies drugs to almost all the nations of the world. Pfizer was founded in the year 1849, initially as a producer of “fine chemicals” .
Pfizer is known for being the first to market various medications such as Lipitor/atorvastatin for blood pressure, Lyrica/pregabalin for pain, Diflucan/fluconazole for fungal infections, Zithromax/azithromycin for bacterial infections, Viagra/Sildenafil for impotence, and Celebrex/celecoxib for inflammation .
Some of the therapeutic areas where Pfizer specializes in are oncology, immunology, cardiology, diabetology, neurology, endocrinology, and other medical disciplines . According to Pfizer, the company applies and uses science along with its global resources in order to create therapies which aim to improve and augment people’s lives .
There is not much information about the quality approvals for Pfizer, but given its tenure in the medical business, it is implied that the company is a multi-awarded and multi-accredited enterprise which is committed to quality and excellence.
Scientific Studies on Sildenafil
Sildenafil has only been introduced in the pharmaceutical industry in 1998, but prior to its introduction in the market, there are already several erectile dysfunction treatments available in the market. The study of Wysowski and Swann described the available treatments for impotence from the year 1996 to 2001 (“Use of medications for erectile dysfunction in the United States, 1996 through 2001” in 2003) . Wysowski described that preceding the marketing of Sildenafil (Viagra) in 1998, alprostadil injections and urethral suppositories are used by the patients to combat impotence . Due to the introduction of Sildenafil in the medical industry, the dispensation of both the injection and the urethral suppository drastically declined . During the period of 1998-2001, the sale of Sildenafil increased 87% while causing the debility of the sale/prescription for alprostadil suppository (-67%) and the injectable (-33%) . Stats for the drugs indicated that Sildenafil was prescribed for younger patients, while the other two impotence medications were prescribed more frequently by urologists, while general practitioners, family doctors, and internists have the propensity to prescribe Sildenafil for their patients . According to the authors, the data collated for Sildenafil indicated its swift integration in medical practice for the management of erectile dysfunction .
Early studies for Sildenafil Citrate included ones which determined the pharmacokinetics of Sildenafil when in various forms, such as in the intravenous drug form. Muirhead et al in 2002 in their study, “Comparative human pharmacokinetics and metabolism of single-dose oral and intravenous sildenafil”, compared the action of the oral Sildenafil product against the IV Sildenafil type . Based on the data amassed by the study from the clinical testing, the orally administered Sildenafil dose was rapid and was absorbed 92% although its bioavailability was only 38%, which can be attributed to the first-pass metabolism . Also, the researchers were able to determine that 60% of the IV administered Sildenafil lasted in the plasma post administration, while only 32% remained in the plasma for the orally-administered Sildenafil dose .
While Sildenafil Citrate is conceived as a drug exclusive for male use alone, it is actually cogitated for female use also. The paper of Caruso et al, entitled “The function of sildenafil on female sexual pathways: a double-blind, cross-over, placebo-controlled study” assessed whether Sildenafil Citrate, the famed drug for male impotence also has an effect on the female sexual pathways . This study was peculiar, though, as the researchers, in this case, studied the effects of Sildenafil in women asymptomatic to sexual disorders . 68 women volunteered to be administered with 50 mg placebo in 4 weeks, plus weeks of washout and placebo administration . According to the results of the volunteers who were able to complete the study, Sildenafil Citrate use was able to ameliorate arousal . Based on the data, the authors assimilated that Sildenafil was able to act on various sexual pathways which led to the augmentation of the women’s sexual experience . However, the recommendation of the authors was to conduct further studies for the clinical use of Sildenafil for women .
Description and Mechanism of Action of Sildenafil
Sildenafil Citrate, being a PDE5 inhibitor, is advantageous in the restoration of erectile function in patients suffering from erectile dysfunction. The drug actually inhibits the PDE5 (thus its name) in order for the erectile response to take place.
PDE5 is produced by the penile tissues to disintegrate the cyclic monophosphate which stimulates vasodilation leading to erection, for the penis to return to its pre-erection size. In patients with erectile dysfunction, PDE5 is capable of disintegrating the cGMP before the patients are actually able to have the erections, which renders the erection insufficient for penetration or any sexual activity. Sildenafil Citrate corrects the imbalance and helps the patients accumulate the proper cGMP levels essential to instigating and sustaining an erection.
Revatio Effects for Erectile Dysfunction and Pulmonary Hypertension
According to the product monograph for Revatio, the drug is indicated primarily for the treatment of patients affected with primary pulmonary arterial hypertension/PPH or pulmonary hypertension secondary to connective tissue disease, and not actually erectile dysfunction.
However, patients are still using Revatio for the management of erectile dysfunction to circumvent healthcare laws. It is said that the patients are not particularly aided by their insurance companies for their concerns with erectile dysfunction, that’s why they resolve to get prescriptions for PAH and end up using Revatio for erectile dysfunction. Sildenafil Citrate is effective on both, so patients find Revatio effective for either health concern.
Doses and Length of Therapy to Treat ED
The product monograph published by Pfizer for Revatio indicated that the drug is prescribed for PAH in 20 mg tablets, while the IV form is 0.8 mg/ml. There is no current recommended dose for Revatio’s use in impotence, but Sildenafil for erectile dysfunction is usually set at 50 mg to 100 mg initially. Patients cannot take Revatio with alcohol, as the substance impedes the efficacy of the drug and may also cause hypotension, which duplicates the effect of Revatio.
For more optimized dosing, patients should consult their doctors and shouldn’t self-medicate using any Sildenafil drug. Also, should Revatio’s effects feel insufficient, the patient should leave the dose increase or decrease to the medical professionals, as there are a number of nursing considerations prior to changing doses for their conditions.
Side Effects and Warnings
Not all patients are eligible to take Revatio, as there are conditions which require extra care and may be incompatible with Sildenafil Citrate. Patients with liver disease are primarily contraindicated with Sildenafil Citrate use, along with patients with heart failure, chronic low blood pressure or hypotension, renal failure, patients who experienced massive weight gain, and other diseases which should be determined by the attending physicians.
Side effects and nursing implications attributed to the use of Revatio/Sildenafil Citrate for various uses are headache, flushing, vision changes, dyspepsia, and other minor side effects. These fleeting side effects are nothing to worry about, but more grave side effects from Sildenafil such as vision loss, hearing loss, thrombocytopenia, heart attack symptoms, seizures, and other reactions which are affecting how patients normally function should be consulted with the doctors immediately.
Main interactions determined for Revatio include nitrates like isosorbide and similar medications, ACE inhibitors such as Lisinopril, and drugs which are used to lower blood pressure. More drugs are contraindicated with Sildenafil use such as fungal medications (ketoconazole), erythromycin, supplements, herbal remedies, and other drugs. To determine which drugs are safe or not, patients should seek medical advice for the safe meds to take concomitantly with Revatio.
Being a famous drug for erectile dysfunction, Revatio actually has a lot of reviews from its clients. There are client feedbacks from various online platforms, but these user evaluations were from Drugs.com, which is a reputable site for pharmaceutical products:
Most of the patient reviews for Revatio were optimistic about the results of the medication for their condition. For instance, an anonymous patient rated the drug with a perfect 10/10 and he mentioned that his quality of life has greatly improved since his use of the medication. However, due to poor healthcare assistance, he will discontinue the drug’s use as he cannot afford the cost of Revatio maintenance for his condition.
Among the sea of affirmative reviews, the comment of KCCARL stood above the rest, as he gave the Pfizer drug with only 2 out of 5. He cited that the drug did nothing to relieve him of his current condition’s symptoms. Besides the brief comment, though, the patient had nothing more to say.
Overall, despite the negative review, most of the assessments for Revatio were encouraging. The only downside to the product, based on the user comments for the drug, is that Revatio is expensive and most of the patients cannot continue using the drug due to its price.
Price, Available Forms and Dosage
Revatio is manufactured by Pfizer in 20 mg pills and in IV solutions. However, the more common form of the drug is the hard pill form, as it is relatively easier to administer and use in general. Pfizer products such as Revatio is usually found at local drugstores all over the world since there is little restriction on the sale of the drug.
Online pharmacies also have stocks for Revatio; however, most of these Revatio drugs are suspected as counterfeit. Some online shops are able to stock the drug and sell the item for way less than the ground drugstore market price. According to one online store’s price, Revatio is sold at $2.48 each pill for the minimum purchase, but the drug also can get lower in price as more of Revatio is bought.
There are no shipping restrictions for Revatio as it is from the company who owns the patent for the brand-name Sildenafil products. Revatio is sold in most parts of the world (USA, Australia, and Canada, plus others more), so there isn’t really much struggle when it comes to procuring the product. However, if patients still find it beneficial to purchase online, they can actually do so, as there are Internet drugstores able to ship the product for as low as $10 for the shipping fee.
Conclusion and Rating
There isn’t really much to expound on regarding Revatio since it is a product from one of the pillars of the pharmaceutical industry (Pfizer). The drug is high-quality, effective, and safe to use, and not to mention it’s from a well-known and respected manufacturer recognized across the globe. Revatio is efficacious for PAH, although it is also used in ED treatment and in other areas of clinical practice. The drug, although costly, can be rated 5 out of 5, but watch out for its exorbitant pricing, as it is the prime complaint of patients using the medication.
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