Adcirca and Revatio: two PDEV inhibitors available to treat PH
Phosphodiesterase type 5 inhibitors or PDEV inhibitors work by inhibiting or decreasing the effect of phosphodiesterase type 5, a substance that breaks down nitric oxide allowing for higher concentrations of nitric oxide to remain in the blood vessels. Nitric oxide is a potent vasodilator (opens up the blood vessels allowing blood to flow more easily through) and is deficient in the pulmonary blood vessels of pulmonary hypertension patients. The FDA (Food and Drug Administration) has approved two PDEV inhibitors for the treatment of PAH.
Revatio (Sildenafil) an oral treatment for PH
Revatio is a PDEV inhibitor available in a 20mg pill form. This drug has another name, Viagra, and is used to treat erectile dysfunction. Before the FDA approved Revatio for the use of PAH, physicians were writing for Viagra for PAH patients. This prompted a huge number of phone calls from concerned pharmacists wondering why a physician was ordering a drug for erectile dysfunction for female patients. The FDA has approved one dose of 20mg three times a day for the treatment of PAH. Many physicians use other dosing regimens which are considered off label or unapproved. This medication is available through specialty pharmacies and local retail pharmacies such as Walgreens, etc. This drug may require a prior authorization from your insurance company which can delay the start of treatment and also delay refills. Many of the pharmacies have to order this medication in so it is a good idea to order refills before you are out of medication.
This medication, like all medications used to treat pulmonary hypertension, has side effects. It is important to communicate any side effects being experienced to the physician as there are medications available to alleviate many of these symptoms. The most common side effect reported while taking Revatio is headache. Revatio is an expensive medication but there are assistance programs so let your nurse coordinator know if your copay is high and they can assist in connecting you to the appropriate program. You should not stop taking this medication without speaking to your health care professional. Each patient should speak with their physician about the risk, benefits, and alternatives before initiating this therapy.
Adcirca (Tadalafil) an oral treatment for PH
Adcirca is a PDEV inhibitor approved for the treatment of pulmonary arterial hypertension. Like Revatio it also has another name, Cialis, and is used for the treatment of erectile dysfunction. Adcirca was approved for treatment of pulmonary arterial hypertension in May of 2009. The recommended dose is two 20mg tablets together once a day. This medication is available through specialty pharmacies and local retail pharmacies such as Walgreens, etc. This drug may require a prior authorization from your insurance company which can delay the start of treatment and also delay refills. Many of the pharmacies have to order this medication in so it is a good idea to order refills before you are out of medication.
Adcirca, like all medications used to treat pulmonary hypertension, has side effects. It is important to communicate any side effects being experienced to the physician as there are medications available to alleviate many of these symptoms. Adcirca is an expensive medication but there are assistance programs available so don’t be shy to call the nurse coordinator and let them know your copay is high. You should not stop taking this medication without speaking to your health care professional. Each patient should speak with their physician about the risk, benefits, and alternatives before initiating this therapy.
