Sildenafil (Revatio®)

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Sildenafil (sil-DEN-a-fil) belongs to a group of medicines called phosphodiesterase (PDE) inhibitors. Many medicines are used for different reasons. This drug is also used to treat impotence (problem having sex) in men. In your child, sildenafil is being used to manage high blood pressure in the lungs. Sildenafil makes it easier for your child’s heart to pump blood into the lungs. A cardiac catheterization may be done to check the pressure in your child’s lungs before starting sildenafil. A catheterization may be repeated after starting sildenafil to see if it is helping.  Refer to Helping Hand HH-III-3: Cardiac Catheterization.


  • If your child is allergic to sildenafil, he or she should not take this medicine.
  • Sildenafil should not be used if your child is taking any nitrate medicines such as nitroglycerin (Nitro-bid®, Nitro-Dur®, Nitrol ointment®, Nitrolingual Spray®) or isosorbide (Isordil®). Sildenafil can cause a serious increase in the effects of these medicines or amyl nitrate (“poppers”).
  • Sildenafil may interact with a lot of other medicines. Let your doctor or pharmacist know if your child has started, stopped, or changed any medicines. This includes prescription medicine, over-the-counter medicines, and herbal medicines.
  • If a patient thinks she might be pregnant, she should tell the doctor before she begins taking this or any medicine.
  • If a patient is breast-feeding her baby, she should tell her doctor before she begins taking this or any medicine.

How to Give This Medicine

  • Shake the bottle of medicine for 10 seconds before each use.
  • Stay with your child until he or she has swallowed the dose of medicine.
  • Give the exact dose of medicine that your doctor ordered.
  • Read the label carefully and make sure you are giving your child the right dose. It is easy to confuse the many different dosage forms and strengths.
    • Use a pediatric measuring device (available at the pharmacy) to measure the exact dose. Do not measure liquid medicines in kitchen spoons. Do not use the syringe that comes with Revatio®.  It may not measure your child’s correct dose.
    • Sildenafil may be taken with or without food.
    • It is very important to give the medicine every day as ordered, even if your child is feeling fine.  Do not change doses or stop the medicine without talking to your child’s doctor.
    • If your child has trouble taking medicine, ask your nurse for Helping Hand HH-IV-28: Medicine: How to Give By Mouth.

Storage of Medicine

  • Store all medicine out of the reach of children.
  • Always keep medicine in the original container from the pharmacy.
  • Keep this medicine away from heat or direct sunlight.
  • Do not use this medicine after the expiration date printed on the container (60 days).

What to Do If You Forget to Give a Dose

If you forget to give a dose of this medicine, but remember within about an hour, give it right away. Then go back to your regular dosing schedule. If you do not remember until later, do not give the missed dose at all and do not double the next one. Instead, go back to your regular dosing schedule. If you have any questions about this, check with your child's doctor or pharmacist.

What to Do If a Dose Is Vomited

If the medicine is vomited (thrown up) right after you give it, do not repeat the dose. Some of the medicine may still be in the stomach. The vomiting might be due to the strong taste of the medicine. At the next scheduled dose, try giving the medicine in applesauce or jelly.

Possible Side Effects

  • Lightheadedness or fainting
  • Heartburn or upset stomach, diarrhea
  • Nosebleeds
  • Headache
  • Flushing (warmth or redness in your face and neck)
  • Nasal congestion
  • Priapism (erection that lasts more than 4 hours)
  • Decrease or loss of hearing or ringing in ears

When to Call for Emergency Help

  • Signs of an allergic reaction: trouble breathing, swelling of the tongue, swelling of hands, feet or ankles
  • Erection that lasts more than 4 hours

When to Call the Doctor

  • More shortness of breath than usual
  • Change in vision
  • Change in hearing
  • If your child takes an extra dose of sildenafil
  • Call your child's doctor if your child is having any side effects that continue or are very bothersome.

Safety Tips and Other Information

  • Tell your child's doctor and pharmacist if your child has an unusual or allergic reaction to any medicine.
  • Have your pharmacist give you 2 labeled containers if your child care provider will be giving this medicine.
  • Get this prescription refilled at least days before the last dose is given. This is very important.
  • Some pharmacies may not have this medicine. Please, ask your nurse to call your pharmacy before you leave the hospital to see if they have this medicine or can order it for you. You may also have the prescription filled at the Nationwide Children’s Hospital Pharmacy.
  • If you carry medicine in your purse, keep it in its childproof container and keep your purse out of the reach of children.
  • Bring all your child's medicines with you in the original containers whenever your child sees a doctor, goes to an emergency room or is admitted to the hospital. This helps doctors who may not know your child.
  • Learn the name, spelling and dose of this medicine. Also, teach your child if he is old enough. You will need to know this information when you call your doctor or pharmacist.
  • If your child takes too much of this medicine, or if someone else takes this medicine, first call the Central Ohio Poison Center at 1-800-222-1222 (TTY 614- 228-2272).  They will tell you what to do.
  • Do not stop giving this medicine or change the amount given without first talking with your child's doctor or pharmacist.
  • The doctor has prescribed this medicine for your child only. Do not give it to anyone else.
  • When the medicine is no longer needed, dissolve the leftover medicine in water or rubbing alcohol. Mix the dissolved medicine with an unwanted material, like coffee grounds, and place the mixture back in the pill container or in another container that will not leak. Throw the container away in the trash where children and pets cannot reach it.

Follow-Up Appointments

  • Your child's follow-up appointment is on (date) at (time) .
  • Be sure to call your doctor if you cannot keep the appointment.
  • You can expect your child to have regular follow-up appointments with the doctor.
  • Write down all your questions as you think of them. Bring this list with you when you see your child’s doctor.

If you have any questions, be sure to ask your child's doctor, nurse or pharmacist.

Sildenafil (Revatio®)

HH-V-163 8/02, Revised 8/16 Copyright 2002 Nationwide Children’s Hospital