Revatio is a pulmonary vasodilator approved for adults with pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise ability and delay clinical worsening. PAH is a progressive condition where the blood vessels in the lungs become narrowed and stiff, forcing the right side of the heart to work harder. By targeting this hemodynamic burden, Revatio can help patients walk farther, breathe easier on exertion, and in some cases reduce hospitalization risk when used as part of a comprehensive PAH plan.
The active ingredient, sildenafil, inhibits phosphodiesterase type 5 (PDE5), an enzyme that breaks down cyclic guanosine monophosphate (cGMP). In PAH, PDE5 inhibition increases cGMP levels in the pulmonary vasculature, relaxing smooth muscle, widening lung blood vessels, and lowering pulmonary arterial pressure and pulmonary vascular resistance. This mechanism is localized primarily to the lungs where PDE5 is abundant, but systemic effects such as reduced blood pressure can occur.
Revatio is distinct from sildenafil formulations used for erectile dysfunction (ED). Although the molecule is the same, the brand, dose, dosing frequency, and clinical monitoring are different for PAH. Do not substitute ED tablets for Revatio without clinician guidance; PAH treatment often requires consistent dosing three times daily, careful drug interaction review, and disease-specific follow-up (including functional class, six-minute walk distance, oxygenation, and echocardiographic or hemodynamic parameters).
Adult dosing for PAH: The commonly used oral dose of Revatio is 20 mg three times daily (approximately 4–6 hours apart), with or without food. Try to take each dose at the same times daily to maintain steady levels. A high-fat meal may delay absorption slightly; consistency in how you take it helps minimize variability.
Formulations: Revatio comes as 20 mg tablets and as an oral suspension (10 mg/mL) that is useful for people who have difficulty swallowing pills or require precise dosing. An IV formulation is available when patients are temporarily unable to take oral medications; the IV dose is generally considered when oral dosing is interrupted and must be managed by clinicians experienced with PAH.
Renal or hepatic impairment: Mild to moderate kidney or liver disease may increase exposure. Clinicians sometimes start at the standard dose and monitor closely, or adjust based on tolerability. Severe hepatic impairment requires particular caution. Always follow specialist recommendations.
Older adults: Sensitivity to blood pressure changes and drug interactions may be higher. Providers may individualize dosing and monitor for dizziness, syncope, or other hypotension-related symptoms.
Pediatric use: Revatio is not routinely recommended in children for PAH outside of specialist care. Historical concerns about dose-related risk mean that pediatric use, when considered, must be supervised by experts in pediatric PAH with individualized risk–benefit assessment.
Administration tips: Avoid grapefruit and grapefruit juice, which can raise sildenafil levels. If you’re starting Revatio alongside other PAH therapies (e.g., endothelin receptor antagonists, prostacyclin analogs, riociguat), your care team will set a titration and monitoring plan specific to your regimen.
Blood pressure effects: Because Revatio lowers vascular resistance, it can reduce systemic blood pressure. If you have baseline hypotension, dehydration, or are on multiple antihypertensives, monitor for dizziness or fainting. Stand up slowly from sitting or lying positions.
Cardiovascular status: Discuss any history of coronary artery disease, heart failure, arrhythmias, recent heart attack, or stroke. While Revatio is used for a heart–lung condition, acute cardiac instability warrants extra caution and tailored care.
Eye and ear warnings: Rare but serious adverse events such as non-arteritic anterior ischemic optic neuropathy (NAION), sudden vision loss, and sudden decrease or loss of hearing have been reported with PDE5 inhibitors. If you experience vision or hearing changes, stop Revatio and seek immediate medical attention.
Pulmonary veno-occlusive disease (PVOD): Revatio can worsen pulmonary edema in PVOD. If symptoms of worsening breathlessness, hypoxemia, or edema occur after starting therapy, clinicians may evaluate for PVOD.
Priapism: Prolonged, painful erections (>4 hours) are rare but possible with PDE5 inhibitors. This is a medical emergency requiring immediate care to prevent long-term injury.
Kidney and liver disease: Impaired clearance can raise drug levels. Your provider may adjust dosing or increase monitoring.
Pregnancy and breastfeeding: Data in pregnancy are limited. In PAH, maternal health is critical; treatment plans are individualized by high-risk obstetric and PAH teams. Breastfeeding data are limited; discuss risks and benefits with your clinicians.
Surgery and anesthesia: Tell your surgical and anesthesia teams you take Revatio. Interactions with anesthetic agents or nitrates used in perioperative settings can be significant.
Absolute contraindications include:
- Concomitant use of nitrates or nitric oxide donors (e.g., nitroglycerin, isosorbide mononitrate/dinitrate) in any form, due to risk of profound, potentially life-threatening hypotension.
- Concomitant use of guanylate cyclase stimulators such as riociguat, due to additive vasodilatory effects.
Relative or specialist-only use:
- Severe hypotension or volume depletion.
- Significant retinal disorders (e.g., history of NAION) or hereditary retinal dystrophies (e.g., retinitis pigmentosa).
- Recent serious cardiovascular events (e.g., acute MI or stroke) without stabilization; requires individualized assessment.
Common adverse effects include headache, flushing, nasal congestion, epistaxis (nosebleeds), indigestion, diarrhea, nausea, back pain, muscle aches, insomnia, and dizziness. Many of these are mild and transient as your body adjusts.
Less common effects can include palpitations, tachycardia, peripheral edema, visual disturbances (e.g., bluish tint, light sensitivity, blurred vision), and rash. If visual changes are persistent or severe, seek evaluation promptly.
Serious but rare events: Severe hypotension with fainting, myocardial ischemia, stroke, sudden hearing decrease or loss (sometimes with tinnitus or dizziness), and NAION causing sudden loss of vision in one or both eyes. Stop Revatio and obtain emergency care if these occur.
Erection-related effects: Prolonged erections (priapism) are uncommon at PAH doses but require urgent treatment if lasting more than four hours. People with conditions predisposing to priapism (e.g., sickle cell disease, leukemia, multiple myeloma) should be monitored closely.
Report side effects to your healthcare team. Sometimes adjusting timing, addressing contributing medications, or switching components of your PAH regimen can improve tolerability.
Nitrates: Do not take any nitrate medications (e.g., nitroglycerin tablets, sprays, patches; isosorbide mononitrate/dinitrate). The combination with Revatio can cause dangerous hypotension. If nitrate therapy becomes necessary, your clinician will guide a safe washout period.
Guanylate cyclase stimulators: Avoid combining with riociguat due to additive vasodilation and hypotension risk.
CYP3A4 inhibitors: Drugs that strongly inhibit CYP3A4 can raise sildenafil levels, increasing side effects. Examples include ketoconazole, itraconazole, clarithromycin, erythromycin, cobicistat, and many HIV protease inhibitors (e.g., ritonavir). Your provider may adjust dosing or recommend alternatives. Moderate inhibitors (e.g., diltiazem, verapamil) also require caution.
CYP3A4 inducers: Agents like rifampin, carbamazepine, phenytoin, and St. John’s wort can reduce sildenafil levels, potentially lowering efficacy.
Alpha-blockers and antihypertensives: Additive blood pressure lowering can occur. Titrate cautiously and monitor for dizziness or syncope.
Other PAH therapies: Bosentan may reduce sildenafil exposure via CYP induction; your PAH specialist will balance doses and monitor response. Combining with prostacyclin pathway drugs requires individualized planning to manage blood pressure and symptomatic effects.
Food and beverages: Avoid grapefruit and grapefruit juice. Alcohol can accentuate blood pressure lowering and dizziness; if you drink, do so cautiously and discuss limits with your clinician.
If you miss a dose of Revatio, take it as soon as you remember unless it is close to the time for your next dose. In that case, skip the missed dose and resume your regular schedule. Do not double up to make up for a missed dose; doubling increases the risk of side effects without added benefit.
Symptoms of taking too much Revatio can include severe dizziness or fainting from low blood pressure, persistent vision or hearing changes, chest pain, or prolonged erection. If you suspect an overdose, seek emergency medical care or contact Poison Control (in the U.S., 1-800-222-1222) immediately. Bring the medication bottle and be ready to list all other medicines and supplements you take.
Store Revatio tablets and oral suspension at room temperature (generally 20–25°C/68–77°F), away from excess heat, moisture, and light. Keep the bottle tightly closed and out of reach of children and pets. Do not store in the bathroom.
For oral suspension, follow the pharmacy’s instructions for reconstitution and expiration. Once mixed, shake well before each dose and discard any unused suspension per the labeled timeframe (often 30 days after reconstitution; verify your pharmacy’s label). Do not freeze. Never use medication past its expiration date.
In the United States, Revatio (sildenafil for PAH) is a prescription-only medication. Federal and state laws require that a licensed clinician evaluates your condition and determines that Revatio is appropriate before a pharmacy can dispense it. This evaluation can occur via in-person visit or telehealth, and in many cases it is integrated into a streamlined process that feels “prescriptionless” from the patient’s perspective, even though a prescription is still issued behind the scenes.
Magoffin County Health Department offers a practical, structured pathway to access Revatio without having a paper prescription in hand: patients complete a health intake and are evaluated by licensed clinicians who, if appropriate, authorize dispensing through partner pharmacies. This approach preserves safety and legal compliance while reducing the friction of separate appointments. Availability, eligibility, and clinical criteria can vary by location and program, so contact the Magoffin County Health Department directly to confirm current options, intake requirements, and participating pharmacies.
What “buy Revatio without prescription” typically means in legitimate U.S. settings is that you do not need to secure a prescription beforehand; instead, the clinician evaluation and prescription issuance are bundled into the service. Be wary of websites selling Revatio without any medical review—those are often illegal or unsafe. For best value and safety, compare:
- Program fees and what’s included (evaluation, follow-up, pharmacy coordination).
- Insurance compatibility and prior authorization support, which is common in PAH therapy.
- Ongoing monitoring (blood pressure checks, symptom tracking, drug interaction reviews).
- Access to PAH specialists if your case is complex or if combination therapy is anticipated.
If you’re transitioning from hospital discharge or another PAH medication, ask the program to coordinate continuity so there are no interruptions in therapy. This may include short-term IV substitution if oral dosing is temporarily not possible, dose verification, and alignment with your pulmonologist or cardiologist.
Bottom line: You can pursue convenient, legal access to Revatio through clinician-supervised services like those offered by the Magoffin County Health Department, but genuine medical review remains the cornerstone of safe therapy. Always verify program legitimacy, confirm that a licensed prescriber is involved, and use state-licensed pharmacies for dispensing.
Revatio is the brand name for sildenafil formulated and dosed to treat pulmonary arterial hypertension (PAH, WHO Group 1). It lowers pressure in the pulmonary arteries and improves exercise capacity by relaxing blood vessels in the lungs.
Revatio is a phosphodiesterase-5 (PDE5) inhibitor that enhances nitric oxide–mediated increases in cGMP. This causes pulmonary vasodilation and improved blood flow, reducing right ventricular strain.
Revatio is approved for adults with PAH to improve exercise ability and delay clinical worsening. It is not approved for erectile dysfunction (ED) under this brand and is not indicated for other forms of pulmonary hypertension unless directed by a specialist.
Both contain sildenafil, but Revatio is indicated and dosed for PAH while Viagra is for ED. Revatio is typically 20 mg three times daily; Viagra is taken as needed at higher single doses for sexual activity.
The typical adult dose is 20 mg by mouth three times daily, about 4–6 hours apart. An intravenous formulation (10 mg three times daily) exists for patients who cannot take oral doses.
Yes, Revatio can be taken with or without food. A high‑fat meal may delay absorption slightly, but this usually isn’t clinically significant for PAH.
Effects begin within 30–120 minutes, and the half‑life is about 4 hours. Three-times-daily dosing maintains consistent pulmonary vasodilation over 24 hours.
Headache, flushing, nasal congestion, indigestion, diarrhea, and dizziness are common. Some people experience epistaxis (nosebleeds), insomnia, or mild visual color tinge.
Seek urgent care for severe dizziness or fainting, chest pain, sudden vision or hearing loss, signs of an allergic reaction, or an erection lasting more than 4 hours. If you develop worsening shortness of breath and signs of pulmonary edema, contact your clinician immediately, as this could indicate pulmonary veno-occlusive disease.
Avoid Revatio if you take any nitrate medication (e.g., nitroglycerin) or riociguat, or if you have severe hypotension. Use caution or avoid if you have recent stroke/heart attack, unstable cardiovascular disease, retinitis pigmentosa, or a history of NAION; your specialist will advise.
Strong CYP3A inhibitors (e.g., ketoconazole, itraconazole, clarithromycin, ritonavir) can raise sildenafil levels and increase side effects; strong inducers (e.g., rifampin) can reduce effectiveness. Combining with alpha‑blockers or other antihypertensives can lower blood pressure further, and grapefruit products can increase sildenafil exposure.
Alcohol can amplify blood pressure–lowering effects and dizziness. If you drink, do so sparingly and monitor how you feel.
Take it as soon as you remember unless it’s close to your next dose. Do not double up; resume your regular schedule.
Human data are limited; use only if potential benefit justifies potential risk as determined by a specialist. It is unknown if sildenafil passes into breast milk in clinically relevant amounts; discuss risks and benefits with your healthcare provider.
Chronic use in pediatric PAH showed dose‑related safety concerns in studies, and use is generally not recommended unless directed by specialists experienced in pediatric PAH. Decisions are individualized and closely monitored.
Your team may track blood pressure, oxygenation, liver and renal function as appropriate, symptoms, and exercise capacity (e.g., 6‑minute walk distance). Report worsening dyspnea, edema, syncope, or new side effects promptly.
Yes, it’s often combined with endothelin receptor antagonists or prostacyclin pathway agents in appropriate patients. Do not combine with riociguat due to risk of severe hypotension.
Store tablets at room temperature away from moisture. If using the oral suspension, follow the pharmacy’s directions; after reconstitution it should be shaken well before each dose and used within the labeled beyond‑use date.
Yes, generic sildenafil formulated for PAH is available in many regions and is typically less expensive. Coverage varies by insurer; patient assistance programs may be available.
Revatio is not labeled for ED. Though the active ingredient is the same as Viagra, the dosing strategy and intended use differ; follow your prescriber’s guidance.
Both are PDE5 inhibitors effective for PAH; Revatio is taken three times daily, while Adcirca is typically once daily (40 mg). Choice depends on convenience, side‑effect profile, drug interactions, renal/hepatic status, and insurance coverage.
Tadalafil (Adcirca/generic tadalafil) offers once‑daily dosing, which some patients prefer. Revatio’s three‑times‑daily schedule may suit others based on tolerability or interaction considerations.
Both can cause headache, flushing, and dyspepsia. Tadalafil more commonly causes back pain and myalgia; sildenafil more often causes nasal congestion and transient visual color changes.
Switching is common and should be guided by your PAH specialist. Typically, you stop Revatio and start tadalafil the next day (often 40 mg once daily) with monitoring for blood pressure and symptom changes.
No. While both contain sildenafil, they are labeled and dosed for different indications; do not substitute without medical guidance.
Revatio and PAH‑labeled generic sildenafil contain the same active ingredient and are therapeutically equivalent when the dose and dosage form match. Differences mainly relate to branding, cost, and available formulations (tablet, suspension, IV).
Both deliver sildenafil for PAH; tablets suit most adults, while suspension helps patients with swallowing difficulties or precise pediatric dosing under specialist care. Your clinician or pharmacist will recommend based on needs and accuracy of dosing.
Vardenafil is a PDE5 inhibitor like sildenafil but is not approved for PAH. Evidence and dosing for PAH are limited, so it is not typically used for this condition.
Avanafil is a PDE5 inhibitor approved for ED, not PAH. It is not used for PAH management due to lack of approval and robust evidence.
Both require caution; tadalafil accumulates more in significant renal impairment and may need dose adjustments or avoidance, whereas sildenafil may be preferred in some renal cases. In moderate to severe hepatic impairment, clinicians often favor sildenafil at cautious dosing; decisions are individualized.
No. Combining two PDE5 inhibitors increases risk of hypotension and adverse effects without proven added benefit in PAH.
Both enhance the nitric oxide–cGMP pathway, but riociguat directly stimulates soluble guanylate cyclase while Revatio inhibits PDE5. They are alternatives, not partners; do not use together due to risk of dangerous hypotension.
They act via different pathways and are often combined. ERAs can add benefits but have unique risks (e.g., liver toxicity with bosentan, teratogenicity), while Revatio’s main risks involve blood pressure and visual/hearing warnings; therapy is tailored to disease severity and tolerance.