Revatio (Sildenafil Citrate) – Patient Information (UK)

Revatio contains sildenafil citrate, a medicine used to treat specific types of pulmonary hypertension. This guide explains how Revatio works, how it is usually taken, key safety information, and practical advice to help you use it confidently.

This information is designed for patients in the United Kingdom. Always follow the instructions given by your healthcare professional.

Basic product information

• Medicine: Revatio
• Active ingredient: Sildenafil citrate
• Medicinal form: Tablets (commonly available strengths include 20 mg)
• Brand use: Pulmonary arterial hypertension (PAH) in certain adults and, in some circumstances, paediatric patients
• ATC code: C01EA03 (sildenafil)
• Availability: Prescription medicines in the UK (procured through appropriate channels)

What Revatio is used for (indications)

Revatio is used to treat pulmonary arterial hypertension (PAH), a condition where blood pressure is high in the blood vessels of the lungs.

In PAH, the medicine helps improve your ability to exercise and can help slow disease worsening in appropriate patients. Revatio may be used alone or in combination with other PAH therapies.

• Pulmonary arterial hypertension (PAH): to improve exercise capacity and delay clinical worsening

Your clinician will confirm whether your specific diagnosis matches the approved use and will advise which treatment plan is most appropriate.

How Revatio works (mechanism of action)

Sildenafil belongs to a group of medicines known as phosphodiesterase type 5 (PDE5) inhibitors. In PAH, the blood vessels in the lungs become narrow and resistant, increasing pressure.

Under normal conditions, the body uses nitric oxide to relax blood vessels. In PAH, this signalling can be impaired. Sildenafil works by:

• Blocking PDE5: preventing the breakdown of cyclic guanosine monophosphate (cGMP)
• Increasing cGMP effects: promoting relaxation of pulmonary blood vessels
• Improving blood flow: reducing pulmonary vascular resistance

The result is improved pulmonary circulation, which may increase exercise tolerance and reduce symptoms related to PAH.

Pharmacokinetics (how the body processes Revatio)

Understanding how a medicine behaves in the body can help you take it consistently and plan around meals.

If you have liver or kidney problems, your clinician may adjust treatment or monitor you more closely.

Typical use and dosing schedule

Revatio is normally taken on a regular schedule. Consistency is important because PAH treatment relies on steady medicine exposure.

Common dosing approach (adult PAH):

• Often prescribed as 20 mg three times daily (morning, mid-day, evening)

For some patients, dose adjustments may be needed (for example, due to other medicines, age, liver function, or side effects). Only follow the exact dose on your treatment plan.

Important: Revatio is usually taken three times daily rather than once daily. Try to spread doses evenly.

Timing: when to take your doses

• Space doses apart: try to keep roughly even intervals between doses (e.g., morning–midday–evening).
• Choose routines: take one dose with your morning routine, one with your midday routine, and one with your evening routine.
• Missed dose: if you miss a dose, take it when you remember unless it is near the time of your next dose. Do not take double to make up for a missed dose.
• Duration of treatment: PAH is typically long-term. Continue as advised.

Food interactions and effects

Food usually does not cause a major restriction for sildenafil in many patients, but individual experiences may vary. Because Revatio is used three times daily, aim for a consistent routine.

• Taking with or without food: many patients can take Revatio either way.
• If you notice nausea or stomach discomfort: consider taking with a light meal.
• Avoid large changes: sudden changes in meal timing may affect how you feel around dosing.

If your healthcare team advises otherwise for your situation, follow their guidance.

Alcohol and medicine interactions

Alcohol can affect blood pressure and may worsen side effects such as dizziness, headache, and flushing. While moderate alcohol may be tolerated by some people, sildenafil can lower blood pressure in certain situations. For best safety:

• Limit alcohol: consider avoiding large amounts.
• Be cautious if you get light-headed: avoid drinking if you feel dizzy.
• Avoid alcohol if advised: if you have low blood pressure, fainting episodes, or significant heart disease, ask your clinician.

The most important interaction category is with nitrates and certain blood-pressure medicines (see the next section).

Important interactions with medicines (including nitrates)

Some medicines can increase sildenafil levels or increase the risk of low blood pressure when combined with Revatio. The safety-critical interaction is with nitrates.

Do not combine with nitrates

Do not take Revatio if you are using nitrates (for chest pain/angina) or medicines that act like nitrates. Examples include:

• Glyceryl trinitrate (GTN) tablets or spray
• Isosorbide mononitrate / isosorbide dinitrate
• Some “nitric oxide” type products or recreational nitrates (“poppers”)

This combination can cause a dangerous drop in blood pressure and may lead to fainting, dizziness, or worse.

Alpha-blockers (for prostate symptoms or blood pressure)

Sildenafil may lower blood pressure further when taken with alpha-blockers. Your clinician may advise careful starting doses and monitoring.

• Examples: doxazosin, tamsulosin (exact advice depends on your medicines)

Medicines that affect liver enzymes (CYP3A4)

Sildenafil is metabolised by CYP3A4. Medicines that strongly affect this pathway can increase or decrease sildenafil levels. Your healthcare professional may adjust the Revatio dose or monitor you more closely.

• Stronger CYP3A4 inhibitors (may increase sildenafil): e.g., certain antifungals (like ketoconazole), HIV protease inhibitors, and some macrolide antibiotics.
• Inducers (may reduce sildenafil): e.g., rifampicin, some anti-seizure medications (exact choices vary).

Other PAH or erectile dysfunction medicines

Combining sildenafil with other PDE5 inhibitors or with other pulmonary vasodilators may increase the risk of side effects and low blood pressure. Do not add or switch medicines without medical advice.

Riociguat

The combination of sildenafil with riociguat (a medicine for pulmonary hypertension) may increase risk. Always confirm your regimen with your clinician.

Tell your healthcare professional about all medicines you take, including over-the-counter products and herbal remedies.

Safety profile and potential side effects

Like all medicines, Revatio can cause side effects. Many patients experience mild, temporary effects, but some require urgent medical attention. Your clinician may adjust treatment if side effects occur.

Common side effects

• Headache
• Flushing (warmth/redness of skin)
• Dyspepsia (indigestion)
• Nasal congestion
• Back pain or muscle aches (reported by some patients)
• Dizziness
• Visual disturbances (e.g., mild colour tinge or blurred vision in some cases)

Less common but important side effects

• Low blood pressure (may feel like light-headedness, especially on standing)
• Abnormal heart rhythms (uncommon, but seek advice if symptoms occur)
• Prolonged or painful erection (rare; requires urgent medical attention)
• Hearing changes (rare reports exist—seek medical care if sudden hearing loss or ringing occurs)

Seek urgent help if

• You faint or feel severely dizzy
• Chest pain occurs
• Severe shortness of breath suddenly worsens
• Vision loss or sudden severe visual symptoms occur
• Any signs of an allergic reaction (swelling of face/lips, difficulty breathing, rash)

Practical use tips for patients

• Set reminders: because it is taken three times daily, phone alarms can help prevent missed doses.
• Keep a consistent schedule: take doses at roughly the same times each day.
• Monitor how you feel: track breathlessness, fatigue, and ability to exercise (as advised by your clinician).
• Stand up slowly: if you get dizziness, especially after a dose, rise gradually.
• Hydration matters: dehydration can worsen low blood pressure symptoms.
• Know your “do not mix” medicines: do not use nitrates or “poppers” alongside Revatio.
• Keep a medication list: carry a list of your current medicines and doses for any urgent situation.

If you vomit shortly after taking a dose, speak to your healthcare professional for advice on whether to repeat it.

Alternative options

PAH treatment may involve different medicines depending on the cause of pulmonary hypertension and your overall health. Alternatives include other classes of PAH therapies such as:

• Endothelin receptor antagonists (e.g., ambrisentan, bosentan)
• Prostacyclin pathway medicines (e.g., epoprostenol, treprostinil, iloprost depending on country and formulation)
• Soluble guanylate cyclase stimulators (e.g., riociguat) – but note interaction concerns with sildenafil
• Other PDE5 inhibitors in some settings (medicine choice depends on the indication and clinical plan)

Only switch or add medicines if your clinician confirms it is appropriate for your specific diagnosis and interactions.

UK market and legal context (what this means for you)

In the United Kingdom, medicines like Revatio are classified as prescription-only medicines. Availability and supply may depend on your prescriber’s assessment and local pharmacy processes. In recent years, NHS and wider UK healthcare systems have continued to emphasise safe prescribing, pharmacy dispensing checks, and clear patient education for medicines affecting blood pressure and lung circulation.

For online pharmacy services, reputable sellers provide:

• verification of eligibility and appropriate use
• clear product information and patient safety messaging
• secure delivery methods with tracking options where available

Always ensure you receive the correct product strength and instructions for your specific PAH treatment plan.

Recent guidance and monitoring (general overview)

PAH management in the UK commonly follows specialist guidance and evidence-based treatment pathways. While recommendations may evolve, general themes include:

• Regular clinical reviews: monitoring symptoms, functional class, and treatment tolerance
• Assessment for drug interactions: careful checks with blood pressure medicines and PAH therapies
• Blood pressure and side effect awareness: especially dizziness, fainting, and vision changes
• Medication adherence: consistent dosing is essential for benefit

If you are adjusting your regimen, your clinician may increase monitoring or request blood tests depending on your overall situation.

Delivery, availability, and packaging (online pharmacy)

Availability depends on current stock levels, manufacturer supply, and strength. When ordering online in the UK:

• Dispatch times: vary by supplier and location.
• Delivery options: may include tracked delivery depending on the service.
• Packaging: medicines are typically supplied in original manufacturer packaging.

To support safe use, store Revatio at appropriate room temperature as indicated on the pack, keep out of sight and reach of children, and do not use after the expiry date.

If your delivery is delayed or you receive an incorrect product, contact the pharmacy service promptly.

FAQ – Frequently asked questions about Revatio

1) What is Revatio used for?

Revatio is used to treat pulmonary arterial hypertension (PAH), helping to improve exercise capacity and delay clinical worsening in suitable patients.

2) How should I take Revatio?

It is usually taken three times daily. Follow the exact dose and timing instructions provided by your clinician. Try to space doses evenly through the day and keep your schedule consistent.

3) Can I take Revatio with food?

Many people can take sildenafil with or without food. If you experience stomach upset, taking it with a light meal may help. Keep meal timing consistent and follow any specific advice given to you.

4) What should I do if I miss a dose?

Take it when you remember unless it is close to your next dose. Do not take a double dose to compensate for a missed one.

5) Is it safe to drink alcohol?

Alcohol can worsen dizziness or lower blood pressure. Limit intake and avoid heavy drinking. If you notice light-headedness, avoid alcohol and seek advice.

6) Why must I avoid nitrates?

Nitrates used for angina (and similar “nitric oxide” products) combined with sildenafil can cause a dangerous drop in blood pressure. If you ever need urgent chest pain treatment, ensure clinicians know you take Revatio.

7) Can Revatio interact with my other medicines?

Yes. Tell your healthcare professional about all medicines including over-the-counter products and herbal supplements. Particular attention is needed for nitrates, alpha-blockers, and strong inhibitors/inducers of liver enzymes such as CYP3A4.

8) What side effects are common?

Common effects include headache, flushing, indigestion, nasal congestion, and dizziness. Report persistent or troubling side effects to your clinician.

9) When should I seek urgent medical help?

Seek urgent advice if you faint, develop severe shortness of breath, have chest pain, experience sudden vision problems, signs of an allergic reaction, or severe dizziness.

10) Are there alternatives to Revatio?

Yes. There are other PAH treatments in different medicine classes. The best option depends on your diagnosis and overall health. Discuss alternatives with your specialist team.

Key takeaways

• Revatio (sildenafil) treats pulmonary arterial hypertension by relaxing pulmonary blood vessels.
• It is typically taken three times daily and should be taken consistently.
• Do not use nitrates or “poppers” with Revatio due to dangerous blood pressure effects.
• Report side effects, especially dizziness, vision changes, or any serious symptoms promptly.
• Keep your medicine schedule and regularly review your treatment plan with your clinician.