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Neonatal Drug Therapy Manual |
Sildenafil
Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.
Classification:
Phosphodiesterase Type-5 Inhibitor
Indications:
- Treatment of persistent pulmonary hypertension of the newborn (PPHN) refractory to treatment with inhaled nitric oxide
Administration:
- IV intermittent infusion
- Loading dose: over 3 hours
- IV continuous infusion
- PO: Dilute in small amount of water or feeds
Dosage:
IV
Load: 0.4 mg/kg over 3 hours followed by a continuous infusion
Continuous infusion: 1.6 mg/kg/day
PO
0.5 - 2 mg/kg/dose Q6h (maximum: 2 mg/kg/dose PO Q4h)
Side Effects:
- CVS: hypotension, tachycardia
- Dermatologic: rash
- GI: diarrhea, dyspepsia
Reconstitution and Stability:
- IV formulation may be administered at a concentration of 0.8 mg/mL undiluted
Compatibility:
- Solution Compatible : D5W
Notes:
- A 10 mg dose of the injection is predicted to have an effect equal to a 20 mg oral dose taking into consideration the parent drug and active metabolite
References:
- Steinhorn RH, Kinsella JP, Pierce C, et al. Intravenous Sildenafil in The Treatment of Neonates with Persistent Pulmonary Hypertension. J Pediatr 2009; 155: 841-7
-Baquero H, Soliz A, Neira F, Veneqas ME, Sola A. Oral sildenafil in infants with persistent pulmonary hypertension of the newborn: a pilot randomized blinded study. Pediatrics 2006; 117: 1077-83
-Herrea J, Castillo R, Concha E, Soliz A. Oral sildenafil treatment as an alternative to inhaled NO therapy for persistent pulmonary hypertension of the newborn. In: E-PAS 2006: 59: 3724.3
-Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 20th Edition. Hudson: Lexi-Comp Inc.; 2013
- Chen J, Lau E (Editors). Drug Handbook and Formulary - The Hospital for Sick Children 2013-14. Toronto: Lexi-Comp Inc; 2013
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