Neonatal Drug Therapy Manual


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.

Alternate Name(s): 
Revatio, Viagra
Phosphodiesterase Type-5 Inhibitor
Original Date: 
December 2008
Revised Date: 
May 2014
  • Treatment of persistent pulmonary hypertension of the newborn (PPHN) refractory to treatment with inhaled nitric oxide
  • IV intermittent infusion
    • Loading dose: over 3 hours
  • IV continuous infusion


  • PO: Dilute in small amount of water or feeds



Load: 0.4 mg/kg over 3 hours followed by a continuous infusion

Continuous infusion: 1.6 mg/kg/day


0.5 - 2 mg/kg/dose Q6h (maximum: 2 mg/kg/dose PO Q4h)

Side Effects: 
  • CVS: hypotension, tachycardia
  • Dermatologic: rash
  • GI: diarrhea, dyspepsia
Parameters to Monitor: 
  • BP, HR
Reconstitution and Stability: 
  • IV formulation may be administered at a concentration of 0.8 mg/mL undiluted

- Solution Compatible : D5W

  • 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

- 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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