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Evidence record

Sildenafil × Pulmonary Arterial Hypertension

PDE5 inhibition elevates pulmonary cGMP, reducing pulmonary vascular resistance.

Approved
PublishedLast updated June 25, 2026Download evidence report
Drug: SildenafilDisease: Pulmonary Arterial HypertensionTarget: Phosphodiesterase-5

Why this drug?

Originally developed for angina, sildenafil's vasodilatory profile was repurposed for erectile dysfunction and later PAH after clinicians observed hemodynamic effects in pulmonary circulation.

Known risks

  • Hypotension (especially with nitrates)
  • Headache and flushing
  • Visual disturbances
  • Priapism (rare)

Evidence behind this

Confidence score94%
Signal strength: HighLevel 1 (RCT + regulatory approval)
Evidence grade
Approved

Improved 6-minute walk distance and hemodynamics; FDA approved as Revatio.

Mechanism

PDE5 inhibition elevates pulmonary cGMP, reducing pulmonary vascular resistance.

clinical trialfda labelPhase III

Authoritative sources

  • PubMed · 12925463

    Sildenafil for treatment of lung fibrosis and pulmonary hypertension

    Ghofrani HA et al. (2003)

    View
  • ClinicalTrials.gov · NCT00033314

    Sildenafil in pulmonary arterial hypertension (SUPER-1)

    View
  • FDA · 021845

    Revatio (sildenafil) FDA approval

    View

AI-generated summary

Generated March 15, 2026Last verified June 25, 2026

Sildenafil is an established, FDA-approved therapy for PAH with robust Phase III evidence. This is a validated repurposing success from erectile dysfunction research to pulmonary vascular disease.

Source papers
  • Ghofrani HA et al., 2003

This summary is AI-assisted and human-reviewed. It does not constitute medical advice. Always consult authoritative sources and qualified professionals.