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PCCS: British Doctors Use Viagra (Sildenafil) to Treat Pulmonary Hypertension By Cameron Johnston Special to DG News TORONTO, ON -- May 31, 2001 -- Viagra (sildenafil) may be useful in treating pulmonary hypertension, researchers report. In a presentation at the 3rd World Congress on Pediatric Cardiology, investigators at the Royal Brompton Hospital in London reported that two patients with pulmonary hypertension, both unresponsive to prostacyclin therapy, were treated successfully with doses of Viagra. This drug captured world attention three years ago because of its ability to treat erectile dysfunction. The first case involved a four-year old girl who had poor cardiac output with extremely high pulmonary arterial pressure and low cardiac systolic pressure. She had not responded to treatment with nitric oxide or prostacyclin. When she was treated with Viagra, 2 mg/kg, four times daily, there was an immediate increase of 10 percent in venous oxygen saturation lasting up to 90 minutes, said lead investigator Dr. Dominic Abrams, a cardiologist with the Royal Brompton. The young girl's performance subsequently improved to the point that she was able to discontinue the use of oxygen and prostacyclin, and more than two years after Viagra was started, she was able to move without the use of her wheelchair and had returned to school. The second case involved a 21-year old man who, after three years with pulmonary hypertension was unable to walk even 100 metres without a rest. He had massive dilation of the pulmonary vessels, and dangerously high pulmonary systolic pressure (128 mm). This patient was put on Viagra 100mg five times daily. After five months, he was able to participate regularly in aerobic exercise. Dr. Abrams explained that the theory behind using Viagra, a phosphodiesterase-5 inhibitor, for this purpose was not unusual. Phosphodiesterase-5, works directly on the endothelial lining of the blood vessels, breaking down cyclic GMP which in turn, blocks smooth muscle relaxation. It is found in large quantities in both the penis and in the lungs. The main benefit of Viagra for these patients was that it was able to substantially improve their quality of life, Dr. Abrams said. He suggested further that it could be used either as an adjunct to conventional prostacyclin therapy, or as a bridge while the patients are awaiting transplant. To date, no adverse effects had been seen in either patient. Although the treatment may be considered unusual (the normal dose of Viagra when used to treat erectile dysfunction ranges from 25-100 mg,) Dr. Abrams said that even when used five times daily, Viagra was still cheaper than prostacyclin therapy. He cautioned that this small case study was unlikely to result in a new wave of patients clamoring for prescriptions for Viagra. Most people respond adequately to conventional therapy so there would be no benefit in prescribing this drug. More important, there might only be five or six new cases of pulmonary hypertension each year in Britain, he said. Related Link: Viagra (sildenafil). E-mail this page to a friend or colleague! To print, use this version