sildenafil

Disclaimer to the Online Edition

This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

sildenafil

Indication

  • Treatment of refractory persistent pulmonary hypertension of the newborn (PPHN) and chronic pulmonary hypertension

Dosage Guidelines

  • Oral:

    Initial starting dose: 0.25-0.5 mg/kg/dose every 4-8 hours.  Titrate to response.

    Dose limit: 2 mg/kg/dose every 4 hours

  • IV:

    Bolus: 0.1 mg/kg over 30 minutes followed by continuous infusion of 0.03 – 0.07 mg/kg/hr

    For neonates with congenital diaphragmatic hernia (CDH) the following regimen is recommended

    Bolus: 0.4 mg/kg over 3 hours followed by continuous infusion of 0.07 mg/kg/hr

  • To avoid the possibility of sudden clinical deterioration during withdrawal of sildenafil, a gradual dose reduction over 48-72 hours should be considered when stopping sildenafil.

Administration

  • IV bolus over 30 minutes – 3 hours followed by continuous infusion
  • Oral

Adverse Effects

  • Hypotension, flushing, diarrhea, myalgia
  • Hearing loss (reversible), transient visual disturbances

Comments

  • Continuous monitoring of blood pressure and oxygenation is required
  • Use caution in patients who are fluid depleted

Supplied As

  • 2.5 mg/mL oral suspension

  • 0.8 mg/mL IV syringe prepared by Pharmacy

References
  1. LexiComp Sick Kids
  2. Lexi Peds and Neofax