Epoprostenol Plus Sildenafil for Pulmonary Arterial Hypertension?

Epoprostenol (Flolan and generics) and sildenafil (Revatio, Viagra) lead to vasodilation via different mechanisms. Therefore, using both agents together could be more effective than using either one alone for patients with pulmonary arterial hypertension. In an international controlled trial sponsored by the manufacturer of sildenafil, 267 patients with pulmonary arterial hypertension who were receiving long-term IV epoprostenol were assigned randomly to placebo or sildenafil (titrated up to 80 mg thrice daily).

At 16 weeks, the sildenafil group exhibited a greater mean increase from baseline in 6-minute walk distance than did the placebo group (29.8 vs. 1.0 meters), with benefits concentrated mainly among those with baseline 6-minute walk d…