Comparative Pharmacology
Head-to-head clinical analysis: REVATIO versus SILDENAFIL CITRATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: REVATIO versus SILDENAFIL CITRATE.
REVATIO vs SILDENAFIL CITRATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
REVATIO (sildenafil) is a phosphodiesterase type 5 (PDE5) inhibitor. By inhibiting PDE5, it increases cyclic guanosine monophosphate (cGMP) levels in pulmonary vascular smooth muscle, leading to vasodilation and reduced pulmonary vascular resistance.
Sildenafil citrate inhibits phosphodiesterase type 5 (PDE5) in the corpus cavernosum, increasing cGMP levels and enhancing nitric oxide-mediated smooth muscle relaxation, leading to penile erection. It also inhibits PDE5 in pulmonary vasculature, causing vasodilation and reducing pulmonary artery pressure.
20 mg orally three times daily, administered 4-6 hours apart.
50 mg orally as needed approximately 1 hour before sexual activity; range 25-100 mg based on efficacy and tolerability; maximum dosing frequency once per day.
None Documented
None Documented
Terminal elimination half-life ~4 hours (range 3-5 hours) in steady state; similar in pulmonary arterial hypertension patients.
Terminal elimination half-life 3-5 hours; clinical effect duration shorter due to distribution.
Primarily hepatic metabolism (CYP3A4) to N-desmethyl sildenafil (active). Renal excretion accounts for ~80% as metabolites; ~13% fecal.
Approximately 80% fecal, 13% renal as metabolites; <1% unchanged in urine.
Category C
Category A/B
PDE5 Inhibitor
PDE5 Inhibitor