Tadalafil in Primary Pulmonary Arterial Hypertension
Authors: Emiliano Antonio Palmieri, Flora Affuso, Serafino Fazio, Danilo Lembo
Journal: Annals of Internal Medicine (2004)

Letters2 November 2004Tadalafil in Primary Pulmonary Arterial HypertensionEmiliano Antonio Palmieri, MD, Flora Affuso, MD, Serafino Fazio, MD, and Danilo Lembo, MDEmiliano Antonio Palmieri, MDFrom University Federico II Medical School, 80131 Naples, Italy, and Eli Lilly, 50019 Florence, Italy., Flora Affuso, MDFrom University Federico II Medical School, 80131 Naples, Italy, and Eli Lilly, 50019 Florence, Italy., Serafino Fazio, MDFrom University Federico II Medical School, 80131 Naples, Italy, and Eli Lilly, 50019 Florence, Italy., and Danilo Lembo, MDFrom University Federico II Medical School, 80131 Naples, Italy, and Eli Lilly, 50019 Florence, Italy.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-9-200411020-00033 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Sildenafil, a short-acting phosphodiesterase-5 inhibitor (1), is safe and may benefit patients with primary pulmonary arterial hypertension (2-8). However, it requires many daily administrations. We describe a patient with end-stage primary pulmonary arterial hypertension who improved while taking tadalafil, a long-acting phosphodiesterase-5 inhibitor (9).Case Report: A 72-year-old woman was hospitalized for progressive cardiopulmonary failure. Five years earlier, primary pulmonary arterial hypertension was diagnosed and the patient was hospitalized for hydropic decompensation and hypoxemia. Since then, she had been receiving permanent oxygen therapy and had also taken digoxin, amlodipine, furosemide, potassium canrenoate, and acenocoumarol.At the ...References1. Cheitlin MD, Hutter AM, Brindis RG, Ganz P, Kaul S, Russell RO, et al . ACC/AHA expert consensus document. Use of sildenafil (Viagra) in patients with cardiovascular disease. American College of Cardiology/American Heart Association. J Am Coll Cardiol. 1999;33:273-82. [PMID: 9935041] CrossrefMedlineGoogle Scholar2. Prasad S, Wilkinson J, Gatzoulis MA. Sildenafil in primary pulmonary hypertension [Letter]. N Engl J Med. 2000;343:1342. [PMID: 11183578] CrossrefMedlineGoogle Scholar3. Wilkens H, Guth A, Konig J, Forestier N, Cremers B, Hennen B, et al . Effect of inhaled iloprost plus oral sildenafil in patients with primary pulmonary hypertension. Circulation. 2001;104:1218-22. [PMID: 11551870] CrossrefMedlineGoogle Scholar4. Ghofrani HA, Wiedemann R, Rose F, Olschewski H, Schermuly RT, Weissmann N, et al . Combination therapy with oral sildenafil and inhaled iloprost for severe pulmonary hypertension. Ann Intern Med. 2002;136:515-22. [PMID: 11926786] LinkGoogle Scholar5. Michelakis E, Tymchak W, Lien D, Webster L, Hashimoto K, Archer S. Oral sildenafil is an effective and specific pulmonary vasodilator in patients with pulmonary arterial hypertension: comparison with inhaled nitric oxide. Circulation. 2002;105:2398-403. [PMID: 12021227] CrossrefMedlineGoogle Scholar6. Ghofrani HA, Wiedemann R, Rose F, Schermuly RT, Olschewski H, Weissmann N, et al . Sildenafil for treatment of lung fibrosis and pulmonary hypertension: a randomised controlled trial. Lancet. 2002;360:895-900. [PMID: 12354470] CrossrefMedlineGoogle Scholar7. Ghofrani HA, Rose F, Schermuly RT, Olschewski H, Wiedemann R, Kreckel A, et al . Oral sildenafil as long-term adjunct therapy to inhaled iloprost in severe pulmonary arterial hypertension. J Am Coll Cardiol. 2003;42:158-64. [PMID: 12849677] CrossrefMedlineGoogle Scholar8. Michelakis ED, Tymchak W, Noga M, Webster L, Wu XC, Lien D, et al . Long-term treatment with oral sildenafil is safe and improves functional capacity and hemodynamics in patients with pulmonary arterial hypertension. Circulation. 2003;108:2066-9. [PMID: 14568893] CrossrefMedlineGoogle Scholar9. Brock GB, McMahon CG, Chen KK, Costigan T, Shen W, Watkins V, et al . Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. J Urol. 2002;168:1332-6. [PMID: 12352386] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University Federico II Medical School, 80131 Naples, Italy, and Eli Lilly, 50019 Florence, Italy. 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