| Pulmonary arterial hypertension
Adcirca vs Revatio
Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.Deep comparison between: Adcirca vs Revatio with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsRevatio has a higher rate of injection site reactions vs Adcirca based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Revatio but not Adcirca, including UnitedHealthcare
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Category
Adcirca
Revatio
At A Glance
Oral
Daily
PDE5 inhibitor
Oral or IV bolus
Three times a day
PDE-5 inhibitor
Indications
- Pulmonary arterial hypertension
- Pulmonary arterial hypertension
Dosing
Pulmonary arterial hypertension 40 mg (two 20 mg tablets) once daily with or without food; dividing the dose over the course of the day is not recommended. Start at 20 mg once daily for mild or moderate renal impairment (creatinine clearance 31 to 80 mL/min), increasing to 40 mg based on tolerability; avoid use in severe renal impairment. Start at 20 mg once daily for mild or moderate hepatic impairment (Child Pugh Class A or B); avoid in severe hepatic impairment. For patients on ritonavir >=1 week, start at 20 mg once daily and increase to 40 mg based on tolerability.
Pulmonary arterial hypertension Adults: 20 mg orally three times a day (may titrate to 80 mg three times a day) or 10 mg IV bolus three times a day; pediatric patients <=20 kg: 10 mg orally three times a day; 20-45 kg: 20 mg three times a day; >45 kg: 20 mg three times a day (may titrate to 40 mg three times a day).
Contraindications
- Concomitant use of any form of organic nitrate, regularly or intermittently
- Concomitant use of guanylate cyclase (GC) stimulators such as riociguat
- Known serious hypersensitivity to tadalafil (ADCIRCA or CIALIS), including Stevens-Johnson syndrome and exfoliative dermatitis
- Concomitant use of organic nitrates in any form, either regularly or intermittently, due to risk of hypotension
- Concomitant use of riociguat, a guanylate cyclase stimulator
- Known hypersensitivity to sildenafil or any component of the tablet, injection, or oral suspension
Adverse Reactions
Most common (>=9%) Headache, myalgia, nasopharyngitis, flushing, respiratory tract infection (upper and lower), pain in extremity, nausea, back pain, dyspepsia, nasal congestion
Serious Hypotension, visual loss, hearing loss, priapism
Postmarketing Serious cardiovascular events (myocardial infarction, sudden cardiac death, stroke, chest pain, palpitations, tachycardia), hypersensitivity reactions (urticaria, Stevens-Johnson syndrome, exfoliative dermatitis), migraine, seizure, transient global amnesia, visual field defect, retinal vein occlusion, retinal artery occlusion, NAION, sudden decrease or loss of hearing, priapism
Most common (>=10%) Headache, flushing, pain in limb, myalgia, back pain, dyspepsia, diarrhea
Serious Hypotension, vision loss, hearing loss, priapism, vaso-occlusive crisis
Postmarketing Myocardial infarction, sudden cardiac death, ventricular arrhythmia, cerebrovascular hemorrhage, transient ischemic attack, hypertension, pulmonary hemorrhage, seizure, NAION
Pharmacology
Tadalafil is a selective inhibitor of phosphodiesterase type 5 (PDE5), the enzyme responsible for degradation of cyclic guanosine monophosphate (cGMP) in pulmonary vascular smooth muscle; by inhibiting PDE5, tadalafil increases cGMP concentrations, resulting in relaxation of pulmonary vascular smooth muscle cells and vasodilation of the pulmonary vascular bed.
Sildenafil is a selective inhibitor of cGMP-specific PDE-5 in pulmonary vascular smooth muscle; by blocking PDE-5-mediated cGMP degradation, it elevates cGMP levels resulting in relaxation and vasodilation of the pulmonary vascular bed in patients with PAH.
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Most Common Insurance
Anthem BCBS
Adcirca
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (4/12) · Qty limit (11/12)
Revatio
- Covered on 5 commercial plans
- PA (12/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Adcirca
- Covered on 4 commercial plans
- PA (8/8) · Step Therapy (0/8) · Qty limit (7/8)
Revatio
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (7/8)
Humana
Adcirca
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (3/3)
Revatio
- Covered on 0 commercial plans
- PA (3/3) · Step Therapy (0/3) · Qty limit (2/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$0/fillfill
Adcirca Co-pay Assistance ProgramCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableAssistance Fund: MPS II- Hunter Syndrome
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.