| Pulmonary arterial hypertension

Revatio vs Veletri

Side-by-side clinical, coverage, and cost comparison for pulmonary arterial hypertension.

Deep comparison between: Revatio vs Veletri with Prescriber.AI

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Safety signalsVeletri has a higher rate of injection site reactions vs Revatio based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Veletri but not Revatio, including UnitedHealthcare

Category

Revatio

Veletri

At A Glance

RouteOral or IV bolus

FrequencyThree times a day

ClassPDE-5 inhibitor

RouteIV infusion

FrequencyContinuous infusion

ClassProstacyclin

Indications

Pulmonary arterial hypertension

Pulmonary arterial hypertension

Dosing

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).

Pulmonary arterial hypertension Initiate continuous IV infusion at 2 ng/kg/min via central venous catheter; increase in increments of 2 ng/kg/min every 15 minutes or longer until tolerance limit established or further increases are not clinically warranted; adjust maintenance dose by 1- to 2-ng/kg/min increments at intervals of at least 15 minutes based on symptom persistence or adverse events.

Contraindications

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

Chronic use in patients with congestive heart failure due to severe left ventricular systolic dysfunction
Pulmonary edema developing during dose initiation (associated with pulmonary veno-occlusive disease)
Known hypersensitivity to epoprostenol or structurally related compounds

Drug Interactions

1152View drug interactions

1224View drug interactions

Adverse Reactions

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

Most common (dose initiation and escalation) Flushing, headache, nausea, vomiting, hypotension, anxiety, chest pain, dizziness, bradycardia, abdominal pain, musculoskeletal pain, dyspnea, tachycardia

Most common (chronic dosing) Headache, jaw pain, flushing, diarrhea, nausea, vomiting, flu-like symptoms, anxiety

Postmarketing Anemia, hypersplenism, pancytopenia, splenomegaly, high output cardiac failure, hyperthyroidism

Pharmacology

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.

Epoprostenol is a naturally occurring prostacyclin (metabolite of arachidonic acid) that produces direct vasodilation of pulmonary and systemic arterial vascular beds, reducing right- and left-ventricular afterload and increasing cardiac output, and inhibits platelet aggregation.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Revatio