Skip to main content
Log in

Emerging role of sildenafil in neonatology

  • Perspective
  • Published:
Indian Pediatrics Aims and scope Submit manuscript

Abstract

Over the last few years, sildenafil is increasingly being used in the neonatal ICU for a variety of indications. The use is even more so in the developing world due to the limited availability of nitric oxide and extracorporeal membrane oxygenation (ECMO). There are still no clear cut guidelines for its use. At present the drug appears relatively safe and effective when other treatment options have been optimized. However, the use of sildenafil must be monitored and reported. Due to its easy availability and ease of administration we must guard against its inappropriate use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kumar S. Indian doctor in protest after using Viagra to save “blue babies”. BMJ. 2002;325:181.

    Article  PubMed  Google Scholar 

  2. Oliver J, Webb DJ, Patole S, Travadi J. Sildenafil for “blue babies”. BMJ. 2002;325:1174.

    Article  PubMed  Google Scholar 

  3. 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.

    Article  PubMed  CAS  Google Scholar 

  4. Shekerdemian LS, Ravn HB, Penny DJ. Intravenous sildenafil lowers pulmonary vascular resistance in a model of neonatal pulmonary hypertension. Am J Respir Crit Care Med. 2002;165:1098–102.

    PubMed  Google Scholar 

  5. Baquero H, Soliz A, Neira F, Venega M, Sola A. Oral sildenafil in infants with persistent pulmonary hypertension of the newborn: a pilot randomized blinded study. Pediatrics. 2006;117:1077–1083.

    Article  PubMed  Google Scholar 

  6. Macrae DJ. Drug therapy in PPHN. Semin Neonatol. 1997;2:49–58.

    Article  Google Scholar 

  7. Namachivayam P, Theilen U, Butt W, Cooper S, Penny D, Shekerdemian L. Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children. Am J Respir Crit Care Med. 2006;174:1042–1047.

    Article  PubMed  CAS  Google Scholar 

  8. Leibovitch I, Matok I, Paret G. Therapeutic applications of sildenafil citrate in management of pediatric pulmonary hypertension. Drugs. 2007;67:57–73.

    Article  PubMed  CAS  Google Scholar 

  9. Ahsman MJ, Witjes BC, Wildschut ED, Sluiter I, Vulto AG, Tibboel D, et al. Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube. Arch Dis Child Fetal Neonatal Ed. 2010;95:F109–114.

    Article  PubMed  Google Scholar 

  10. Saxena A, Juneja R, Ramakrishnan S. Drug therapy of cardiac diseases in children.Working Group on Management of Congenital Heart Diseases in India. Indian Pediatr. 2009;46:310–338.

    PubMed  Google Scholar 

  11. Mourani PM, Sontag MK, Ivy DD Abman SH. Effects of long-term sildenafil treatment for pulmonary hypertension in infants with chronic lung disease. J Pediatr. 2009;154:379–384.

    Article  PubMed  CAS  Google Scholar 

  12. Galie N, Ghofrani HA, Torbici A, Barst RJ, Rubin LJ, Badesch D, et al. Sildenafil citrate therapy for pulmonary arterial hypertension. N Engl J Med. 2005;353:2148–2157.

    Article  PubMed  CAS  Google Scholar 

  13. Shekerdemian LS, Ravn HB, Penny DJ. Interaction between inhaled nitric oxide and intravenous sildenafil in a porcine model of meconium aspiration syndrome. Pediatr Res. 2004;55:413–418.

    Article  PubMed  CAS  Google Scholar 

  14. Marsh CS, Marden B, Newsom R. Severe retinopathy of prematurity (ROP) in a premature baby treated with sildenafil acetate (Viagra) for pulmonary hypertension. Br J Ophthalmol. 2004;88:306–307.

    Article  PubMed  CAS  Google Scholar 

  15. Gamboa D, Robbins D, Saba Z. Bleeding after circumcision in a newborn receiving Sildenafil. Clin Pediatr (Phila). 2007;46:842–843.

    Article  Google Scholar 

  16. Shah P, Ohlsson A. Sildenafil for pulmonary hypertension in neonates (review). Cochrane Database Syst Rev. 2007;3:CD005494.

  17. Hunter L, Richens T, Davis C, Walker G, Simpson JH, et al. Sildenafil use in congenital diaphragmatic hernia. Arch Dis Child Fetal Neonatal Ed. 2009;94:F467.

    Article  PubMed  CAS  Google Scholar 

  18. Carroll WD, Dhillon R. Sildenafil as a treatment for pulmonary hypertension. Arch Dis Child. 2003;88:827–828.

    Article  PubMed  CAS  Google Scholar 

  19. Raja SG, Macarthur KJ, Pollock JC. Is Sildenafil effective for treating pulmonary hypertension after pediatric heart surgery? Interact Cardiovasc Thorac Surg. 2006;5:52–54.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Manish Malik.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Malik, M., Nagpal, R. Emerging role of sildenafil in neonatology. Indian Pediatr 48, 11–13 (2011). https://doi.org/10.1007/s13312-011-0012-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-011-0012-2

Key words

Navigation