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Cerebral hemorrhage associated with sildenafil (Revatio) in an infant

Kazunori Samada1, Hirohiko Shiraishi, Jun Aoyagi

  • 1Department of Pediatrics, Jichi Children's Medical Center Tochigi, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan. ksamada@jichi.ac.jp

Pediatric Cardiology
|July 8, 2009
PubMed

Insights

Sildenafil use in infants for pulmonary arteriovenous fistula can lead to cerebral hemorrhage. Careful dose increases are crucial to mitigate this serious risk.

Area of Science:

  • Pediatric Cardiology
  • Neurology
  • Pharmacology

Background:

  • Sildenafil is increasingly prescribed for pulmonary arterial hypertension and pulmonary arteriovenous fistulas in infants.
  • Pulmonary arteriovenous fistulas can cause significant right-to-left shunting, impacting oxygenation.

Observation:

  • A case study involving an infant treated for pulmonary arteriovenous fistula with sildenafil is presented.
  • The infant experienced cerebral hemorrhage following a rapid dose escalation of sildenafil to 4.7 mg/kg/day.

Findings:

  • Sildenafil improved the right-to-left shunting across the pulmonary fistula in the infant.
  • Cerebral hemorrhage occurred as a complication, a previously documented adverse event associated with sildenafil.

Implications:

  • This case highlights the potential risk of cerebral hemorrhage with sildenafil use in infants.
  • Clinicians should exercise caution when increasing sildenafil dosage and remain vigilant for signs of cerebral hemorrhage.

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