Begin with the lowest recommended dose of sildenafil for pulmonary hypertension. Closely monitor the patient’s response, focusing on clinical symptoms and hemodynamic parameters.
Typical starting doses are 20mg three times daily. Increase the dose gradually, typically by 20mg increments at intervals of at least 4 weeks, based on tolerability and efficacy.
Assess improvement through clinical evaluation including exercise capacity (e. g., 6-minute walk test), symptoms (e. g., dyspnea, chest pain), and quality of life scores.
Regularly monitor blood pressure and heart rate. Significant drops in blood pressure or increases in heart rate may necessitate dose reduction or cessation of therapy.
Liver and kidney function should also be tracked. Dose adjustments may be necessary in patients with impaired organ function. Always refer to relevant guidelines for specific adjustments.
| Insufficient improvement in exercise capacity or symptoms | Increase dose (within recommended limits and after sufficient observation period) |
| Significant hypotension or tachycardia | Reduce dose or discontinue temporarily; reassess |
| Significant adverse effects (headache, flushing, visual disturbances) | Reduce dose or consider alternative therapy |
| Impaired liver or kidney function | Reduce dose according to clinical guidelines |
The maximum recommended daily dose is generally 80mg three times daily, but this can vary depending on individual patient factors and physician judgment. Always prioritize patient safety and well-being.
