This is a review article that discusses the role of sildenafil in pediatric pulmonary hypertension. The etiopathogenesis as well as prognosis for pediatric pulmonary hypertension (PH) differs from adults. The basic tenets of targeted management of PH however are similar. Sildenafil and other phosphodiesterase-5 inhibitors play a very important role in PH management, especially because of the ease of administration, low adverse effect profile, better tolerability and relative cost effectiveness. This is especially vital in situations where inhaled nitric oxide is not easily available and fills an important therapeutic gap. Large double blinded and controlled studies studying the effects of sildenafil in pediatric PH are not available. Equally vital would be long term efficacy studies, which should be initiated through large multicenter trials, to study the beneficial as well as long term side effects of this medication in the pediatric age group.
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