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Patients who are refractory to sildenafil may benefit from vardenafil or tadalafil therapy. If none of these is successful, combine the agent with an injection of prostaglandin E-1. Gutierrez et al demonstrated that this combination was more effective than either one alone. Other successful combinations include using a PDE-5 inhibitor with MUSE.5
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"We would anticipate that tadalafil will be reviewed and approved by the regulatory agencies as an additional therapy available for the treatment of pulmonary hypertension," Barst said. "It is useful for the treatment for pulmonary hypertension, as for many other diseases, to have more than one drug per class approved, due to individual patient responses and side effects," she added.
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