Viagra for Babies with Pulmonary Hypertension

Strange Bedfellows

Viagra for men with erectile dysfunction is old hat; but for tiny babies with pulmonary hypertension? Using Viagra on babies seems counter intuitive but as we shall see, it makes allot of sense.

Pulmonary hypertension is a rare condition in which the arteries carrying blood form the heart to the lungs becomes constricted. This condition is very disabling—even laughing leaves a patient gasping for breath—and all too often it is life threatening.

Standard treatment includes the use of inhaled nitric oxide but sometimes it does not work. It is also very expensive and cumbersome to use at home. Viagra appears to get much better results with much less expense and much greater ease of use. However, nitric oxide helps doctors identify patients who might respond to other medications. Currently only a few doctors have used Viagra on babies and it has been used “off label” as a last resort. Doctors in the United States, Canada, India, and Great Britain have used it. The most comprehensive study done so far is a Toronto based study of 14 children. After a year of treatment, all were still alive and all could walk. Usually the pulmonary hypertension has a 32% mortality rate one year out.
There are also studies being done with adults and Pfizer, the maker of Viagra plans to do a large-scale study with infants.

Viagra works for pulmonary hypertension by targeting the same type of chemical messages in the lungs and heart as those for the penis. This causes the blood vessels to relax, improving the flow of blood to the heart. Critics have expressed concern that no clinical trials have taken place for this use of Viagra and at the wide variation of dosages used. They point out that long term effects are not known. There is also concern that Viagra may affect the developing retina. Some parents report unusually aggressive behavior with children who have received the drug.

Doctors who have used Viagra on children with pulmonary hypertension point out that it is used only as a last resort on children with very severe life threatening disease and that it seems to show great promise.