Skip to Content


Active Substance: sildenafil citrate
Common Name: sildenafil
ATC Code: G04BE03
Marketing Authorisation Holder: Accord Healthcare Ltd
Active Substance: sildenafil citrate
Status: Authorised
Authorisation Date: 2016-11-14
Therapeutic Area: Hypertension, Pulmonary
Pharmacotherapeutic Group: Urologicals

Therapeutic Indication

Treatment of adult patients with pulmonary arterial hypertension classified as WHO functional class II and III, to improve exercise capacity. Efficacy has been shown in primary pulmonary hypertension and pulmonary hypertension associated with connective tissue disease.

Paediatric population
Treatment of paediatric patients aged 1 year to 17 years old with pulmonary arterial hypertension. Efficacy in terms of improvement of exercise capacity or pulmonary haemodynamics has been shown in primary pulmonary hypertension and pulmonary hypertension associated with congenital heart disease.

What is Granpidam and what is it used for?

Granpidam is a medicine used to treat adults and children from 1 year of age with pulmonary arterial hypertension (PAH, abnormally high blood pressure in the arteries in the lungs). In adults, it is used in patients with class II (slight limitation of physical activity) or class III (marked limitation of physical activity) PAH.

Granpidam contains the active substance sildenafil. It is a ‘generic medicine’. This means that Granpidam is similar to a ‘reference medicine’ already authorised in the European Union (EU) called Revatio.

How is Granpidam used?

Granpidam can only be obtained with a prescription and treatment should be started and monitored by a doctor who has experience in the treatment of PAH.

Granpidam is available as tablets (20 mg). In adults, Granpidam is taken at a dose of 20 mg three times a day. Lower doses of Granpidam may be needed in patients taking some medicines that affect the way Granpidam is broken down in the body.

In children aged 1 to 17 years, the recommended dose is 20 mg three times a day in those over 20 kg. Higher doses should not be used. In children weighing less than 20 kg the maximum recommended dose would be 10 mg three times a day but Granpidam can only be used when a 20-mg dose is to be given. For lower doses, other medicines containing sildenafil should therefore be used.

How does Granpidam work?

PAH is a debilitating disease where there is severe constriction (narrowing) of the blood vessels of the lungs. This leads to high blood pressure in the vessels taking blood from the heart to the lungs and reduces the amount of oxygen that can get into the blood in the lungs, making physical activity more difficult. The active substance in Granpidam, sildenafil, belongs to a group of medicines called ‘phosphodiesterase-type-5 (PDE5) inhibitors’, which means that it blocks the PDE5 enzyme. This enzyme is found in the blood vessels of the lungs. When it is blocked, a substance called ‘cyclic guanine monophosphate’ (cGMP) cannot be broken down, so that it remains in the vessels where it causes relaxation and widening of the blood vessels. In patients with PAH, sildenafil widens the blood vessels of the lungs, which lowers the blood pressure and improves symptoms.

How has Granpidam been studied?

Because the effectiveness and safety of sildenafil in PAH is already well established, studies in people have been limited to tests to determine that it is bioequivalent to another authorised sildenafil-containing tablet. Two medicines are bioequivalent when they produce the same levels of the active substance in the body. In this case Granpidam was not compared with the reference product Revatio, but with Viagra. This was considered acceptable since Revatio and Viagra have the same composition and are made in the same way by the same manufacturer.

What are the benefits and risks of Granpidam?

Because Granpidam is a generic medicine, its benefits and risks are taken as being the same as the reference medicine’s.

Why is Granpidam approved?

The Agency’s Committee for Medicinal Products for Human Use (CHMP) concluded that, in accordance with EU requirements, Granpidam was considered to be comparable to Revatio. Therefore, the CHMP’s view was that, as for Revatio, the benefit of Granpidam outweighs the identified risk. The Committee recommended that Granpidam be approved for use in the EU.

What measures are being taken to ensure the safe and effective use of Granpidam?

Recommendations and precautions to be followed by healthcare professionals and patients for the safe and effective use of Granpidam have been included in the summary of product characteristics and the package leaflet.

Other information about Granpidam

The European Commission granted a marketing authorisation valid throughout the European Union for Granpidam on 14 November 2016.

For more information about treatment with Granpidam, read the package leaflet (also part of the EPAR) or contact your doctor or pharmacist.

Source: European Medicines Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.