Following an abbreviated submission, the Scottish Medicines Consortium (SMC) has accepted sildenafil citrate injection (Revatio®) for restricted use within NHS Scotland for treatment of patients with pulmonary arterial hypertension who are currently prescribed oral sildenafil and who are temporarily unable to take oral medicine, but are otherwise clinically and haemodynamically stable.  It is restricted to use on the advice of specialists in the Scottish Pulmonary Vascular Unit and from the Scottish Adult Congenital Cardiac Service.

The drug advice (available at the link below) notes that the SMC has previously accepted the use of oral sildenafil for this orphan indication.  Although the intravenous formulation is significantly more expensive than the oral preparation, it is intended only for short-term use (the estimated average duration of intravenous treatment is three days).