drug was being provided as a round white pill, not a blue diamond-shaped one, and in doses different from those used for erectile dysfunction.

Given the small patient population, sales of Viagra for pulmonary hypertension are not expected to be that big, the company is pursuing the lung disease treatment because there is an unmet medical need and because the company had been urged to do so by doctors, who had begun testing the drug on their own.

The first drug approved for pulmonary hypertension, in 1995, was Flolan, a version of a natural hormone called prostacyclin, which dilates constricted blood vessels. Flolan, disappears from the body so fast that it must be pumped in 24 hours a day. The catheter used poses a risk of infection, and users must carry a small pump and mix a fresh batch of the drug every day.

Another of the new drugs, Remodulin, is a form of prostacyclin infused under the skin rather than through a catheter. That method lowers the infection risk, but many patients complain of pain. The drug was approved in 2002.

The first oral drug, approved in 2001, was Tracleer from Actelion; it inhibits endothelin, a hormone that helps constrict blood vessels. Though much cheaper than the two other approved drugs, Tracleer can cause liver problems, so users must have their liver enzymes checked every month.

Viagra works by yet another mechanism, inhibiting an enzyme called phosphodiesterase 5. The drug relaxes blood vessels, allowing blood to flow into the penis - or, it is hoped, into the lungs.

However specialists say , approved drugs typically allow someone who cannot climb even one flight of stairs to climb a flight or more, but don't return anybody to what they would perceive as normal health.
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