sildenafil + pirfenidone

**Sildenafil + pirfenidone** is a combination therapy of two small molecule drugs—**sildenafil**, a phosphodiesterase-5 (PDE5) inhibitor, and **pirfenidone**, an antifibrotic agent. The combination has been studied primarily for the treatment of advanced idiopathic pulmonary fibrosis (IPF) in patients at risk for or with pulmonary hypertension. The rationale is that pirfenidone slows fibrotic progression in IPF, while sildenafil may mitigate pulmonary hypertension and improve oxygenation through vasodilation of the pulmonary vasculature. Clinical trials, however, have found that the addition of sildenafil to pirfenidone does not provide significant benefit in terms of disease progression, mortality, or hospitalization rates beyond pirfenidone alone in this patient population[1][2][3][4]. The combination is not approved as a commercial product, and is used only in clinical research or off-label for specific cases. Safety profiles of the combination are comparable to pirfenidone alone, with no new safety signals identified[3].