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Consequences of Other Medicines on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (main route) and CYP2C9 (small route). Consequently, inhibitors of such isoenzymes may perhaps lower sildenafil clearance and inducers of such isoenzymes could increase sildenafil clearance.Sildenafil can also be in some cases utilized to deal with pul