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Effects of Other Medicines on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (key route) and CYP2C9 (slight route). For that reason, inhibitors of these isoenzymes may cut down sildenafil clearance and inducers of these isoenzymes might improve sildenafil clearance.Use an correct measuring unit to evaluate your dose of sildenafil or