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Consequences of Other Drugs on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (significant route) and CYP2C9 (insignificant route). As a result, inhibitors of such isoenzymes may possibly cut down sildenafil clearance and inducers of such isoenzymes might increase sildenafil clearance.Sildenafil performs by blocking an enzyme in the