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Consequences of Other Medications on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (main route) and CYP2C9 (insignificant route). For that reason, inhibitors of such isoenzymes may possibly reduce sildenafil clearance and inducers of those isoenzymes may enhance sildenafil clearance.The next situations occurred in < 2% of sufferers