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Outcomes of Other Medications on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (big route) and CYP2C9 (slight route). For that reason, inhibitors of these isoenzymes may perhaps lessen sildenafil clearance and inducers of these isoenzymes may well boost sildenafil clearance.Viagra should only be taken when wanted, about 1 hour prio