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Consequences of Other Prescription drugs on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (big route) and CYP2C9 (minimal route). As a result, inhibitors of these isoenzymes may cut down sildenafil clearance and inducers of these isoenzymes may well raise sildenafil clearance.The first indicator of sildenafil is treatment of erecti