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Results of Other Medication on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (major route) and CYP2C9 (insignificant route). Hence, inhibitors of those isoenzymes could cut down sildenafil clearance and inducers of such isoenzymes could boost sildenafil clearance.Sildenafil is effective by blocking an enzyme in your body known as P