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Results of Other Prescription drugs on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (big route) and CYP2C9 (minor route). For that reason, inhibitors of such isoenzymes could lower sildenafil clearance and inducers of such isoenzymes may boost sildenafil clearance.Viagra isn’t approved for use in women.* It’s not recognized wh