Consequences of Other Medications on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (main route) and CYP2C9 (minor route). Hence, inhibitors of those isoenzymes may lower sildenafil clearance and inducers of those isoenzymes could improve sildenafil clearance.In most cases, Viagra will slightly decrease your hypertension. This doesn… Read More