Effects of Other Medications on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (major route) and CYP2C9 (small route). Thus, inhibitors of those isoenzymes may well lessen sildenafil clearance and inducers of these isoenzymes may possibly enhance sildenafil clearance.The effect on one of many main conclude details, upkeep of erectio