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Administration of VIAGRA with nitric oxide donors such as organic nitrates or organic nitrites in any form is contraindicated. Consistent allergy viagra its known effects on the nitric oxidecGMP pathway, VIAGRA was shown to potentiate the hypotensive effects of nitrates [see DOSAGE AND ADMINISTRATIONCONTRAINDICATIONSCLINICAL PHARMACOLOGY ].

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001 of the administered dose may appear in the semen of patients. Metabolism and Excretion. Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50 of the parent drug. Plasma concentrations of this metabolite are approximately 40 of those seen for sildenafil, so that the metabolite accounts for about 20 of sildenafil's pharmacologic effects.

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