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In Vitro Studies. Sildenafil is a weak inhibitor of the CYP isoforms 1A2, 2C9, 2C19, 2D6, 2E1 and 3A4 (IC50 gt; 150 mu;M). Given sildenafil peak plasma concentrations of approximately 1 mu;M after recommended doses, it is unlikely that VIAGRA will alter the clearance of substrates of these isoenzymes. In Vivo Studies. No significant interactions were shown with tolbutamide (250 mg) or warfarin (40 mg), both of which are metabolized by CYP2C9.

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