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Therefore, inhibitors of these isoenzymes may reduce sildenafil clearance and inducers of these isoenzymes may increase sildenafil clearance. In vivo studies. Population pharmacokinetic analysis of clinical trial data indicated a reduction advenum sildenafil clearance when co-administered with CYP3A4 inhibitors (such controinvicazioni ketoconazole, erythromycin, cimetidine). Although no increased incidence of adverse events was observed in contrindicazioni patients, when sildenafil is administered concomitantly with CYP3A4 inhibitors, a starting dose of 25 mg should be considered. Co-administration of the HIV protease inhibitor ritonavir, which is a highly viagra sildenafil tabs P450 inhibitor, at steady state (500 mg twice daily) with sildenafil (100 mg single dose) resulted in a 300 (4-fold) increase in sildenafil C max and a 1,000 (11-fold) increase in sildenafil plasma AUC. At 24 hours, the took 200 mg viagra levels of sildenafil were still approximately 200 ngmL, compared arvenum controindicazioni viagra approximately 5 ngmL when sildenafil was administered alone. This is consistent with ritonavir's marked effects on a broad range of Arvennum substrates. Sildenafil had no effect on ritonavir pharmacokinetics. Based on these pharmacokinetic results co-administration of sildenafil with ritonavir is not advised (see section 4.

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