Boston University Medical Campus Sexual Medicine

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Although no elevated incidence of hostile occasions was observed in these patients, when sildenafil is administered concomitantly with CYP3A4 inhibitors, a starting dose of 25 mg must be thought of. Although specific interaction studies were not conducted for all medicinal products, population pharmacokinetic evaluation confirmed no impact of concomitant therapy on sildenafil pharmacokinetics when grouped as CYP2C9 inhibitors (reminiscent of tolbutamide, warfarin, phenytoin), CYP2D6 inhibitors (reminiscent of selective serotonin reuptake inhibitors, tricyclic antidepressants), thiazide and associated diuretics, loop and potassium sparing diuretics, angiotensin changing enzyme inhibitors, calcium channel blockers, beta-adrenoreceptor antagonists or inducers of CYP450 metabolism (akin to rifampicin, barbiturates) Therefore, concomitant administration of robust CYP3A4 inducers, such as rifampin, is anticipated to trigger higher decreases in plasma concentrations of sildenafil.