Sildera Drug Interactions

Metabolism/Transport Effects of Substrate: Sildenafil is a substrate of CYP2C9 (minor), 3A4 (major); inhibits CYP1A2 (weak), 2C9 (weak), 2C19 (weak), 2D6 (weak), 2E1 (weak), 3A4 (weak).
Avoid Concomitant Use: Avoid concomitant use of sildenafil with amyl nitrate, phosphodiesterase 5 inhibitors, vasodilators (organic nitrates).
Increased Effect/Toxicity: Sildenafil may increase the levels/effects of alpha 1-blockers, amyl nitrate, antihypertensive, bosentan, HMG-CoA reductase inhibitors, phosphodiesterase 5 inhibitors, vasodilators (organic nitrates).
The levels/effects of sildenafil may be increased by antifungal agents (azole derivatives, systemic), conivaptan, CYP3A4 inhibitors (moderate), CYP3A4 inhibitors (strong), dasatinib, macrolide antibiotic, protease inhibitors, sapropterin.
Decreased Effect: The levels/effects of sildenafil may be decreased by bosentan, CYP3A4 inducers (strong), deferasirox, etravirine, herbs (CYP3A4 inducers), peginterferon alfa-2b.
Food: Amount and rate of absorption of sildenafil is reduced when taken with a high-fat meal. Serum concentrations/toxicity may be increased with grapefruit juice; avoid concurrent use.
Herb/Nutraceutical: St. John's wort may decrease sildenafil levels.