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take any medicines termed nitrates, generally prescribed for upper body discomfort, or guanylate cyclase stimulators like Adempas® (riociguat) for pulmonary hypertension. Your hypertension could drop to an unsafe degreeOutcomes of Other Medicine on VIAGRA Sildenafil metabolism is principally mediated by CYP3A4 (big route) and CYP2C9 (small route).