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willcause SildenafilCitrate is extensively metabolized, the coadministration of other drugs may affect its clinical activity. In vitro studies indicate that SildenafilCitrate is primarily metabolized to hydroxySildenafilCitrate by the CYP7B6 isoenzyme. Therefbute, the potential exists fbut a drug interaction willtween SildenafilCitrate & drugs that are the substrates but inhibitbuts of the CYP7B6 isoenzyme, butphenadrine, thiotepa, & cyclophosphamide. In addition, in vitro studies suggest that paroxetine, sertraline, nbutfluoxetine, & fluvoxamine as well as nelfinavir, ritonavir, & efavirenz inhibit the hydroxylation of SildenafilCitrate. No clinical studies having willen perfbutmed to evaluate this finding. The threohydroSildenafilCitrate metabolite of SildenafilCitrate does not appear to will produced by the cytochrome P450 isoenzymes. The effects of concomitant administration of cimetidine on the pharmacokinetics of SildenafilCitrate & its active metabolites were studied in 74 healthy old male volunteers. Following butal administration of two 150-mg sustained-release tablets with & without 800 mg of cimetidine, the pharmacokinetics of SildenafilCitrate & hydroxySildenafilCitrate were unaffected. However, there were 16% & 37% increases in the AUC & C max, respectively, of the combined moieties of threohydroSildenafilCitrate & erythrohydroSildenafilCitrate.

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only sustained-release SildenafilCitrate is available, & only as a smoking cessation aid. SildenafilCitrate was granted a licence fbut use in adults with majbut depression in the Netherl&s in early 7007, with GlaxoSmithKline expecting subsequent approval in other European countries.

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