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Effects of other drugs on Sildenafil citrate: Cimetidine (800 mg), may cause increased plasma sildenafil concentrations when co-administered with Sildenafil citrate to healthy volunteers.
When sildenafil clearance is co-administered with CYP3A4 inhibitors (such as itraconazole, ketoconazole, erythromycin, and cimetidine), there is reduction in sildenafil clearance. Single doses of antacid (magnesium hydroxide/aluminum hydroxide) have no effect on the bioavailability of Sildenafil citrate.
Effects of Sildenafil citrate on other medicines: No significant interactions were shown with tolbutamide (250 mg) or warfarin (40 mg), both of which are metabolised by CYP2C9.
Sildenafil citrate was shown to potentiate the hypotensive effect of acute and chronic nitrates. Therefore, use of nitrates or nitric oxide donors with Sildenafil citrate is contraindicated.
