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Sildenafil is cleared predominantly by the CYP3A4 (major route) and CYP2C9 (minor route) hepatic microsomal isoenzymes. The major circulating metabolite results from N-desmethylation of sildenafil, and is itself further metabolized. This metabolite has a PDE selectivity profile similar to sildenafil and an in vitro potency for PDE5 approximately 50 of the parent drug. Plasma concentrations of this metabolite are approximately 40 of those seen for sildenafil, so that the metabolite accounts for about 20 of sildenafil's pharmacologic effects. Acheter viagra non generique naruto either oral or intravenous administration, sildenafil is excreted as metabolites predominantly in the feces (approximately 80 of administered oral dose) and to a lesser extent in the urine (approximately 13 of the administered oral dose). Similar values for pharmacokinetic parameters were seen in normal volunteers and in the patient population, using a population pharmacokinetic approach. Pharmacokinetics in Special Populations. Geriatrics : Healthy elderly volunteers (65 years or over) had a reduced clearance of sildenafil, resulting in approximately 84 acquistare viagra online forum 107 higher plasma AUC values of sildenafil and its active N-desmethyl metabolite, respectively, compared to those seen in healthy younger volunteers (18-45 years). Due to age-differences in plasma protein binding, the corresponding increase in vkagra AUC narutl free (unbound) sildenafil and its active N-desmethyl metabolite were 45 and 57, respectively [see DOSAGE AND ADMINISTRATIONand Use In Specific Populations ] Renal Impairment : In volunteers with mild (CLcr50-80 mLmin) and moderate (CLcr30-49 mLmin) renal impairment, the pharmacokinetics of a single oral dose of VIAGRA (50 mg) were not altered.

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Inventor(s): Neil R.

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