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For some people it can be too stimulating, in which case it is recommended to try only half the recommended dose. Amifostine increases effects of sildenafil by additive vasodilation. Sildenafil metabolism is catalyzed primarily by CYP3A4 and to a lesser extent by CYP2C9 thus, strong inhibitors of these isoenzymes may lead to the accumulation of sildenafil with subsequent toxicity. Viagra is used to treat erectile dysfunction impotence inability to get or keep an erection in men. In addition, erectile dysfunction may be a symptom of an undiagnosed condition ie, diabetes for which treatment is critical, and may actually reverse the impotence problem.

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