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If taken with a high-fat meal, absorption is reduced; the time taken to reach the maximum plasma concentration increases by around one hour, and the maximum concentration itself is decreased by nearly one-third. Sildenafil acts by blocking phosphodiesterase 5 , an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. Acetildenafil and other synthetic structural analogs of sildenafil which are PDE5 inhibitors have been found as adulterants in a number of “herbal” aphrodisiac products sold over-the-counter….

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