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Nature s Intolerance of Abuse ALL About Issues, August 1981, page 6. Therefore, concomitant administration of strong CYP3A4 inducers, such as rifampin, is expected to cause greater decreases in plasma concentrations of sildenafil. Cases of a sudden loss of hearing or decrease in hearing, sometimes accompanied by tinnitus and dizziness, with the use of PDE 5 inhibitors, including sildenafil. Prolonged erection greater than 4 hours and priapism have been reported infrequently since market approval of VIAGRA.
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