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Sildenafil was unfavorable in in vitro bacterial and Chinese hamster ovary cell assays to detect mutagenicity, and in vitro human lymphocytes and in vivo mouse micronucleus assays to detect clastogenicity.g., creatinine clearance < thirty mL/min), and concomitant utilization of erythromycin or powerful CYP3A4 inhibitors, plasma levels of sildenafil