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A sildenafila e o seu principal metabólito circulante, o N-desmetil, apresentam uma ligação às proteínas plasmáticas de aproximadamente 96%. This incident was subsequently dubbed the "Montreal Screwjob". There are no safety or efficacy issues, only fair trade practices. This includes aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others.

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