Malegra FXT, a combination medication containing Sildenafil Citrate and Fluoxetine, undergoes metabolism primarily in the liver through specific enzymatic pathways. Malegra FXT, a phosphodiesterase type 5 (PDE5) inhibitor, is metabolized mainly by the cytochrome P450 enzymes, especially CYP3A4 and to a lesser extent CYP2C9. Its major circulating metabolite, N-desmethyl sildenafil, retains pharmacologic activity. Fluoxetine, an SSRI, is also metabolized in the liver via CYP2D6 to form norfluoxetine, which is active and has a long half-life. The combined metabolic profile of both drugs means Malegra FXT may remain in the body for an extended period, influencing both therapeutic effects and potential side effects.
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