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As first-line drugs for treating ED, PDE inhibitors prevent PDE5 enzymes from neutralizing cGMP in a way that prolongs penile erection

Abou Ziki MD, Strulovici-Barel Y, Hackett NR, Rodriguez-Flores JL, Mezey JG, Salit J, Radisch S, Hollmann C, Chouchane L, Malek J, Zirie MA, Jayyuosi A, Gotto AM Jr, Crystal RG

Role of DNA Methylation and Adenosine in Ketogenic Diet for Pharmacoresistant Epilepsy: Focus on Epileptogenesis and Associated Comorbidities

Avicenna Journal of Phytomedicine , 11 (2), 199209

This can affect your baseline levels

This metabolite is hepatotoxic and interferes with CPS I, that enzyme involved in the initial step of the urea cycle, and hyperammonemia occurs (see Figures 1 and 2)