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The liver is the primary organ responsible for metabolizing sildenafil, so liver conditions can have a significant impact on how the drug is processed. In men with liver disease, especially those with cirrhosis, hepatitis, or liver failure, Fildena’s metabolism may be slowed, leading to an increased concentration of the drug in the bloodstream. This can elevate the risk of side effects, including low blood pressure, dizziness, and even more severe complications like priapism (a prolonged and painful erection).