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PDE5 inhibitors are used cautiously in this population because sildenafil and tadalafil are extensively metabolized by hepatic CYP3A4, and their clearance is reduced 2- to 3-fold in Child-Pugh B cirrhosis

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After 812 weeks on a medically guided protocol: Photos are not mandatory , but tracking body metrics like weight, circumference, or DEXA scans can help validate results

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