Malegra FXT (a combination of sildenafil and fluoxetine) should be used only under the supervision of a qualified healthcare professional because it combines two prescription medications with important potential interactions and side effects. Medical supervision is especially important if you: Have erectile dysfunction and premature *****, the main conditions this medication is intended to treat. Have heart disease, a history of heart attack or stroke, or high or low blood pressure. Have liver or kidney disease, which can affect how the medication is processed. Take other medications that may interact, including nitrates, alpha-blockers, other antidepressants, or MAO inhibitors. Have a history of depression, anxiety, bipolar disorder, or seizures, because fluoxetine may not be appropriate for everyone and requires monitoring. Do not use Malegra FXT recreationally or combine it with other ED medications unless your clinician specifically advises you to do so. Alcohol may increase dizziness and lower blood pressure, so limiting or avoiding alcohol while taking it is generally recommended.