Malegra 200 mg contains sildenafil citrate because sildenafil is the active medicine that helps improve erectile function in men. It belongs to a group of medicines called PDE-5 inhibitors. Sildenafil works by: Blocking an enzyme called PDE-5. Increasing a natural chemical called cGMP, which relaxes blood vessels. Improving blood flow to the ***** during ***** stimulation. Helping a man get and maintain an erection when *****ly aroused. However, Malegra 200 mg is a very high dose. The usual maximum recommended sildenafil dose for erectile dysfunction is generally 100 mg in a 24-hour period. A 200 mg dose may increase the risk of side effects without necessarily improving effectiveness. Possible side effects at higher doses may include: Severe headache Flushing Dizziness or low blood pressure Fast heartbeat Indigestion Vision changes Prolonged erection (priapism), which requires urgent medical attention Do not take sildenafil with nitrate heart medicines (such as nitroglycerin) or recreational “poppers,” as this combination can cause a dangerous drop in blood pressure. If you are considering Malegra 200 mg, tell me your age, whether you have used sildenafil before (and what dose), and any heart/BP medicines you take, and I can help assess the safety concerns.