Malegra 200 mg contains sildenafil citrate, a PDE5 inhibitor used for erectile dysfunction. The 200 mg dose is higher than the usual recommended maximum of 100 mg, which increases the risk and severity of side effects. Here’s how it can cause side effects: Mechanism of Side Effects: Vasodilation (blood vessel widening): Sildenafil relaxes blood vessels to improve blood flow to the *****. This lowers blood pressure, which can cause dizziness, lightheadedness, fainting, or headache. Effect on other smooth muscles: Can relax blood vessels in the face, nose, and stomach → flushing, nasal congestion, indigestion. Vision changes: Sildenafil can inhibit PDE6 in the retina → blurred vision, blue-tinted vision, or increased light sensitivity. Higher doses increase the likelihood. Heart-related stress: For those with heart disease, the blood pressure drop plus ***** activity can strain the heart, potentially causing chest pain or palpitations. Priapism (prolonged erection): Very rare but more likely at higher doses. Can damage the ***** if not treated quickly.