Malegra 120 is a prescription medicine, and almost everyone who uses it legally or safely should have a doctor’s prescription. In practical terms, a prescription is needed for: 1. All first-time users of sildenafil Anyone starting treatment for erectile dysfunction (ED) should be evaluated by a doctor to confirm the cause of ED and check whether it is safe to use a PDE5 inhibitor like sildenafil. 2. People with health conditions Men with conditions such as heart disease, high blood pressure, diabetes, kidney or liver disease, or history of stroke need a prescription because dosing and safety must be carefully assessed. 3. Older adults Older men are more likely to have hidden cardiovascular risk or be taking multiple medications, so medical supervision is important before using higher-strength tablets like Malegra 120. 4. Anyone considering higher-than-standard doses A 120 mg dose is above the commonly recommended maximum sildenafil dose (usually 100 mg). Because of this, it should only be used under strict medical guidance, if prescribed at all.