Malegra DXT Plus combines sildenafil citrate (for erectile dysfunction) and duloxetine hydrochloride (an antidepressant that can help with premature ejaculation or mood). While effective, some people experience side effects because of how these two drugs affect the body.

Sildenafil works by relaxing blood vessels to improve blood flow to the penis. This mechanism can also lower blood pressure, leading to headache, dizziness, flushing, or nasal congestion in sensitive individuals. It can rarely cause vision changes or prolonged erections (priapism).

Duloxetine, as an SNRI antidepressant, affects serotonin and norepinephrine levels in the brain. This can lead to nausea, dry mouth, insomnia, fatigue, or mood changes. Some people may also experience sexual side effects, including delayed ejaculation or decreased libido.

Side effects are more likely if:

Dosages are high, or both drugs interact with other medications like nitrates, antihypertensives, or SSRIs.

The person has pre-existing conditions, such as heart, liver, kidney problems, or low blood pressure.

There is individual sensitivity, as metabolism and drug clearance vary between people.

Because Malegra DXT Plus acts on both the cardiovascular system and the central nervous system, even small variations in health status, drug interactions, or individual physiology can increase side-effect risk.

Key takeaway: Side effects are a result of the combined pharmacological action on the vascular and nervous systems, individual health factors, and potential drug interactions, so medical supervision is essential.