Malegra DXT Plus (sildenafil, duloxetine) is a combine erectile dysfunction (ED) and premature ejaculation (PE) tablet, which offers men the ability to overcome any ED issues and promote longer, more satisfying intercourse with greater control over ejaculation.

The two active ingredients in this product are:

• Sildenafil is a PDE5 inhibitor more widely recognized by the brand name Viagra. This medication improves blood flow, allowing an erection firm enough for intercourse to be achieved and maintained for the duration of intercourse.
• Duloxetine is an SNRI antidepressant better known by the brand name Cymbalta. This product also works to delay ejaculation, particularly when PE is a problem. Men who ejaculate prior to or immediately after the start of intercourse find that with duloxetine ejaculation occurs within one or two minutes of normal ejaculation times.

Both of the above products can be purchased and used independently; patients will find sildenafil here and duloxetine here. Malegra DXT Plus combines them both for easier administration.

The Plus in this product's name indicates it has a higher dose of duloxetine than regular Malegra DXT; the Plus version contains 60 mg while the regular version contains 30 mg. Both tablets contain 100 mg sildenafil.

Men new to using Malegra DXT Plus should be aware that most patients are started on 50 mg sildenafil and 30 mg duloxetine, with dosage increased only if needed and no adverse reactions develop at lower doses. Elderly men and those who have other medical concerns or are taking other medications should take Malegra DXT only with doctor approval, and may want to start with lower doses, which can be found at the links given above. Bood pressure and other cardiovascular issues are of particular concern.

Taking Malegra DXT Plus

Malegra DXT Plus, or rather its active ingredient sildenafil, temporarily resolves ED issues in the majority of men who take it, regardless of the underlying cause---which can range from emotional to other medications being taken. Exceptions here include physical damage or abnormalities to the penis.

A single Malegra DXT Plus tablet should be taken 30 minutes to one hour prior to intimacy; it takes 30 minutes to one hour after ingestion for effects to be significant. The tablet will remain effective for 4 to 6 hours, with 5 being average. Most men will quickly figure out personal response and can adjust accordingly.

A full glass of fluid is recommended with each dose. Food is optional, and taking a tablet with food may ease any gastrointestinal side effects experienced. However, men should be aware that taking a tablet with a heavy or fatty meal will likely slow absorption, causing effects to be delayed.

No more than a single tablet should be taken in a 24-hour period, and no more than three tablets per week.

To summarize:

• Take one dose (one tablet) about 30 minutes to one hour prior to intimacy.
• Taking tablets with food is optional, but note that heavy or fatty meals can slow absorption.
• Do not take more than one dose in a 24 hour period.
• Do not take more than three doses in one week.

Once the medication begins working, men should be able to form an erection firm enough for intercourse, and the erection should remain firm until ejaculation. Once ejaculation has occurred the penis should become flaccid, at least for a short time, as usual.

Some stimulation, either mental or physical, is required for an erection to form. Malegra DXT Plus will not cause an erection to form spontaneously, nor will it spontaneously increase desire. It will, however, give men back the ability to enjoy intercourse, and without the stress of worrying about PE.

A rare side effect of Malegra DXT Plus is priapism, in which an erection lasts for 4 or more hours. Medical attention should be sought if this occurs; failure to address the issue can lead to permanent damage to the penis.

Precautions & Tips

Men with other medical conditions or taking other medications are at increased risk of serious side effects from Malegra DXT Plus. Medical conditions of particular concern include:

• Significantly low or high blood pressure
• Heart, liver or kidney problems
• Any blood cell or bleeding disorders
• Any vision or hearing disorders
• Penile implants or physical abnormalities

And other medications of concern include:

• Other PDE5 inhibitors
• Nitrates
• Protease inhibitors
• Alpha-blockers
• High blood pressure treatments
• Any other cardiovascular medication
• Antibiotics
• Antifungal medications
• Guanylate cyclase stimulators

To be on the safe side, men with any medical condition or taking any other medication should speak with a doctor about the safety of taking Malegra DXT Plus. The majority of serious complications arise when men use this product while other medications or medical conditions are also present.

Some men take more than 100 mg sildenafil per day; provided a doctor has approved such high doses, this is fine. Note, however, that taking more than 60 mg of duloxetine per day should be avoided; higher doses are likely to contribute to ED. Men who need additional sildenafil will need to take it separately from Malegra DXT Plus, which already contains 60 mg duloxetine.

Neither of Malegra DXT Plus's ingredients will cure either ED or PE; the conditions will almost certainly return when the tablet wears off. A handful of men find that after using such medications for a while ED and/or PE are no longer an issue, but this is the exception rather than the rule. Most men will need to address the underlying issues to resolve them, or rely on Malegra DXT Plus---or similar medications---indefinitely.