Malegra 200, a high-dose sildenafil citrate medication used to treat erectile dysfunction (ED), generally begins to work within 30 to 60 minutes after oral consumption. Malegra 200 mg requires sexual stimulation to be effective, as it works by increasing blood flow to the penis through the inhibition of the PDE5 enzyme. For optimal results, it is advised to take the tablet on an empty stomach since high-fat meals may delay its onset. The effects can last for up to 4 to 6 hours, depending on individual metabolism and health conditions. However, it’s important to use Malegra 200 only under medical supervision due to its potency.