Malegra

Malegra is similar to Viagra and contains sildenafil citrate as an active ingredient.

Sildenafil is a phosphodiesterase 5 (PDE5) inhibitor. It is the most common medication used to treat erectile dysfunction.

This article will cover all the important things you need to know before taking Malegra. All details on the mechanism of action, dose, duration, cost, side effects, safety, contraindications, and possible drug interactions will be included here.

There’s also a list of natural alternatives to try if you don’t want to use prescriptions.

What Is Malegra?

Malegra is a brand name for the generic drug sildenafil manufactured in India by Sunrise Remedies Pvt. Ltd.

Sildenafil is a PDE5 inhibitor drug used to treat erectile dysfunction in men. Erectile dysfunction is the inability to attain and maintain a penile erection for satisfactory sexual intercourse.

Sildenafil acts by inhibiting the enzyme PDE5 in the corpus cavernosa of the penis. This causes relaxation of the smooth muscles of the blood vessels and increases blood flow leading to penile erection.

Sildenafil is the same compound found in viagra. Viagra was the first drug for erectile dysfunction to hit the market and is also the most common and widely used medication for ED since 1998.

What Is the Dose Of Malegra?

Malegra is available as oral tablets of doses 25 mg, 50 mg, 75 mg, 100 mg, 120 mg, 150 mg, and 200 mg.

It is also available as oral jelly of 100 mg dosage in sachets with different fruit flavors for those who don’t like swallowing tablets.

The starting dose is 50 mg. This dose can be titrated according to efficacy and tolerability.

People with liver disorders, renal disease, and people above 65 should start with the lowest dose of 25 mg.

You should not repeat the dose within a 24-hour period.

Before starting the drug, consult your physician to avoid possible side effects and dose adjustments.

How Long Does It Take for Malegra to Kick In?

Malegra takes about 30 to 60 minutes to kick in. However, it can take as little as 15 minutes or even 2 hours for some people.

It is recommended to take the pill 15 to 30 minutes before sexual intercourse.

You should not take Malegra after a fatty meal. This is because it will slow down the absorption process, which will cause the drug to kick in late.

However, Malegra will not work unless there is sexual stimulation. Sexual excitement is a prerequisite for all ED medications, including Malegra, to work.

How Long Does Malegra Last?

Malegra lasts for about 3 to 4 hours.

How Much Does Malegra Cost?

Malegra costs $0.5 to $1.1 per tablet, depending on the dose. It is available as strips of 10 tablets.

It is a lot cheaper than Viagra, which costs $70 per tablet.

The History Of Malegra

Malegra is a brand name for the generic drug sildenafil, which is mainly used to treat erectile dysfunction. It is manufactured in India and exported to other countries.

Sildenafil has quite a fascinating history. It was investigated initially for the treatment of heart-related chest pain. During the clinical research phase, sildenafil caused erection in men. It was then investigated for the treatment of ED.

Later, it was patented in 1996 as Viagra by Pfizer and approved by the FDA in 1998. Pfizer performed extensive and diverse clinical trials to establish the efficacy and safety of sildenafil for the treatment of ED.

There are currently many generic versions of sildenafil available. They are much cheaper and accessible to people all around the world.

Who Should Take Malegra?

Malegra is recommended for men aged 18 years and above suffering from erectile dysfunction of any organic cause like old age, stress-related, diabetes, obesity, hyperlipidemia, high blood pressure, and in patients using antidepressants.

Malegra is not effective in ED due to STDs.

Is Malegra Safe?

Yes, Malegra is safe to use.

Many clinical trials have been conducted to prove the safety and efficacy of sildenafil [1, 2]. There are some dose-related adverse effects that are usually mild to moderate in severity.

Common Side Effects Of Malegra

Some of the common side effects of Malegra are as follows:

Back pain
Diarrhea
Dizziness
Dyspepsia
Facial flushing
Headache
Nasal congestion
Palpitation
Prolonged erection
Rashes
Sudden hearing loss
Visual disturbances (blurred vision, flashing lights, blue haze, and change in color perception)
Vomiting

Potential Drug Interactions Of Malegra

Nitrates

The use of nitrates with Malegra is contraindicated as they can potentiate the actions of each other and lead to a life-threatening drop in blood pressure [3].

Anti-Hypertensives

Any person taking alpha-blockers for hypertension must be stable on it before using Malegra, as their use together can cause a drop in blood pressure [4, 5].

Guanylate Cyclase GC-Stimulators

GC stimulators (drugs used for pulmonary arterial hypertension) and Malegra should not be used together because this combination potentiates the hypotensive effects of the former.

CYP3A4 Inducers

These medications increase the activity of this enzyme leading to faster metabolism of Malegra and shorter, less pronounced effects. Some common CYP3A4 inducers include rifampin, carbamazepine, phenytoin, and phenobarbitone.

CYP3A4 Inhibitors

Malegra undergoes extensive biotransformation in human liver microsomes, mainly via cytochrome P450 (CYP3A4), with a minor contribution from CYP2C. The administration of CYP3A4 inhibitors with Malegra leads to decreased metabolism and an increase in the half-life of the latter. Common CYP3A4 inhibitors include ritonavir, ketoconazole, itraconazole, erythromycin, and grapefruit.

Food

Taking Malegra after a fatty meal can slow its absorption and delay its onset of action.

Alcohol

A small amount of alcohol may cause little to no adverse effects, but consuming large quantities of alcohol with Malegra should be avoided.

One study showed that over 45% of men who took sildenafil with alcohol for recreational purposes had a higher risk of side effects, including facial flushing, headaches, chest pain, changes in vision, and lightheadedness [6].

Who Should Avoid Using Malegra?

Malegra should not be used without a doctor’s prescription. Always consult with your doctor so they can rule out potential risks.

Here are a few examples of conditions that are contraindicated with Malegra:

Severe heart disease
Severe liver disease
A history of NAION or “crowded” optic disc
Retinitis pigmentosa
Known hypersensitivity to any PDE5 inhibitors
A history of priapism
Severe kidney disease
Certain blood disorders (hemophilia, leukemia, sickle-cell anemia)
Low blood pressure

How Does Malegra Work?

The active compound in Malegra is sildenafil.

Sildenafil belongs to the phosphodiesterase-5 (PDE5) inhibitor group of drugs. It is the first drug in this class. It acts by inhibiting the enzyme PDE5, which promotes the degradation of cGMP. cGMP regulates blood flow in the penis and influences penile erection.

During sexual stimulation, nitric oxide (NO) is produced by the endothelium of the penile arteries. NO then travels to the smooth muscles and binds to guanylate cyclase receptors leading to the activation of guanylate cyclase (GC). The GC then produces cGMP from GTP.

Under normal conditions, the PDE5 enzyme present in the corpus cavernosa would destroy this cGMP and decrease its local concentration. But after sildenafil use, cGMP concentrations can rise.

The cGMP formed activates cGMP-dependent protein kinase, which, in turn, activates certain proteins. These proteins decrease intracellular calcium levels.

The rise in calcium levels enhances vascular relaxation and increases blood flow to the penile vessels. This ultimately results in penile erection. This erection is maintained until sexual stimulation is withdrawn [7].

Sildenafil has no direct relaxing effect on isolated human corpus cavernosum. Instead, its mechanism is via the relaxant effect of NO on penile smooth muscles and blood vessels.

But, NO is released only after sexual stimulation. Therefore, it requires sexual arousal to cause an erection. It is advised to take the drug 15 to 30 minutes before the anticipated sexual intercourse.

Sildenafil also acts on the PDE-5 receptors present in the lung vasculature. Hence, it is also used to treat pulmonary artery hypertension [8].

Medical Research Involving Malegra

Malegra is the generic version of Viagra. Malegra contains the same compound and recipe as Viagra, i.e., sildenafil citrate.

There isn’t much research available that was done explicitly using Malegra. But the initial sildenafil manufacturer has conducted many trials since its discovery to prove its efficacy and safety.

Pharmaceutical Alternatives To Malegra

There are hundreds of ED medications, some using the same active ingredient, others with different ingredients that share the same mechanism of action.

Malegra is the brand name for sildenafil. Many other generic versions of sildenafil are manufactured by different companies with a variable range of prices. But, they have the same compound and dose as Malegra.

The most widely used PDE-5 inhibitor prescription drug is Viagra/ sildenafil.

Other available prescription-only drugs for ED are:

Avanafil (Avaforce, Stendra, Avana)
Mirodenafil (Mvix)
Tadalafil (Cialis, Adcirca, Vidalista, Tadacip, Forzest, & more)
Vardenafil (Levitra, Staxyn, Vilitra, Zhewitra, Savitra, & more)

Before jumping into medications to treat ED, always consult your physician to evaluate its cause.

Many people who suffer from ED have treatable causes such as stress, anxiety, and depression.

Lifestyle changes alone may help treat ED in these patients, such as:

Avoid smoking and alcohol
Balanced diet
Exercise
Meditation
Natural alternatives
Psychotherapy
Weight loss

Natural Alternatives to Malegra

Certain herbs and nutrients have been shown to improve erectile dysfunction. However, these compounds have their benefits and side effects.

Ginseng (Panax ginseng)

Clinical studies have been conducted on men with mild to moderate ED using red ginseng. These studies have reported positive findings [9, 10].

Ginseng induces the release of nitric oxide (NO). NO relaxes the smooth muscles of the corpus cavernosum, leading to an erection.

Horny Goat Weed (Epimedium spp.)

The main compound in horny goat weed is icariin, which acts with a similar mechanism as sildenafil.

Catuaba (Erythroxylum catuaba)

Catuaba Extract is a central nervous system stimulant. It has long been used to enhance libido and treat sexual disorders.

Tribulus (Tribulus terrestris)

It may help with sexual performance in two ways. Firstly, it increases testosterone levels, and, secondly, it promotes the synthesis of NO.

Where To Buy Malegra?

You can buy Malegra with a doctor’s prescription from any authorized pharmaceutical store. You can also buy Malegra from online pharmaceutical stores that deliver the product to your doorsteps.

Online shopping for medications has become very convenient in the past few years. It is a more discreet, easier, and cheaper way to purchase ED medications like Malegra.

Because prescription drugs come with side effects, many people first choose to try natural alternatives. These are usually much safer, but some still cause interactions with certain medications, so check with your doctor.

References

Giuliano, F., Jackson, G., Montorsi, F., Martin‐Morales, A., & Raillard, P. (2010). Safety of sildenafil citrate: Review of 67 double‐blind placebo‐controlled trials and the postmarketing safety database. International journal of clinical practice, 64(2), 240-255.
Buvat, J., Hatzichristou, D., Maggi, M., Farmer, I., Martinez-Jabaloyas, J., Miller, P., & Schnetzler, G. (2008). Efficacy, tolerability and satisfaction with sildenafil citrate 100-mg titration compared with continued 50-mg dose treatment in men with erectile dysfunction. BJU international, 102(11), 1645.
Ishikura, F., Beppu, S., Hamada, T., Khandheria, B. K., Seward, J. B., & Nehra, A. (2000). Effects of sildenafil citrate (Viagra) combined with nitrate on the heart. Circulation, 102(20), 2516-2521.
Zusman, R. M., Prisant, L. M., Brown, M. J., & Sildenafil Study Group. (2000). Effect of sildenafil citrate on blood pressure and heart rate in men with erectile dysfunction taking concomitant antihypertensive medication. Journal of hypertension, 18(12), 1865-1869.
Rosenkranz, S., & Erdmann, E. (2001). Interaction between sildenafil and antihypertensive drugs: what is evidence-based?. Deutsche medizinische Wochenschrift (1946), 126(41), 1144-1149.
Kim, J. N., Oh, J. J., Park, D. S., Hong, Y. K., & Yu, Y. D. (2019). Influence of Alcohol on Phosphodiesterase 5 inhibitors Use in Middle-to Old-Aged Men: A Comparative Study of Adverse Events. Sexual medicine, 7(4), 425-432.
Hatzimouratidis, K. (2006). Sildenafil in the treatment of erectile dysfunction: an overview of the clinical evidence. Clinical interventions in aging, 1(4), 403.
Barnett, C. F., & Machado, R. F. (2006). Sildenafil in the treatment of pulmonary hypertension. Vascular health and risk management, 2(4), 411.
De Andrade, E., De Mesquita, A. A., de Almeida Claro, J., De Andrade, P. M., Ortiz, V., Paranhos, M., … & Erdogrun, T. (2007). Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian journal of andrology, 9(2), 241-244.
Hong, B., Ji, Y. H., Hong, J. H., Nam, K. Y., & Ahn, T. Y. (2002). A double-blind crossover study evaluating the efficacy of korean red ginseng in patients with erectile dysfunction: a preliminary report. The Journal of urology, 168(5), 2070-2073.
Stanislavov, R., & Nikolova, V. (2003). Treatment of erectile dysfunction with pycnogenol and L-arginine. Journal of Sex &Marital Therapy, 29(3), 207-213.