Malegra FXT is a combination medicine with the active ingredients of Sildenafil citrate and fluoxetine. Sildenafil citrate is a phosphodiesterase 5 inhibitor that increases blood flow to the penis and improves penile erection in patients having erectile dysfunction. Fluoxetine is a selective serotonin reuptake inhibitor that is commonly used in depression but delaying ejaculation is one of the side effects of the medicine. So, it is used in premature ejaculation.
Since, two problems coexist in many situations, combination medicine like Malegra FXT would be beneficial in such situations. However, combining two drugs has various complexities involved and it must be used under the prescription of the doctor.
In the article, we would try to explain each of the components of the Malegra FXT, the benefits of combining the medicines, the price, and dosing of the medicine, the side effects involved, when to take the medicine, and when not to take the medicine.
What is sildenafil citrate?
Sildenafil citrate is medicine under the class of phosphodiesterase 5 inhibitors. It works by increasing blood flow to the vessels of the penis leading to penile erection for satisfying sexual intercourse. The drug was discovered in 1992 and was approved by US Food and Drug Administration (FDA) in 1998. The drug was marketed by pharmaceutical giant Pfizer under the brand name Viagra. Viagra is today a well-known brand for treating erectile dysfunction
Sildenafil citrate is also used for pulmonary hypertension in males and females. It dilates the blood vessels and decreases the resistance of arteries of the lungs. Hence lowering the blood pressure.
The medicine begins to work after 30 to 60 minutes of intake and its effects last for around 4 to 6 hours. If sexual arousal is present, you can achieve an erection within this period. However, it is important to note that sildenafil citrate is not a sexual stimulant.
What is Fluoxetine?
Fluoxetine is medicine under the class of selective serotonin reuptake inhibitor (SSRI). It works by regulating a type of neurotransmitter called serotonin. Serotonin is found to be associated with various medical conditions and most commonly fluoxetine is known for its antidepressant effects. However, serotonin is also found to be associated with premature ejaculation.
So, delayed ejaculation which was considered to be one of the side effects of SSRI was studied for its therapeutic benefit on premature ejaculation. It was found that fluoxetine and other SSRIs were effective in improving premature ejaculation when used on-demand basis 1 to 2 hours before sexual intercourse.  The drug was marketed by Eli Lilly under the well-known brand name Prozac.
Combining sildenafil citrate and fluoxetine
Erectile dysfunction is a condition in which a man cannot get or maintain the sufficient erection required for satisfying sexual intercourse. Premature ejaculation is an ejaculation problem where a man ejaculates too quickly. There is no scientific time limit but it is subjective to a couple’s sexual experience.
In many situations, these two conditions coexist. So, a combination drug like Malegra FXT would be helpful in such situations. But combining two drugs can sometimes have different effects than expected. So, a study conducted found that fluoxetine combined with sildenafil shows improvement in ejaculatory latency time and overall sexual satisfaction when compared with SSRI alone. 
Also, a study has shown that sildenafil reduces the angiogenic effects of fluoxetine, and fluoxetine works synergetically to reduce the anxiolytic effect of sildenafil. 
Hence, the combination drug is found to be more effective for sexual problems like erection problems and ejaculation problems.
What’s the Dose of Malegra FXT?
The recommended dose of Malegra FXT is 70 mg, which contains 50 mg of sildenafil and 20 mg of fluoxetine. You must take the dose as prescribed by your doctor. Do not take more than one pill per day.
The medicine is prescribed on-demand basis. That means it should be taken around 60 minutes before engaging in sexual intercourse. The medicine will show its peak effect in around 90 minutes of taking it. The dose of the medicine is available in various combinations.
How Long Does it Take for Malegra FXT to Kick In?
The effects of Malegra FXT will start to kick in about 60 minutes after you take it. In a few cases, it may take longer. Do not increase the dose on your own if it does not work. In such situations, the dose can be increased only after the recommendation of the doctor.
If you have intentionally or accidentally consumed more than the prescribed amount of Malegra FXT Tablet, then you might feel severe dizziness, fainting, and painful/prolonged erection. In such situations, seek medical help immediately.
How Long Does Malegra FXT Last?
The effect of Malegra FXt usually lasts for 4 hours to 5 hours but could last up to 18 hours. So, you should not be worried for a night. Also, you should only take one pill in 24 hours.
How Much Does Malegra FXT Cost?
Malegra FXT costs between $1.25 and $2.05 per pill. The price varies with the dose and manufacturer.
The History of Malegra FXT
Sildenafil citrate was discovered for its benefit in erectile dysfunction accidentally when the study for its use in high blood pressure was going on. Pfizer patented the drug in 1996. Two years later in 1998, FDA approved the drug and Pfizer marketed the drug under the brand name Viagra. The patent of Pfizer expired in 2019. So, currently, it is available in various brand names and various combinations.
The study of fluoxetine began in 1970. In 1977 Eli Lilly & Company applied to the US FDA for approval. Finally, US FDA approved the drug in 1987, and one month later Eli Lilly & Company marketed the medicine with the brand name Prozac. The patent for the drug expired in 2001 and after that generic fluoxetine became available in many brand forms.
Who Should Take Malegra FXT?
The combination of the two drugs Sildenafil citrate and fluoxetine help to alleviate various sexual problems in men. As described earlier it can be used for patients suffering from both erectile dysfunction and premature ejaculation.
Sildenafil also has FDA approval for the treatment of World Health Organization Group I pulmonary hypertension (also known as pulmonary arterial hypertension (PAH)) in adults to improve exercise tolerance and delay clinical worsening. 
Fluoxetine is a commonly used medicine for depression and anxiety as well but there is a difference in the way of taking medicine for premature ejaculation and depression. For depression, medicine is taken daily on regular basis. For premature ejaculation, it is taken before sexual intercourse on a demand basis.
Is Malegra FXT Safe?
The medicine is usually well tolerated but there are few side effects involved related to either sildenafil citrate or Fluoxetine
Some side effects related to sildenafil citrate are:
- Flushing (feeling of warmth)
- Difficulty falling asleep or staying asleep
- Numbness, burning or tingling in the arms, hands, feet, or legs
- Muscle aches
- Changes in color vision (seeing a blue tinge on objects or having difficulty telling the difference between blue and green)
- Sensitivity to light
- Sudden vision loss
- Sudden hearing loss
- Chest pain
- Prolonged and painful erections
- Allergic reactions
- Shortness of breath
Some side effects of fluoxetine are:
- Weight changes
- Ejaculation disorder
- Feeling weak
- Suicidal ideations
Drug Interactions of Malegra FXT
Malegra FXT can interact with several other medications, causing different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.
Before taking Malegra FXT, talk with your doctor and pharmacist. Tell them about all prescriptions, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
Some of the potentially serious drug interactions are:
- Using Malegra FXT with drugs like Nitrates ( a medicine used for treating chest pain related to angina), alpha-blockers, and antihypertensives can severely lower blood pressure leading to dizziness, fainting, and lightheadedness
- Drugs like azole antifungals (ketoconazole, itraconazole), Histamine antagonists (Cimetidine), protease inhibitors for HIV (ritonavir), macrolide antibiotics ( erythromycin, azithromycin), opioid analgesics, can interact with Malegra FXT by decreasing its metabolism and increasing the risk of side effects and toxicity.
- The medications like rifampicin, carbamazepine, and phenytoin can increase the metabolism of the Malegra FXT reducing the effectiveness of the drug.
- Alcohol intake with Malegra FXT can cause dizziness, lightheadedness, or fainting. It might also reduce the efficacy of the medicine.
Who Should Avoid Using Malegra FXT?
Here are a few examples of when you should avoid using Malegra FXT altogether:
- You have severe heart disease or heart valve failure
- You have a history of Bipolar disorder with an episode of mania or hypomania
- You have a history of Non-arteritic anterior ischemic optic neuropathy (NAION)
- You are diagnosed with retinitis pigmentosa
- You have a history of sildenafil hypersensitivity
- You have a history of priapism
- You have severe kidney disease
- You are diagnosed with blood disorders (hemophilia, leukemia, sickle-cell anemia)
- You are taking nitrates.
You need to talk to your doctor in the following situations before taking Malegra FXT:
- You are pregnant or breastfeeding.
- you are taking any prescription or nonprescription medicine, herbal products, or nutritional supplements.
- You have a deformed penis such as Peyronie disease
- You have a history of ulcers, high or low blood pressure, heart disease
How Does Malegra FXT Work?
Each active component of the medicine has a separate mechanism of action. Sildenafil citrate works by inhibiting phosphodiesterase type 5 which is responsible for the breakdown of cyclic guanosine monophosphate (cGMP). Thus the accumulation of cGMP causes dilatation of blood vessels in the penis increasing blood flow to the penis and thus causing an erection. 
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI). It helps to regulate the serotonin level in the body. One of the causes of premature ejaculation is thought to be dysregulation of serotonin levels. Thus by maintaining the balance of serotonin levels, fluoxetine prolongs ejaculatory latency timing.
Thus, these two medications work synergetically in Malegra FXT to improve overall sexual function in men by enhancing their sexual experience.
Is Malegra FXT Helpful for Women?
The common sexual problem in women is most likely the problem of sexual stimulation associated with sexual desire and arousal. Since Malegra FXT is not a sexual stimulant, it would not be beneficial in women. Hence, Malegra FXT is not recommended for use in women.
However individual components of Malegra FXT can be used separately for other purposes other than sexual problems.
Sildenafil citrate can be used for pulmonary artery hypertension. Similarly, fluoxetine can be used for depression, anxiety disorders, obsessive-compulsive disorders, and fibromyalgia.
Where to Buy Malegra FXT?
Malegra FXT helps to solve a complex sexual problem in men. Having said that we should not forget that combining two drugs might also increase the adversity of the drug reaction. So, it is essential to get this drug under the prescription of the doctor. After your doctor prescribes you the medicine it can be bought from a medical store or online drug stores.
Alternatives to Malegra FXT
Alternatives to sildenafil citrate are:
- Pharmaceutical alternatives like tadalafil, vardenafil, avanafil, mirodenafil, and udenafil.
- Natural alternatives like horny goat weed (Epimedium spp.), L- Arginine, Korean Red Ginseng (Panax quinquefolium), and yohimbe.
Alternatives to Fluoxetine are:
- Pharmaceutical alternatives like Escitalopram, Sertraline Dapoxetine, and lidocaine spray
- Natural alternatives like Kaunch beej, and yauvanamrit vati.
Where to Buy Malegra FX in 2020?
Malegra FXT is useful for solving problems like erectile dysfunction and premature ejaculation. However, these medical conditions are usually the way of our body telling us that there might be some underlying cause for the problems. The cause could be organic or functional. So, it is very important to investigate and find the cause of the problem. Once the cause of the problem is identified, then only an appropriate management plan would be beneficial.
Malegra FXT is prescribed as a part of the management plan until the cause of the sexual problem is completely resolved.
You also should note that you must provide information about your past medical history and the medications or supplements that you are taking to your healthcare provider before the prescription.
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- Shahidi, S., Hashemi-Firouzi, N., & Mahmoodi, M. (2013). Co-administration of fluoxetine and Sildenafil has benefits in anxiety behavior in mice. Neurochemical Journal, 7(1), 34-38.
- Silvestro, S., & Allegretti, G. Viagra (sildenafil): uses, side effects, interactions, and more.
- McCullough, A. R. (2002). Four-year review of sildenafil citrate. Reviews in urology, 4(Suppl 3), S26.