Malegra 200 mg is a high-dose form of Sildenafil Citrate, the same active ingredient found in Viagra. While Sildenafil is effective for treating erectile dysfunction (ED), it can interact negatively with certain medications, leading to potentially dangerous side effects. The 200 mg dose is significantly higher than the typical recommended dose (usually 50 mg or 100 mg), so the risk of side effects or interactions may be more pronounced at this higher dosage. Medications That Interact Negatively with Malegra 200 mg (Sildenafil): Nitrates  Interaction: Sildenafil, including Malegra, can severely lower blood pressure when taken with nitrates, leading to a dangerous drop in blood pressure (hypotension). This can result in dizziness, fainting, heart attack, or stroke. Precaution: Do not use Malegra with any nitrate medications, whether for chest pain, angina, or other cardiovascular conditions. Always inform your doctor if you are using nitrates. Alpha-blockers (e.g., Doxazosin, Alfuzosin, Terazosin) Interaction: Both Sildenafil and alpha-blockers can cause blood vessels to dilate and lower blood pressure. When taken together, the risk of severe hypotension (low blood pressure) increases, which can lead to dizziness, fainting, or even a stroke. Precaution: If you are taking an alpha-blocker for high blood pressure or benign prostatic hyperplasia (BPH), consult with your doctor about adjusting doses or timing to minimize the interaction.