Malegra FXT Plus
✅ Treats Erectile Dysfunction
✅ Delays premature ejaculation
✅ Enhances stamina
✅ Improves mood
✅ Boosts confidence
Malegra FXT Plus contains Sildenafil 100 mg + Fluoxetine 60 mg.
✓ Medically reviewed by Morgan Ellis — Pharmacy Researcher · 8 years experience · Last reviewed: May 2026
⚡ Quick Answer — What is Malegra FXT Plus?
Malegra FXT Plus contains sildenafil 100 mg + fluoxetine 60 mg and is used for erectile dysfunction with premature ejaculation. Available in sildenafil 100 mg + fluoxetine 60 mg. Clinical effect lasts around 4–6 hours for ED; fluoxetine steady-state over weeks. Manufactured by Sunrise Remedies.
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Malegra FXT Plus combines sildenafil 100 mg (a short-acting PDE5 inhibitor for erectile dysfunction) with fluoxetine 60 mg (a long-acting SSRI that can delay ejaculation). Unlike dapoxetine-based combinations, fluoxetine is a daily-use SSRI — the ejaculation-delay effect builds over weeks of regular use rather than immediately from a single dose.
Manufactured by Sunrise Remedies, Malegra FXT Plus is intended for men with co-existing ED and PE who are already on (or planning to start) daily SSRI therapy for PE.
What Is Malegra FXT Plus?
Malegra FXT Plus is a combination tablet containing:
- Sildenafil 100 mg — a PDE5 inhibitor that improves erectile response; effects last 4–6 hours
- Fluoxetine 60 mg — an SSRI that extends ejaculatory latency when taken regularly over weeks
Important: unlike dapoxetine, fluoxetine is not an on-demand PE drug — it requires continuous daily dosing (typically 4–6 weeks to take full effect) and should be reviewed by a doctor before starting. Many clinicians prefer dapoxetine (as in Super Tadalis Sx or Super Vilitra) for the PE side of combined treatment because it is specifically engineered for on-demand use.
How Does Malegra FXT Plus Work?
- Sildenafil blocks PDE5 in the corpus cavernosum, prolonging cyclic GMP activity and allowing increased blood inflow during sexual arousal
- Fluoxetine selectively inhibits the serotonin transporter; raised synaptic serotonin delays the ejaculatory reflex. This effect builds over 2–6 weeks of daily use
Because fluoxetine’s active metabolite (norfluoxetine) has a half-life of 7–15 days, the SSRI effect accumulates slowly and persists long after stopping.
Uses and Indications
- Co-existing erectile dysfunction and premature ejaculation — where daily SSRI therapy is acceptable
- ED with depressive symptoms — rarely, where the fluoxetine component is also treating mood
Malegra FXT Plus Dosage and Administration
| Scenario | Recommended Approach | Notes |
|---|---|---|
| First-time combination use | 1 tablet daily under medical supervision | Sildenafil effect is per-tablet on-demand; fluoxetine effect builds over 2–6 weeks |
| ED — single dose | 100 mg sildenafil component works per tablet | 30–60 min before activity |
| PE — sustained effect | Fluoxetine requires 2–6 weeks of daily dosing | Not effective as a one-off “pop-a-pill” for PE |
| Mild hepatic impairment | Reduce dose; caution | Fluoxetine is heavily hepatically cleared |
| Severe hepatic or renal impairment | Avoid | Use separate lower-dose components |
| Maximum sildenafil exposure | 1 tablet per 24 hours | Do not exceed — contains a full 100 mg sildenafil dose |
How to Take Malegra FXT Plus Properly
- Swallow whole with water — food has modest impact; a fatty meal slows sildenafil onset
- For PE benefit, take daily at roughly the same time (fluoxetine steady-state takes 2–6 weeks)
- For ED benefit, take 30–60 min before activity
- Do not exceed one tablet per 24 hours
- Do not combine with MAOIs — 14-day washout required
- Avoid abrupt discontinuation after weeks of use — fluoxetine has a long tail but some men experience SSRI-discontinuation symptoms
Side Effects of Malegra FXT Plus
| Component / Severity | Side Effect |
|---|---|
| Sildenafil — common | Headache, flushing, dyspepsia, nasal congestion, visual disturbance |
| Fluoxetine — common | Nausea, insomnia, sexual dysfunction (ironic but real — delayed/absent orgasm), anxiety, weight change, somnolence |
| Fluoxetine — less common | Suicidal ideation (especially in first weeks), QT prolongation, bleeding risk, hyponatraemia in elderly |
| Rare | Serotonin syndrome (with other serotonergic drugs), Stevens-Johnson syndrome, priapism |
Black-box style caution: SSRI initiation can transiently increase suicidal thoughts, particularly in young adults. Regular contact with a prescriber during the first weeks of use is essential.
Warnings and Precautions
- Cardiovascular fitness for sex — sexual activity places cardiac demand on the heart. Men with active angina, recent MI (within 90 days), uncontrolled arrhythmia, or severe heart failure should have a cardiac assessment before starting a PDE5 inhibitor
- Blood pressure — PDE5 inhibitors cause mild, transient reductions in BP; use with caution if taking multiple antihypertensives
- Priapism — higher risk in men with sickle-cell disease, multiple myeloma, or leukaemia; seek urgent care if an erection lasts more than 4 hours
- Vision — discontinue and seek review if sudden visual changes occur; rare cases of non-arteritic anterior ischaemic optic neuropathy (NAION) have been reported
- Hearing — rare reports of sudden sensorineural hearing loss — stop and consult a doctor if affected
- Alcohol — significant alcohol intake combined with any PDE5 inhibitor can compound dizziness, headache, and low blood pressure
- Grapefruit juice — inhibits CYP3A4 and can raise blood levels
Contraindications — Who Should NOT Take This Medication
- Concurrent use of any nitrate — GTN, isosorbide mono/dinitrate, nicorandil, amyl nitrite (“poppers”)
- Concurrent use of guanylate cyclase stimulators such as riociguat
- Recent heart attack (within 90 days), unstable angina, or angina during intercourse
- NYHA Class II or greater heart failure within the last 6 months
- Uncontrolled arrhythmia, hypotension (BP <90/50) or uncontrolled hypertension (BP >170/100)
- Stroke within the last 6 months
- Known non-arteritic anterior ischaemic optic neuropathy (NAION) in one or both eyes
- Severe hepatic impairment (Child-Pugh C)
- Hypersensitivity to the active ingredient or any excipient
Drug Interactions
| Drug / Class | Interaction |
|---|---|
| Nitrates (GTN, ISMN, ISDN, amyl nitrite/”poppers”) | Absolute contraindication — severe, potentially fatal hypotension |
| Alpha-blockers (doxazosin, tamsulosin, alfuzosin) | Additive blood-pressure lowering — stabilise alpha-blocker dose first, start at lowest PDE5 dose |
| CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, clarithromycin) | Raise PDE5 plasma levels — reduce dose or avoid combination |
| CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St John’s wort) | Lower PDE5 plasma levels — efficacy may be reduced |
| Riociguat and other sGC stimulators | Contraindicated — severe hypotension risk |
| Other PDE5 inhibitors | Do not combine — additive side effects without extra efficacy |
| Antihypertensives | Small additive BP reduction — usually clinically insignificant |
| Grapefruit juice | Inhibits CYP3A4 — avoid large or regular intake |
Always share a full list of your current medications, including over-the-counter products, recreational drugs, and herbal supplements, with your prescriber before starting this medication.
What to Do in Case of Overdose
Symptoms of a PDE5 overdose include severe headache, marked hypotension, dizziness, back or muscle pain, and prolonged erection. Management is supportive, with fluid resuscitation and cardiac monitoring. Contact your local poisons service or emergency department immediately if an overdose is suspected.
Storage Instructions
- Store below 30 °C in a dry place, away from direct sunlight
- Keep in the original blister packaging until use
- Keep out of reach of children and pets
- Do not use after the expiry date printed on the pack
- Dispose of unused tablets via a pharmacy take-back scheme where available
Related Alternatives on MedsBase
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Frequently Asked Questions
Is Malegra FXT Plus on-demand or daily?
Mixed. The sildenafil component is on-demand (per-tablet ED effect). The fluoxetine component is daily — and requires 2–6 weeks of regular dosing to reach full PE-delay effect. Fluoxetine is NOT useful as a single-dose PE drug.
Why not just use dapoxetine instead?
Dapoxetine is engineered for on-demand use with a short half-life — simpler, cleaner pharmacology for PE. Fluoxetine is only appropriate when you want long-term SSRI cover (for mood or chronic PE) and are willing to tolerate daily SSRI side effects. For most men with co-existing ED + PE, a dapoxetine-based combination like Super Tadalis Sx or Super Vilitra is more practical.
When does the PE-delay effect start?
Fluoxetine requires 2–6 weeks of daily use to reach full effect. If you expect an immediate effect from the first tablet, this product will disappoint — switch to a dapoxetine-based combination.
How long does the sildenafil effect last?
4–6 hours per tablet, as with any sildenafil product.
Can I take Malegra FXT Plus with alcohol?
Moderate alcohol with sildenafil alone is usually fine. Fluoxetine amplifies alcohol’s sedation and impairs judgement — best to limit strictly.
Does fluoxetine cause sexual side effects?
Ironically, yes — delayed or absent orgasm is one of fluoxetine’s most common side effects, which is actually what produces the PE-delay benefit. In some men this becomes excessive (“anorgasmia”) and may require dose reduction or switching drugs.
Can I stop Malegra FXT Plus abruptly?
Fluoxetine has a long half-life, so discontinuation symptoms are rarer than with short-half-life SSRIs. Even so, taper under medical guidance rather than stopping suddenly after weeks of use.
Is Malegra FXT Plus safe for men with heart conditions?
Contraindicated with nitrates, within 90 days of MI, or in unstable angina. Fluoxetine can modestly prolong QT — caution with other QT-prolonging drugs. Cardiac review recommended.
What if Malegra FXT Plus doesn’t work for my PE?
Allow 6 weeks of daily use first. If still inadequate, switch to a dapoxetine-based combination, add behavioural therapy (stop-start technique), or consider topical anaesthetics under medical supervision.
Can I take Malegra FXT Plus if I’m already on another SSRI?
No. Do not combine fluoxetine with another SSRI — serotonin syndrome risk. Wash out the existing SSRI under medical supervision before starting fluoxetine.
Malegra FXT Plus is the higher-strength sildenafil 100 mg + fluoxetine 60 mg tablet; for users who tolerate fluoxetine 40 mg and prefer the lower SSRI shoulder, the standard-strength Malegra FXT (sildenafil 100 mg + fluoxetine 40 mg) is the corresponding step-down option in the same brand line.
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| Strength | 100+60 mg |
|---|---|
| Quantity | 10 Tablet/s, 30 Tablet/s, 60 Tablet/s, 90 Tablet/s, 180 Tablet/s |
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