Extra Super Avana can work the first time it is used, but its effectiveness may vary depending on individual factors such as your health, the severity of your condition (erectile dysfunction and/or premature ejaculation), and how your body responds to the medication. Here's how Extra Super Avana works: Active Ingredients: Avanafil (100 mg): A PDE5 inhibitor that helps increase blood flow to the penis to aid in achieving and maintaining an erection. Dapoxetine (60 mg): A selective serotonin reuptake inhibitor (SSRI) that helps delay ejaculation and increase control over sexual activity. Effectiveness on Extra Super Avana can be effective on the first use, as long as it is taken according to the instructions. It typically works within 15-30 minutes after taking the pill, but it’s important to note that sexual stimulation is still necessary for the medication to work. Duration of Effectiveness: The effects of Extra Super Avana can last up to 4-6 hours, so it provides a window for sexual activity within this time frame. Factors Influencing Effectiveness: Dosage: The standard dosage is usually effective for most individuals, but in some cases, it might need to be adjusted based on individual health conditions. Health Conditions: Conditions such as diabetes, high blood pressure, or cardiovascular issues can impact how well the medication works. Alcohol and Food: Avoid heavy meals and excessive alcohol before taking the medication, as these can reduce its effectiveness. Psychological Factors: Stress, anxiety, or mental health issues can impact how well the medication works for ED or PE. Important Tips: Always take Extra Super Avana as prescribed by your healthcare provider. Allow the medication time to take effect—usually 30 minutes before sexual activity. If it doesn't work the first time, do not double the dose. Instead, consult your doctor for advice on how to improve the outcome or whether a dosage adjustment is necessary.