Malegra 200 mg can work after meals, but the type and size of your meal can affect how quickly it starts working. Malegra contains sildenafil, a medicine used to treat erectile dysfunction. Here’s what to know: After a light meal: It will generally work as expected. After a heavy or fatty meal: It may take longer to start working, so the effect may be delayed. On an empty stomach: Sildenafil usually starts working faster, often within 30–60 minutes. Sexual stimulation is necessary: The medicine does not automatically cause an erection. Malegra 200 mg safety warning: Malegra 200 mg is a very high dose. For erectile dysfunction, the usual maximum recommended sildenafil dose is 100 mg in 24 hours. Do not take 200 mg unless a qualified doctor has specifically advised it. Higher doses can increase the risk of serious side effects. DailyMed +1 Never combine sildenafil with nitrate medicines for chest pain, as this can cause a dangerous drop in blood pressure. Seek emergency care for an erection lasting more than 4 hours.