Tadalis SX 20 mg contains tadalafil 20 mg, a medicine used mainly for erectile dysfunction (ED). Some people feel stronger effects from it than others because of differences in body response, health, and other substances taken. People who may experience stronger effects include: Those taking tadalafil for the first time — they may notice more pronounced effects such as facial flushing, headache, nasal congestion, dizziness, or a stronger erection response. People who are more sensitive to medicines or who have slower drug clearance (for example, some people with liver or kidney problems). A doctor may adjust dosing in such cases. Tadalis SX 20 mg taking interacting medicines, especially: Nitrate medicines for chest pain (dangerous combination; can cause a severe blood-pressure drop) Some blood-pressure medicines or alpha-blockers (may increase dizziness or low blood pressure risk) People who combine it with a lot of alcohol, which can increase dizziness and blood-pressure-related effects. A “strong effect” does not necessarily mean a better effect. Tadalafil does not create sexual desire by itself; it helps erection response when there is sexual stimulation. Effects can last up to about 36 hours in some people. Seek urgent medical help if there is: An erection lasting more than 4 hours Chest pain Sudden vision or hearing changes If you mean “who gets a very hard/long-lasting erection from Tadalis SX 20 mg?” or “why did I feel unusually strong effects?”, tell me your age, whether it was your first time taking it, and any other medicines/alcohol involved.