Cenforce 200 contains a high dose of sildenafil (200 mg) and is intended for severe cases of erectile dysfunction. However, this high dose also increases the risk of side effects. Who is most at risk of Cenforce 200 side effects? Older adults (65+) Slower metabolism can increase drug levels in the body, leading to stronger side effects like dizziness or low blood pressure. People with heart conditions Risk of chest pain, irregular heartbeat, or heart attack when combined with sexual activity or nitrates. Men taking nitrates or alpha-blockers Cenforce 200 cause dangerously low blood pressure when combined with sildenafil. Diabetics with complications Especially those with neuropathy, retinopathy, or cardiovascular issues. People with liver or kidney disease These organs help remove sildenafil from the body. Impairment can lead to buildup and stronger side effects. Men with low blood pressure (hypotension) Cenforce 200 can make it worse, causing fainting or severe dizziness. Those sensitive to side effects Headache, flushing, nasal congestion, blurred vision, and muscle pain are more likely with higher doses Bottom line: Cenforce 200 is not for everyone. It should only be used under strict medical supervision, especially if you fall into one of the risk categories above. Lower doses (like 50–100 mg) are usually safer starting points.