Cenforce D Extra Power is a medication used to treat erectile dysfunction (ED) and premature ejaculation. It combines two active ingredients: Sildenafil and Dapoxetine. Here’s how it works and where it starts to take effect: Mechanism of Action Sildenafil: PDE5 Inhibition: Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor. It works by blocking the PDE5 enzyme, which leads to increased levels of cyclic guanosine monophosphate (cGMP). This results in the relaxation of blood vessels in the penis, allowing for increased blood flow during sexual arousal. Onset of Action: Sildenafil typically starts to work within 30 to 60 minutes after ingestion, Cenforce D Extra Power on individual factors such as metabolism and whether it is taken on an empty stomach. Dapoxetine: SSRI Action: Dapoxetine is a selective serotonin reuptake inhibitor (SSRI) that helps delay ejaculation. It works by increasing serotonin levels in the brain, which can lead to improved control over ejaculation. Onset of Action: Dapoxetine generally begins to work within 1 to 3 hours after taking the medication. Combined Effect Dual Action: Cenforce D Extra Power combines the effects of both Sildenafil and Dapoxetine, making it effective for treating both erectile dysfunction and premature ejaculation. Timing: Users can expect the medication to start working within 30 to 60 minutes for erectile function, while the effects on ejaculation control may be felt within a couple of hours.