Malegra with nitrates (used for chest pain/angina) can cause a dangerous drop in blood pressure, leading to fainting, stroke, or heart attack. Severe Cardiovascular Conditions: Men with recent heart attack, stroke, uncontrolled high or low blood pressure, or severe heart diseases should avoid Malegra unless advised by a doctor. Allergic Reactions: If you are allergic to Sildenafil or any component of Malegra, taking it can cause serious allergic reactions (rash, itching, swelling, difficulty breathing). Certain Eye Conditions: Patients with retinitis pigmentosa or those who experienced sudden vision loss should avoid Malegra. Priapism Risk: Prolonged erections lasting more than 4 hours (priapism) can cause permanent damage to the ***** and require emergency care. Use with Other ED Medications: Combining Malegra with other PDE5 inhibitors (like Tadalafil or Vardenafil) increases side effect risks. Liver or Kidney Impairment: Dosage adjustments or avoidance may be necessary for those with significant liver or kidney problems. If you experience chest pain, severe dizziness, vision changes, or prolonged erection, seek immediate medical attention.