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Malegra DXT Plus is usually taken 30 to 60 minutes before sexual activity. The effects of Sildenafil last 4 to 6 hours, while Duloxetine provides a longer duration of ejaculatory control. Common side effects may include headache, dizziness, nausea, dry mouth, flushing, or changes in blood pressure. More serious effects, like prolonged erections or serotonin syndrome (from Duloxetine), are rare but possible.