Malegra FXT Plus is a combination medication that primarily contains Sildenafil Citrate, Fluoxetine, and Tadalafil. Sildenafil Citrate and Tadalafil are phosphodiesterase type 5 (PDE5) inhibitors, which help relax blood vessels in the penis by increasing blood flow. Malegra FXT Plus work by inhibiting the enzyme PDE5, which typically breaks down cGMP (cyclic guanosine monophosphate). Elevated cGMP levels promote the relaxation of smooth muscle cells in blood vessels, leading to vasodilation. This process enhances blood flow to the penis, helping to achieve and maintain an erection during sexual stimulation. Fluoxetine, an SSRI, is included to help with premature ejaculation, making the overall treatment more effective.