Fildena Double 200 is an ultra-high-strength medication formulated to treat severe erectile dysfunction (ED) in men. Manufactured by Fortune Healthcare in India, it contains 200 milligrams of sildenafil citrate, the same active ingredient found in Viagra. 

Fildena Double 200 is not recommended for first-time users or those with mild to moderate ED. It is usually taken 30 to 60 minutes before sexual activity, and while it does not cause an erection without sexual stimulation, its effects can last between 4 to 6 hours.

The medication should be swallowed whole with water, ideally on an empty stomach to maximize absorption and onset time. Fatty meals can delay its effect, so lighter food is preferable when planning its use.

Fildena 200mg should only be used under strict medical guidance. Men with heart conditions, high or low blood pressure, liver or kidney disease, or a history of stroke should avoid this dose unless specifically approved by a doctor.

Additionally, those taking nitrate-based medications or alpha-blockers must not use Fildena, as this combination can lead to dangerously low blood pressure. Alcohol and grapefruit juice should also be avoided while using this medication, as they can intensify the drug's effects and increase the risk of side effects.