Malegra 200 Pill works similarly to other medications in its class, such as Viagra. The active ingredient, sildenafil citrate, helps to increase blood flow to the penis by inhibiting the action of the enzyme phosphodiesterase type 5 (PDE5). This enzyme normally breaks down cyclic guanosine monophosphate (cGMP), a substance that promotes relaxation of smooth muscles and vasodilation (widening of blood vessels) in the penis. Malegra 200 should be taken orally, typically with a glass of water, about 30 minutes to 1 hour before sexual activity.