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Sildenafil Citrate, the active ingredient in Malegra 120 mg, works by inhibiting the enzyme PDE5. This enzyme normally breaks down cGMP (cyclic guanosine monophosphate), a molecule that plays a key role in the relaxation of smooth muscles and the dilation of blood vessels. By inhibiting PDE5, Sildenafil allows cGMP levels to increase, which leads to the relaxation of blood vessels in the penis and improved blood flow. This helps men achieve and maintain an erection when sexually stimulated.