Fildena Double 200 is one of the highest-strength sildenafil citrate tablets available for erectile dysfunction (ED). It is not recommended as a starting dose, and it should only be taken if prescribed by a doctor, specifically after lower doses have proven ineffective and you have been evaluated for any underlying health risks. If you’ve been prescribed Fildena Double 200, start with a half tablet unless your doctor has advised otherwise. You can always increase later under supervision, but it’s far safer to start lower and assess how your body reacts. Combining it with nitrates or certain heart medications can cause serious, even life-threatening, blood pressure drops.