Malegra FDA approved 200mg Tablet works by increasing blood flow to the penis, which helps to facilitate and sustain an erection when sexually stimulated. It achieves this by inhibiting the action of an enzyme called PDE5, which is responsible for breaking down a substance called cyclic guanosine monophosphate (cGMP). cGMP is a chemical messenger that relaxes the smooth muscles in the blood vessels of the penis, allowing them to widen and increase blood flow.