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Zhewitra 20 mg is typically taken about 30 to 60 minutes before sexual activity. The effects can last for up to 4–5 hours, although sexual arousal is still required for the medication to work. It should not be taken more than once per day. The dosage may vary depending on a person’s health condition and response to treatment. Common side effects include headache, flushing, dizziness, nasal congestion, and upset stomach. In rare cases, it may cause vision changes or prolonged erections. Men with heart problems, low blood pressure, or those taking nitrates should consult a healthcare provider before using this medication. Always use Zhewitra under medical supervision for safety and effectiveness.