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Cenforce D should be taken 30 to 60 minutes before sexual activity and not more than once per day. It’s best taken on an empty stomach with a full glass of water. The effects can last for 4 to 6 hours, depending on individual response. Common side effects may include headache, nausea, dizziness, flushing, or mild digestive upset. It should not be used with nitrates, alcohol, or certain medications, and is not recommended for men with serious heart or liver conditions.