Taking Cenforce 200 mg, which is the highest dose of sildenafil citrate, can lead to a very strong and long-lasting erection—especially if you're sexually aroused. But it’s important to understand that you don’t get an instant erection just by taking the pill. It works only when you’re sexually stimulated, and when that happens, it can definitely result in a firmer erection than lower doses. Because it’s a high dose, the effects can be more intense—and that includes the potential for side effects like headache, dizziness, flushing, nasal congestion, upset stomach, or even vision changes. In rare cases, it can cause priapism, which is an erection lasting more than 4 hours, and that’s a medical emergency.