Malegra FXT is a combination medication typically containing Sildenafil Citrate (used for erectile dysfunction) and Fluoxetine (an SSRI used for depression and premature ejaculation). When taken with blood thinners such as warfarin, apixaban, or rivaroxaban, it may pose certain risks. Malegra FXT can affect platelet function, increasing the risk of bleeding, particularly when used alongside anticoagulants. This interaction can lead to prolonged bleeding times, easy bruising, or even gastrointestinal or internal bleeding. Sildenafil itself does not directly interact with blood thinners but may cause blood pressure fluctuations, which can indirectly influence bleeding risk, especially in those on anticoagulation therapy. Therefore, co-administration should be approached cautiously, under medical supervision. Patients should inform their healthcare provider of all medications to avoid adverse effects or serious complications.