In order to maximize the effectiveness of , it is recommended that you take the entire tablet with a glass of water, 30 to 60 minutes prior to the planned sexual activity. Avoid eating your last meal or consuming large amounts of fat right before the medicine time as this could prolong the duration needed. At this time, it is not recommended to take more than one pill in a 24-hour period. You should let your doctor choose how to take kamagra if you have renal or liver problems. Avoid taking Kamagra and ED medications at the same time without first talking to your doctor. Consult a physician if you get a 4-hour erection or any other serious side effects.