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As with any medication, Megalis 20 mg can cause side effects. Common side effects may include headache, flushing, upset stomach, stuffy or runny nose, back pain, muscle aches, and dizziness. Serious side effects are rare but can include sudden vision loss, sudden hearing loss, chest pain, and an erection lasting more than four hours (priapism). If you experience any serious side effects, seek medical attention promptly.