When Zhewitra 60 Mg is combined with exercise, a synergistic effect may occur, leading to enhanced efficacy in treating ED. Research suggests that regular physical activity can potentiate the effects of PDE5 inhibitors like Zhewitra by further improving blood flow and vascular health. Additionally, exercise may help alleviate some of the underlying causes of ED, such as obesity, diabetes, and hypertension, thereby complementing the pharmacological action of the medication.