The responsibility for monitoring the safety and efficacy of medications like Sildigra XL Plus 150 mg lies with several regulatory agencies and stakeholders:

1. Regulatory Agencies: Regulatory agencies such as the Food and Drug Administration (FDA) in the United States, the European Medicines Agency (EMA) in Europe, and similar organizations in other countries are responsible for reviewing and approving medications for market authorization. These agencies assess the safety, efficacy, and quality of medications through pre-market approval processes, including clinical trials and rigorous testing.

2. Pharmaceutical Companies: Pharmaceutical companies that manufacture and market medications like Sildigra XL Plus 150 mg are responsible for conducting clinical trials to evaluate the safety and efficacy of their products. They must adhere to regulatory guidelines and standards set by regulatory agencies during the drug development process.

3. Healthcare Professionals: Healthcare professionals, including physicians, pharmacists, and other healthcare providers, play a crucial role in monitoring the safety and efficacy of medications. They evaluate patient responses to treatment, monitor for adverse effects, and provide guidance on appropriate medication use.

4. Patients and Consumers: Patients and consumers who use medications like Sildigra XL Plus 150 mg are encouraged to report any adverse effects or concerns about the medication to healthcare providers or regulatory agencies. Reporting adverse drug reactions helps regulatory agencies and healthcare professionals identify potential safety issues and take appropriate action to protect public health.

5. Post-Marketing Surveillance: After a medication is approved and marketed, regulatory agencies continue to monitor its safety and efficacy through post-marketing surveillance programs. These programs involve ongoing monitoring of adverse drug reactions, safety signals, and real-world effectiveness data to identify and address emerging safety concerns.

Overall, the monitoring of Sildigra XL Plus 150 mg's safety and efficacy involves collaboration among regulatory agencies, pharmaceutical companies, healthcare professionals, patients, and consumers to ensure the continued safe and effective use of the medication.