Highlights
- Can you build a tolerance to Viagra long-term? The science says no.
- Some medications, like antibiotics, gradually lose their potency with long-term use.
- Viagra is not like other medications in that it seems to work as well in the long term as it does when first taken.
- Users are unlikely to develop a tolerance to Viagra or other oral erectile dysfunction drugs.
Can you build a tolerance to Viagra? Probably not. It is true that some medications lose their potency over time, and some patients develop tolerance to them. This does not seem to be true for Viagra, the brand name of the drug sildenafil. Men taking Viagra or other medications for ED aren’t likely to build up a tolerance.
Can you build a tolerance to Viagra?
If you’ve been taking Viagra (sildenafil) for a long time, you may have wondered if it may eventually let you down as you build a tolerance to it. For most men, the news is good: when used as directed, Viagra retains its potency.
While many medications lose their effectiveness over time and require larger doses, Viagra is not one of them — if you’re taking it as directed. That means no more than once in 24 hours and usually with a single tablet of 25, 50, or 100 milligrams, the lowest dose that will do the job.
It’s very unlikely that a man will build a tolerance to Viagra over time.
Here’s What the Science Says
There were a few early studies that suggested that men could build a tolerance to sildenafil. But that research has mostly been discredited, and there’s far more clinical evidence that tolerance is rare.
The Yeas – Weak Evidence
These are early studies whose results are questioned.
- A case study describes one patient who needed to keep increasing his sildenafil for more than ten years of worsening ED. He was ultimately taking an ultra-high dose. However, the study’s author pointed out that a full medical history wasn’t taken on this patient. He may have had an underlying disease (in addition to aging) that caused the worsening ED. Also, the experience of one patient isn’t enough for a reliable conclusion.
- In a 2001 trial, the authors followed a small group of patients for two years. In that time, 17% stopped taking the sildenafil because it stopped working, and 20% had to increase the dose to have the same effect. The study concluded that there is a possible tolerance effect to sildenafil. In the year following, however, the authors of another study suggested that there were design issues with that 2001 trial. There were too few participants, many of them didn’t show up for follow-up (54%), and the methods used were of low quality.
To date, there is no good-quality research that suggests that Viagra (or any of the PDE5 inhibitors — including Cialis and Levitra — can lead to tachyphylaxis (the fancy name for tolerance buildup).
The Nays – Stronger Evidence
These are just a few examples of studies showing little to no evidence of sildenafil tachyphylaxis:
| Year of Study | Number of Participants | Length of Study | Results |
|---|---|---|---|
| 2003 | 360 | 4 years | 96% satisfied |
| 2003 | 3 years | 71% satisfied | |
| 2007 | 979 | 4 years | 94% satisfied |
| 2010 review of 67 trials | 13,000+ | 7 years of data | no evidence of tolerance |
| Postmarketing reports* | 39,277 | Not reported | 58 (0.15%) reported dependence |
- A 2003 study of men taking Viagra for ED caused by prostate cancer treatment with radiation. The study followed 360 men for four years and found that 96% of them reported that the drug was still as effective as it had been at first, according to WebMD.
- Another 2003 study found that 71% of men were still satisfied with their dosages of Viagra in a three-year follow-up.
- In a similar study published in 2007, 979 participants were followed for four years to assess the safety and effectiveness of flexible-dose (50 or 100 milligrams used as needed) sildenafil. They were interviewed once a year. At the end of the four years, more than 94% of participants were still happy with their erections and satisfied with their sex lives. As shown in the chart below, that percentage included 189 men who took a total of 451 to 550 doses in the four years covered by the study. Even the 13 men who took up to 1300 doses reported little or no tachyphylaxis in that time.
Usage of flexible-dose (25, 50, and 100 mg) sildenafil over 2–1561 days by the 979 participants who entered the study. 94% of these men said that they were satisfied with their erections and their sexual activity after four years of use. (Source)
But What If I Don’t Use Viagra as Directed?
If you’re using Viagra recreationally (meaning you don’t have ED but use it to prolong your erections or to have more than one in a session), then you may be at risk for building a tolerance. However, this is more likely to be a psychological issue than a physical one.
Overall, there is about a 0.15% chance of developing a dependency on Viagra. Almost always, the dependence is psychological and due to misuse or abuse.
If you don’t have ED but use sildenafil as a regular part of your sex life, you may be training your mind to believe it needs Viagra to achieve an erection. In this case, Viagra may cause impotence rather than treat it. It’s probably not a risk worth taking for most guys.
Why Has Viagra Stopped Working for Me?
There are many reasons for a man to have weaker effects from Viagra than he did in the beginning. Here are just a few:
- You didn’t follow the manufacturer’s instructions. It’s essential to take Viagra just as directed.
- You didn’t allow enough time for it to work. Viagra enters the system and starts working after about an hour.
- You took too much. Again, you should only take the recommended dose.
- You used it after a heavy, high-fat meal. Eating a high-fat meal can slow your body’s ability to absorb Viagra.
- You may have been tired or too stressed. Erections need you to be able to relax and let it happen.
- You may be taking a medication that can interfere with Viagra’s effects.
- You may have a health condition (like diabetes) that would make a different PDE5 inhibitor a better choice for you. (Diabetics may want to give Cialis a try.)
If you continue to have unsatisfactory experiences with your Viagra, check out our article about things you can try to improve how Viagra works for you. If all else fails, talk to your doctor about switching medications. Not all men react the same way to ED medications.
The Bottom Line
The most reliable studies say that it’s unlikely you can develop a Viagra or sildenafil tolerance. If you follow your doctor’s advice and learn about the factors that could be affecting your response, you and Viagra should have a long and satisfying relationship.
If you are interested in trying Viagra or considering another ED medication, we have what you need. Take advantage of our discreet online ordering process and free medical evaluation to get started on a more satisfying love life today.
Elizabeth Nichols is an experienced and flexible author with extensive experience in both popular media and academic publishing. She specializes in health, medical and travel writing.
