Many men in the UK who use sildenafil (Viagra) for erectile dysfunction wonder whether they can simply stop taking it or if they need to reduce their dose gradually. Unlike some medications that require careful tapering, sildenafil for erectile dysfunction does not cause physical dependence or withdrawal symptoms when discontinued. This article explains how to safely stop taking sildenafil, what to expect when you do, and when to seek advice from your GP. Whether you've addressed underlying health issues, made lifestyle changes, or simply wish to try managing without medication, understanding the process can help you make an informed decision about your treatment.

Understanding Sildenafil and Why People Stop Taking It

Sildenafil is a phosphodiesterase type 5 (PDE5) inhibitor prescribed in the UK for two main indications: erectile dysfunction (ED) and pulmonary arterial hypertension (PAH). For ED, sildenafil (available as Viagra and generic formulations) is typically taken on an as-needed basis, approximately one hour before sexual activity, at doses of 25–100 mg. The medication works by enhancing blood flow to the penis during sexual stimulation, facilitating the achievement and maintenance of an erection. For PAH, sildenafil (Revatio) is prescribed at a lower per-dose strength (commonly 20 mg three times daily) and taken regularly under specialist supervision to reduce pulmonary artery pressure.

Many men consider stopping sildenafil for ED for various reasons. Some individuals find that their erectile function has improved naturally due to lifestyle modifications, such as weight loss, increased physical activity, smoking cessation, or better management of underlying conditions like diabetes or hypertension. Others may experience side effects that outweigh the benefits, including headaches, facial flushing, indigestion, nasal congestion, or visual disturbances. If you experience side effects, you can report them via the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or through the Yellow Card app. Financial considerations can also play a role, as the cost of ongoing treatment may become burdensome, particularly for those purchasing medication privately.

Additionally, some men may wish to discontinue sildenafil after addressing psychological factors contributing to ED, such as performance anxiety or relationship issues, often with the support of counselling, NHS Talking Therapies, or psychosexual therapy. It is important to note that sildenafil for ED is not a daily maintenance medication for most users—it is taken only when needed—so the concept of 'stopping' differs from discontinuing chronic medications.

Important safety information: Sildenafil is contraindicated if you are taking nitrates (e.g. glyceryl trinitrate, isosorbide mononitrate), nicorandil, or riociguat, as the combination can cause a dangerous drop in blood pressure. Caution is also required if you take alpha-blockers or potent CYP3A4 inhibitors. Do not combine sildenafil with other PDE5 inhibitors. Understanding your personal reasons for wanting to cease treatment is an important first step in making an informed decision about your ongoing care.

If you are taking sildenafil for pulmonary arterial hypertension (PAH), do not stop or alter your treatment without advice from your specialist team, as abrupt cessation may worsen your condition.

Do You Need to Wean Off Sildenafil for Erectile Dysfunction?

The short answer is no—if you are taking sildenafil for erectile dysfunction, it does not require a gradual tapering or weaning process when you decide to stop. Unlike certain medications such as antidepressants, benzodiazepines, or corticosteroids, sildenafil does not cause physical dependence or withdrawal symptoms when discontinued abruptly. This is because sildenafil works acutely to facilitate erections only when taken, rather than building up in your system or altering your body's baseline hormonal or neurological function over time.

Sildenafil has a relatively short half-life of approximately three to five hours, meaning it is cleared from your bloodstream fairly quickly after ingestion. There is no evidence in the Summary of Product Characteristics (SmPC) or NICE guidance of physiological withdrawal or rebound erectile dysfunction when sildenafil is stopped. Your erectile function after discontinuation will reflect your underlying health status, psychological state, and any contributing factors that were present before you began treatment.

However, some men may experience psychological adjustment when they stop using sildenafil, particularly if they have relied on the medication for an extended period. This can manifest as performance anxiety or concern about whether they will be able to achieve erections without pharmaceutical support. Such concerns are understandable but do not represent a physical need to taper the medication. If you have been using sildenafil regularly and feel apprehensive about stopping, it may be helpful to discuss your plans with your GP or a healthcare professional who can provide reassurance and explore any underlying psychological factors. NHS Talking Therapies or psychosexual therapy may be beneficial if anxiety or relationship issues are contributing to your concerns.

This advice applies to sildenafil used for erectile dysfunction only. If you are taking sildenafil for pulmonary arterial hypertension (PAH), you must not stop or reduce your dose without consulting your specialist, as PAH treatment requires careful, specialist-led management.

How to Safely Stop Taking Sildenafil for Erectile Dysfunction

While sildenafil for erectile dysfunction can be stopped immediately without medical risk, taking a thoughtful and planned approach can help ensure a smooth transition and address any concerns you may have. The first step is to consult your GP or prescribing clinician, especially if sildenafil was prescribed for an underlying medical condition or if you are taking other medications. Your doctor can review your overall health, discuss the reasons you wish to stop, and determine whether any further investigation or alternative management strategies are appropriate.

If you have been using sildenafil to manage erectile dysfunction, consider whether the underlying causes have been addressed. For example:

• Lifestyle modifications: Have you made sustainable changes such as regular exercise, a balanced diet, reduced alcohol intake, or smoking cessation?

• Management of chronic conditions: Are conditions like diabetes, hypertension, or high cholesterol well controlled?

• Psychological factors: Have issues such as stress, anxiety, or relationship difficulties been resolved or improved, perhaps with support from NHS Talking Therapies or psychosexual therapy?

If these factors have been addressed, you may find that your erectile function has improved independently of medication. Some men choose to trial stopping sildenafil gradually in a behavioural sense—for instance, attempting sexual activity without the medication on occasions when they feel confident and relaxed, while keeping it available as a backup if needed. This approach can help build confidence and reduce performance anxiety.

It is also important to monitor your response after stopping. If erectile difficulties persist or worsen, this may indicate that further evaluation is needed. According to NICE Clinical Knowledge Summaries (CKS), your GP may recommend investigations such as:

• Blood pressure measurement

• Cardiovascular disease risk assessment (QRISK)

• Fasting lipid profile

• HbA1c (to assess glucose control)

• Morning total testosterone level (if symptoms of hypogonadism are present, such as reduced libido, fatigue, or mood changes; repeat if borderline)

Your GP may refer you to a specialist if appropriate, for example:

• Urology: if PDE5 inhibitors have failed or are not tolerated, or if there is penile deformity (e.g. Peyronie's disease)

• Endocrinology: if confirmed hypogonadism is identified

• Cardiology: if high cardiovascular risk or symptoms are present

If you are taking sildenafil for pulmonary arterial hypertension (PAH), do not stop or alter your dose without specialist advice, as abrupt cessation may worsen your condition.

What to Expect When You Stop Using Sildenafil for Erectile Dysfunction

When you stop taking sildenafil for erectile dysfunction, your experience will largely depend on the underlying cause of your erectile dysfunction and whether those factors have been addressed. If your ED was primarily situational or related to temporary stressors, you may find that your erectile function remains stable or even improves after discontinuation. Conversely, if the underlying causes—such as vascular disease, hormonal imbalances, or psychological factors—remain unresolved, you may notice a return of erectile difficulties.

Physically, you should not experience any withdrawal symptoms, rebound effects, or adverse health consequences from stopping sildenafil for ED. Your body will simply return to its baseline state of erectile function. Some men report feeling psychologically vulnerable initially, particularly if they have used sildenafil for a long time and have concerns about their ability to perform without it. This is a normal response and often improves with time and positive experiences. Support from NHS Talking Therapies or psychosexual therapy can be helpful if anxiety persists.

If you do experience persistent or worsening erectile dysfunction after stopping sildenafil, it is important to contact your GP rather than simply resuming the medication on your own. Persistent ED can be an early indicator of cardiovascular disease or other health conditions that warrant further investigation. NICE guidance recommends that men with ED should be assessed for cardiovascular risk factors (using tools such as QRISK), and appropriate management should be initiated where necessary. Remember, if you are taking nitrates, nicorandil, or riociguat, you must not take sildenafil, as the combination can cause a dangerous drop in blood pressure.

When to seek urgent medical attention (call 999 or attend A&E):

• Chest pain during or after sexual activity

• An erection lasting more than four hours (priapism)

• Sudden loss of vision or hearing

When to contact your GP:

• Erectile dysfunction persists or worsens after stopping sildenafil

• You experience new symptoms such as reduced libido, fatigue, or mood changes (which may suggest hormonal issues)

• You have concerns about your cardiovascular health or other underlying conditions

• You would like to explore alternative treatments or psychological support

Remember, stopping sildenafil does not mean you are without options. Your healthcare team can work with you to explore alternative pharmacological treatments (other PDE5 inhibitors, vacuum erection devices, intracavernosal injections), psychological therapies, lifestyle interventions, or other management strategies tailored to your individual needs and circumstances, in line with NICE and NHS guidance.

Frequently Asked Questions