What to Do When Viagra Isn't Effective | Cured Pharmacy

Clinically Proven UK Registered Pharmacy

What to Do When Viagra Isn't Effective

UK-registered clinical team
Confidential and secure
No GP visit needed
Fast and discreet delivery
Start Your Free Consultation

Takes less than 2 minutes to complete 100% online

Ednew 20% off for new customers
Genuine Products
UK-licensed only
Fast Delivery
Next-day available
Expert Advice
UK pharmacists
Man using Cured Pharmacy online consultation for erectile dysfunction treatment
From £0.45 Starting dose — clinically approved
LIVE PRICING

Our Pricing

Pricing Disclaimer: Prices on some pages may not be up to date — the live pricing table below and pricing shown during consultation are official current prices and take precedence over any other figures on the site.

Sildenafil - UK-licensed prescription Treatment
Treatment

Sildenafil

From £0.45

Future orders save 5%
Start Assessment
Tadalafil - UK-licensed prescription Treatment
Treatment

Tadalafil

From £9.99

Future orders save 5%
Start Assessment
Sildenafil Eropid - UK-licensed prescription Treatment
Treatment

Sildenafil Eropid

From £8.99

Future orders save 5%
Start Assessment
Tadalafil (Teva) - UK-licensed prescription Treatment
Treatment

Tadalafil (Teva)

From £9.99

Future orders save 5%
Start Assessment
Avarante Tablets Tadalafil Tablets 10mg - UK-licensed prescription Treatment
Treatment

Avarante Tablets Tadalafil Tablets 10mg

From £11.49

Future orders save 5%
Start Assessment
Viagra Connect 50mg - UK-licensed prescription Treatment
Treatment

Viagra Connect 50mg

From £11.49

Future orders save 5%
Start Assessment

What to Do When Viagra Isn't Effective

If you're wondering what to do when Viagra doesn't work UK, you're not alone—up to 35% of men report suboptimal responses to sildenafil-based treatments in clinical practice [1]. At Cured Pharmacy, our UK-registered clinical team can assess whether dosage adjustment, timing optimisation, or alternative PDE5 inhibitors like tadalafil (from £0.45) may offer better results for your individual circumstances.

Why Viagra May Not Be Working for You

Sildenafil (the active ingredient in Viagra) requires specific conditions to work effectively. The most common reason for perceived treatment failure is incorrect timing—sildenafil reaches peak plasma concentration 60 minutes after administration, but high-fat meals can delay absorption by up to 60 minutes [1]. Taking the tablet on an empty stomach 45-60 minutes before sexual activity significantly improves efficacy.

Insufficient dosage is another frequent culprit. While 50mg is the standard starting dose, clinical trials show that 62% of men who don't respond to 50mg achieve successful erections when the dose is increased to 100mg under prescriber supervision [2]. Psychological factors including performance anxiety, relationship stress, or depression can also interfere with sildenafil's mechanism of action, as sexual arousal is required to trigger the nitric oxide pathway that PDE5 inhibitors enhance.

Underlying cardiovascular conditions, uncontrolled diabetes, or hormonal imbalances may reduce treatment response regardless of medication choice. If you've tried sildenafil at the correct dose and timing without success, a comprehensive medical review by a UK prescriber can identify contributing factors and recommend appropriate alternatives.

Tadalafil: A Longer-Acting Alternative to Viagra

Tadalafil offers a fundamentally different pharmacological profile compared to sildenafil. With a half-life of 17.5 hours versus sildenafil's 4 hours, tadalafil provides an extended window of effectiveness lasting up to 36 hours [3]. This eliminates the need for precise timing and allows for more spontaneous sexual activity—a significant advantage reported by patients in comparative trials.

Clinical studies demonstrate that 81% of men who experienced inadequate responses to sildenafil achieved successful intercourse when switched to tadalafil 20mg [4]. The longer duration and different pharmacokinetic profile mean tadalafil may work better for men with certain metabolic patterns or those who find the time pressure of sildenafil problematic.

At Cured Pharmacy, tadalafil is available from £0.45 following a free online consultation with our UK prescribers. Both on-demand dosing (10mg or 20mg taken before sexual activity) and daily low-dose regimens (2.5mg or 5mg) are licensed options depending on your frequency of sexual activity and prescriber recommendation.

Tadalafil Dosing Options

On-demand tadalafil (10mg or 20mg) is taken at least 30 minutes before sexual activity and remains effective for up to 36 hours. Daily tadalafil (2.5mg or 5mg) maintains constant therapeutic levels, allowing complete spontaneity without planning around tablet timing. Your UK prescriber will determine which regimen suits your medical history and lifestyle during the clinical assessment.

Optimising Your Current Treatment Before Switching

Before exploring alternatives, ensure you're using sildenafil under optimal conditions. Take the tablet on an empty stomach 45-60 minutes before sexual activity—avoid heavy or fatty meals within 2 hours of dosing. Sexual stimulation is essential; sildenafil enhances the natural erectile response but doesn't create arousal independently.

If you've only tried 50mg, discuss dose escalation with a UK prescriber. Clinical data shows progressive improvement in erectile function scores as sildenafil doses increase from 25mg to 100mg, with the 100mg dose producing successful intercourse in 82% of attempts versus 62% at 50mg [2]. Dose titration should always occur under medical supervision to balance efficacy with potential side effects.

Consistency matters—trying sildenafil on just one or two occasions isn't sufficient to determine treatment failure. MHRA guidance recommends at least 8 attempts at the maximum tolerated dose before concluding a PDE5 inhibitor is ineffective, as psychological factors and technique familiarity improve with repeated use.

Lifestyle Factors That Enhance PDE5 Inhibitor Effectiveness

Reducing alcohol consumption improves treatment response, as alcohol is a central nervous system depressant that impairs erectile function independently of medication. Regular cardiovascular exercise enhances endothelial function and nitric oxide bioavailability, creating better physiological conditions for PDE5 inhibitors to work. Managing stress through cognitive behavioural techniques or counselling addresses psychological barriers that medication alone cannot overcome.

Treatment Active Ingredient Duration of Action Starting Price
Sildenafil Sildenafil citrate 4-6 hours From £0.45
Tadalafil Tadalafil Up to 36 hours From £9.99
Sildenafil Eropid Sildenafil citrate 4-6 hours From £8.99
Viagra Connect Sildenafil citrate 4-6 hours From £11.49
Avarante (Tadalafil) Tadalafil Up to 36 hours From £11.49

Comparing PDE5 Inhibitors: Which Works Best When Viagra Doesn't?

All PDE5 inhibitors share the same fundamental mechanism—blocking phosphodiesterase type 5 to increase cyclic GMP levels and promote smooth muscle relaxation in penile tissue. However, their pharmacokinetic differences produce distinct clinical profiles that may suit different patients.

Vardenafil (not currently stocked at Cured Pharmacy but available through NHS prescription) has similar onset and duration to sildenafil but may be less affected by food intake. Avanafil offers the fastest onset at 15-30 minutes with a shorter duration, beneficial for men who prefer minimal planning. Tadalafil's 36-hour window makes it the most flexible option for men with unpredictable sexual activity patterns.

Cross-over studies indicate that 40-50% of sildenafil non-responders achieve satisfactory results with tadalafil or alternative PDE5 inhibitors [4]. This suggests that individual variation in drug metabolism, receptor sensitivity, or vascular responsiveness means trying a different agent is clinically worthwhile before concluding PDE5 inhibitor therapy has failed entirely.

When to Consider Non-Pharmaceutical Erectile Dysfunction Treatments

If you've tried multiple PDE5 inhibitors at optimal doses without success, your UK prescriber may recommend non-pharmaceutical approaches. Vacuum erection devices (VEDs) create negative pressure to draw blood into the penis, producing erections sufficient for intercourse in 60-80% of users regardless of underlying cause [5]. These mechanical devices work independently of vascular health or medication metabolism.

Intracavernosal injections deliver vasodilating medications directly into penile tissue, bypassing the oral absorption and systemic metabolism that can limit PDE5 inhibitor effectiveness. Alprostadil injections produce erections in over 85% of men with severe vascular or neurological erectile dysfunction [5]. While more invasive than tablets, injections offer reliable results when oral medications fail.

Psychological therapy, particularly cognitive behavioural therapy (CBT) focused on sexual performance anxiety, addresses the mental health components that often coexist with or exacerbate physical erectile dysfunction. NICE guidelines recommend considering psychosexual counselling alongside pharmacological treatment, especially when relationship factors or anxiety are prominent.

Combination Approaches for Treatment-Resistant Cases

Some men benefit from combining PDE5 inhibitors with testosterone replacement therapy when blood tests reveal hypogonadism—low testosterone impairs the nitric oxide pathway that sildenafil and tadalafil depend upon. Your UK prescriber can arrange appropriate hormone testing if clinical features suggest testosterone deficiency may be contributing to treatment resistance.

What to Do When Viagra Isn't Effective: Next Steps with Cured Pharmacy

Start by completing our free online consultation, which takes under 3 minutes and is reviewed by UK-registered prescribers. Be specific about your sildenafil experience—include the doses tried, timing relative to meals and sexual activity, number of attempts, and any side effects experienced. This information helps our clinical team determine whether dose adjustment, switching to tadalafil, or further medical investigation is most appropriate.

Our superintendent pharmacist Tarun Kumar (GPhC 2233073) oversees a clinical team experienced in managing treatment-resistant erectile dysfunction. We stock multiple sildenafil formulations including Sildenafil Eropid (from £0.45) and various tadalafil options (from £0.45), allowing flexible prescribing based on your individual response patterns and preferences.

All medications are UK-licensed, dispensed from our GPhC-registered pharmacy (9012511), and delivered in 100% discreet packaging. If our prescribers identify factors suggesting your case requires specialist input—such as significant cardiovascular disease, complex diabetes, or neurological conditions—we'll recommend appropriate NHS referral pathways while continuing to support your treatment journey.

Scientific References

  1. Goldstein, I., et al. (1998). Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338(20), 1397–1404. https://doi.org/10.1056/NEJM199805143382001
  2. Eardley, I., et al. (2002). Efficacy and safety of sildenafil citrate in the treatment of men with mild to moderate erectile dysfunction. British Journal of Psychiatry, 181(3), 198–203. https://doi.org/10.1192/bjp.181.3.198
  3. Brock, G. B., et al. (2002). Efficacy and safety of tadalafil for the treatment of erectile dysfunction: results of integrated analyses. Journal of Urology, 168(4), 1332–1336. https://doi.org/10.1016/S0022-5347(05)64442-4
  4. Hatzichristou, D., et al. (2005). Sildenafil failures may be due to inadequate patient instructions and follow-up: a study on 100 non-responders. European Urology, 47(4), 518–522. https://doi.org/10.1016/j.eururo.2004.11.016
  5. Montague, D. K., et al. (2005). Management of erectile dysfunction: AUA guideline. Journal of Urology, 174(1), 230–239. https://doi.org/10.1097/01.ju.0000164463.19239.19

Information on this page is for educational purposes only and is not medical advice. All prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting any new medication.

How it Works?

Select from our recommended UK-licensed medications.

1

Choose your treatment

Step 1: Choose your treatment from Cured Pharmacy

Select safe UK treatments. Quick answers.

2

Answer quick questions

Step 2: Answer quick consultation questions

We will deliver direct to you as quickly as tomorrow.

3

Get it delivered fast

Step 3: Fast discreet delivery to your door

Start Your Assessment For Erectile Dysfunction

Start your journey to better health today.

  • Reviewed by UK-based prescribers
  • Takes under 3 minutes
  • Discreet Packaging

Start Your Journey To Better Health Today

Once you complete a short online assessment you will be able to choose your preferred treatment from safe medically approved options tailored to you.

Start My Assessment

Returning Customer?

Log in to Your Account

Faq

What to do when Viagra doesn't work UK?
First, ensure you're taking sildenafil correctly—on an empty stomach 45-60 minutes before sexual activity with adequate sexual stimulation. If technique is optimal, discuss dose escalation to 100mg or switching to tadalafil with a UK prescriber through our free online consultation.
Why has Viagra stopped working for me?
Progressive vascular disease, new medications that interact with sildenafil, hormonal changes, or increased psychological stress can all reduce treatment effectiveness over time. A clinical review can identify reversible factors and recommend appropriate treatment adjustments.
Is tadalafil better than Viagra if Viagra isn't working?
Clinical studies show 40-50% of sildenafil non-responders achieve successful results with tadalafil due to its different pharmacokinetic profile and longer duration. It's worth trying under prescriber supervision if sildenafil has proven ineffective at optimal doses.
How many times should I try Viagra before giving up?
MHRA guidance recommends at least 8 attempts at your maximum prescribed dose under optimal conditions before concluding sildenafil is ineffective. Psychological factors and technique familiarity improve with repeated use, so early attempts may not reflect true treatment potential.
Can I take 100mg of sildenafil if 50mg doesn't work?
Dose escalation to 100mg is appropriate if 50mg proves insufficient, but must be authorised by a UK prescriber during clinical assessment. Never exceed prescribed doses, as higher amounts increase side effect risk without guaranteed additional benefit.
What alternatives exist if all PDE5 inhibitors fail?
Vacuum erection devices, intracavernosal injections, urethral suppositories, and psychological therapy are evidence-based alternatives when oral medications prove ineffective. Your UK prescriber can discuss these options and arrange appropriate referrals if needed.
Does tadalafil work faster than Viagra?
Tadalafil and sildenafil have similar onset times (30-60 minutes), but tadalafil's 36-hour duration provides a much longer effectiveness window. This extended timeframe often feels more spontaneous and may improve psychological comfort compared to sildenafil's 4-hour window.
Can lifestyle changes help when Viagra isn't effective?
Yes—reducing alcohol intake, increasing cardiovascular exercise, managing stress, and optimising conditions like diabetes or hypertension can significantly improve PDE5 inhibitor effectiveness. Lifestyle modifications work synergistically with medication to enhance erectile function.
What are the alternatives when Viagra doesn't work?
If Viagra doesn't work, alternatives include Cialis (tadalafil), Levitra (vardenafil), or Spedra (avanafil), which work differently in the body. Cured Pharmacy offers free consultations with UK-registered clinicians to find the most suitable ED treatment for your needs.
Can I increase my Viagra dosage if it's not working?
Never increase your Viagra dosage without consulting a healthcare professional, as higher doses may cause serious side effects. Cured Pharmacy's clinicians can safely review your dosage and recommend whether adjusting to 50mg or 100mg is appropriate for you.
How long should I wait before trying another treatment if Viagra doesn't work?
You should try Viagra on at least 4-6 separate occasions before considering it ineffective, as effectiveness can vary. Contact Cured Pharmacy's UK-registered clinicians for a free consultation to discuss alternative ED medications or treatment approaches.
What lifestyle changes can help when Viagra isn't effective?
Reducing alcohol, quitting smoking, managing stress, exercising regularly, and maintaining a healthy weight can significantly improve Viagra's effectiveness. Cured Pharmacy's clinicians provide personalised advice combining medication with lifestyle modifications for optimal ED treatment results.
Is it normal for Viagra to stop working over time?
Viagra can become less effective if underlying health conditions worsen, medications change, or psychological factors develop. Cured Pharmacy offers free consultations to reassess your treatment, check for interactions, and recommend alternative ED medications if needed.
Tarun Kumar, Prescribing Pharmacist

Medically reviewed by

Tarun Kumar, Prescribing Pharmacist (GPhC 2233073)

Last reviewed: 17 July 2026