A false positive result occurs when a drug test indicates the presence of an illegal substance that wasn’t actually consumed. Such results can have serious consequences, affecting sports eligibility, employment, and even legal cases. While uncommon, some prescription medicines can cause a false positive in certain situations.
Sildenafil, known by the brand name Viagra, is an FDA-approved active ingredient used for the treatment of Erectile Dysfunction (ED). It functions by promoting an increased blood flow into the penis. ED medications are generally not included in standard screening tests, and Sildenafil is not known to interfere with test results.
In this article, we will discuss whether Sildenafil can actually cause a false positive drug test, which medicines are linked to false positives, and which tests can detect Sildenafil. Additionally, you’ll learn key points to keep in mind when taking a Sildenafil-containing pill and undergoing screening.
Is Sildenafil linked with a false positive drug test?
No, Sildenafil, or generic Viagra, has not been linked to false positive drug tests in any clinical data. Moreover, it does not typically show up on standard panel tests, which usually include a Urine Drug Test (UDS), and is not a controlled substance.
Regarding UDS, it is a broad testing technique that uses antibodies to detect drug classes rather than identify specific substances. Standard panel tests, including 5-, 10-, or 12-panel urine tests, are common types of UDS used in clinical settings and the workplace. They are designed for substances associated with controlled or illicit use, including:
- Amphetamines
- Benzodiazepines
- Cocaine
- Opioids
- Cannabinoids
- Phencyclidine (PCP)
Since the chemical structure of this PDE-5 inhibitor differs significantly from the controlled substances listed above, it prevents cross-reactivity (when the test reacts to a similar substance mistakenly) in immunoassays (performed at the initial screening stage) and gives no false positives.
However, a recent 2023 study, following a 6-year review, reported that Sildenafil is among the medications frequently associated with false-positive results for Amphetamines. Note that research on Sildenafil’s role in causing false positives is still ongoing and at an early stage, so no definitive conclusions can be drawn at this time.
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Can Sildenafil be detected in any test?
Yes, Sildenafil can only be detected when specifically tested for. There are some advanced laboratory tests, called toxicological analysis, that are highly specific and sensitive, and can identify ED medications. Sildenafil is generally detectable in the body for about 24 hours, with its metabolites, like N-desmethylsildenafil, detectable for longer, 24-48 hours.
- Sampling: This active ingredient and its metabolites can be detected in urine, blood, hair, and gastric content, like enzymes, mucus, and stomach acid. Moreover, Sildenafil can also be detected in saliva (oral fluid) samples.
- Testing methods: Enzyme-Linked Immunosorbent Assay (ELISA), Near-Infrared Spectroscopy (NIRS), Gas Chromatography/Mass Spectrometry (GC-MS), and High-Performance Liquid Chromatography (HPLC) are advanced tests that are highly specific and can efficiently detect Sildenafil Citrate.
- Post-mortem detection: Several studies have reported that Sildenafil can even be detected in hair samples after death, when used chronically, using LC/MS in post-mortem investigations.
Cause of a false positive and medicines involved
False positives can occur due to numerous reasons, even when the person getting tested has not used any controlled or regulated substance. Cross-reactivity in initial immunoassays can misidentify similar compounds, while rare liver or kidney conditions can influence results. Additionally, mishandling or laboratory errors, such as improper storage, contamination, or sample mix-ups, can compromise accuracy.
Apart from this, studies report that some prescription or over-the-counter medicines can trigger false positives by mimicking controlled substances. The most common ones among them are:
| Medicines involved | Compounds mimicked |
| Poppy seeds | Opoids |
| Antidepressant (Sertraline) | Benzodiazepines |
| HIV medicine (Efavirenz) | Marijuana |
| Cough and cold medicine (Benadryl, Avil) | Methadone, PCP |
| Antibiotic (Rifampin) | Opiates |
| Antipsychotic medicine (Quetiapine, Chlorpromazine) | Methadone, amphetamine |
Key considerations for a drug test while taking Sildenafil
Since Sildenafil is typically not included in a standard sports drug or workplace tests, and is not a substance of abuse, no special actions need to be taken before a routine screening. However, you can consider some of the following points to prevent any complications or unnecessary worry:
- Avoid discontinuation: Do not stop or change your ED medication before going for a drug test, as doing so can disrupt the treatment. However, if worried and want to skip a dose 24 hours before the test, consult a doctor for safety.
- Disclose your medication: Before testing, inform the testing authority of your current medication list.
- Keep documentation: Keep a doctor’s note or prescription to verify the legal use of the medicine. It will also help avoid complications if the test gives an unexpected result.
Conclusion
Sildenafil, approved for treating ED, does not typically cause a false positive drug test. It is generally not included in standard workplace or sports tests, like UDS. Controlled substances looked for include cocaine, PCP, amphetamines, cannabinoids, opioids, and benzodiazepines. However, a recent 2023 study has linked Sildenafil with false positives for Amphetamines. As research is ongoing, no conclusions can be established.
Sildenafil can be detected using advanced analytical methods such as ELISA, GC-MS, NIRS, and HPLC. For detection, samples used are gastric contents, hair, blood, saliva, and urine. Moreover, it can also be detected post-death when used excessively.
Furthermore, False positives are usually triggered by cross-reactivity, mishandling of samples, underlying liver or kidney issues, and some medications, such as antidepressants, antipsychotics, poppy seeds, antibiotics, and medicines for cough and cold.
When undergoing a drug test, avoid discontinuing Sildenafil Citrate since it’s unnecessary. If worried, disclose your medication to the tester and keep your prescription with you to prevent complications.
Frequently Asked Questions
How long does Sildenafil last in the urine?
Sildenafil is generally detectable in the urine for approximately 24 hours after taking a single dose. However, this can vary depending on an individual’s metabolism, age, dosage, and liver or kidney function.
Who should avoid Sildenafil?
Men taking nitrates or dealing with severe heart issues should altogether avoid Sildenafil as it can trigger a dangerous drop in blood pressure. Also, avoid it if you have blood disorders, liver or kidney conditions, or a known allergy to PDE-5 inhibitors. Always consult a doctor to review potential Sildenafil interactions before use.
What is the most common false positive drug test?
The most common false positive drug test on a Urine Drug Test (UDS) is for amphetamines. Many over-the-counter decongestants, used for a stuffy nose, or antidepressants, such as Bupropion, can be mistaken for amphetamines on initial tests, mainly immunoassay (a biochemical test).
What’s the fastest way to clean your urine for a drug test?
There is no fastest or safest way to clean your urine for a drug test, since only the normal body metabolism can reduce the medication levels after the intake. Methods like detox drinks, drinking excessive water, and baking soda are unreliable and can be dangerous.
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