Can Viagra be put under the tongue? It is not made for that. The label says to swallow the tablet whole with a full glass of water (Viagra CMI). Sildenafil can be absorbed through the lining of the mouth, and one small study found a crushed tablet held under the tongue started working sooner, but no Australian or European label gives a dose, a timing or safety data for an ordinary tablet taken that way. The forms made for the mouth are separate products, and in Australia they need a prescription like the tablets.
What does the label say about taking Viagra under the tongue?
Nothing: its only instruction is to swallow it. "Swallow the tablet whole with a full glass of water" (Viagra CMI). Viagra is a film-coated tablet, and every figure on its label is for the tablet swallowed: it normally starts working in half an hour to an hour, and sildenafil peaks in the blood 30 to 120 minutes after an empty-stomach dose (EMA product information). It is not a slow-release tablet: the label describes sildenafil as "rapidly absorbed". Crushing it therefore does not break a time-release coating, as is sometimes claimed; the label simply gives no data for it.
Does sildenafil absorb under the tongue?
Some of it does. Swallowed, only about 41% of a dose reaches the bloodstream on average (range 25 to 63%), and sildenafil is cleared mainly by enzymes in the liver (EMA product information). When two children being treated for high blood pressure in the lungs were given sildenafil under the tongue, their blood levels were 314% to 361% higher than when the same medicine went in through the gut. The authors read this as the first pass through the liver being partly bypassed (Carls et al., 2014). That was two children with heart and lung disease, not men with erectile dysfunction, and no label gives a figure for a tablet held under the tongue.
Does it work faster under the tongue?
One small study says it may. At a hospital in Italy, 30 men took a 50 to 100 mg tablet swallowed for three months, then for the next three months crushed it in the mouth and let it dissolve under the tongue. The average time until it worked fell from 62.8 to 29.3 minutes, with no difference in how well it worked or in how often side effects occurred (De Siati et al., 2003). The study had no placebo group and was not randomised: every man swallowed the tablet first and took it under the tongue second. It has not changed the label, which still gives half an hour to an hour for the tablet. The delay the label does name is a heavy meal, which can make the tablet slower to start (Viagra CMI); see empty stomach or after eating?
Is it safe to take Viagra under the tongue?
The label has no safety data for it, and its dose limits were set for a swallowed tablet: 50 mg to start, 100 mg at most, once a day. A bigger dose does not mean a better result: "Doses above 100 mg do not increase the efficacy", while side effects can increase in number and severity (EMA package leaflet); see is it safe to take 200 mg of Viagra? The rules that do not change with the route: never with nitrates, the medicines for angina, and an erection that lasts more than 4 hours needs the nearest hospital emergency department (healthdirect). If the tablet does not work well enough for you, the leaflet's advice is to tell your doctor (Viagra CMI), not to change how you take it.
Is there a form of sildenafil made to go under the tongue?
Yes. The Australian register holds sildenafil 25 mg and 50 mg sublingual wafers, sold as Wafesil and made to be placed under the tongue. They were registered in 2018 for erectile dysfunction in adult men and are prescription-only (ARTG 288497; healthdirect — Wafesil). In Europe, Viagra also comes as a 50 mg orodispersible tablet, which is placed on the tongue, dissolves in seconds and is then swallowed; taken without water it gives the same blood levels as the ordinary tablet (EMA product information). That form is not on the Australian register. How fast these forms work and how long they last is covered in the duration and effectiveness of sublingual sildenafil. Chewable tablets sold by a US service are covered in BlueChew chewable sildenafil; Kamagra Oral Jelly is not on the Australian register.
What about chewing it, or dissolving it in water?
The label covers neither. Both are answered in their own pages: does chewing or crushing Viagra make it work faster? and can I dissolve Viagra in water?
The short answer
Viagra tablets are made to be swallowed whole with water. Sildenafil can be absorbed under the tongue, and one small study found a crushed tablet worked sooner that way, but the label gives no dose or safety data for it. If you want a form made for the mouth, ask your doctor about the sublingual wafers registered in Australia. More on doses is in our dosage guide.
