Can Sildenafil Cause a False Positive Drug Test?

Drug tests have many applications, such as use by employers, sports organizations, healthcare providers, and law enforcement agencies. With the advent of more accurate technologies to test for the illegal/given drugs, the likelihood of false positives that cause unnecessary stress is rare.

False positives, by definition, mean that a person who has not engaged in illegal drug use tests positive for that drug. There are many prescription drugs that can and do interfere with drug screenings.

So, can Sildenafil cause a false positive drug test?

The answer to this remains, in most cases, no. Sildenafil is a prescription medication that is not a controlled substance and, thus, will not be included in a drug test to show controlled substance levels. However, limited discussion and reporting about the possibility for false positives exist. In that sense, it is helpful to understand the drug testing process more clearly.

Can Sildenafil Cause a False Positive or Show Up on a Drug Test?

Generally, a false positive showing Sildenafil is improbable. Drug tests are routinely conducted to indicate the presence of the following:

• Amphetamines
• Cocaine
• Opioids
• Marijuana (THC)
• Benzodiazepines
• PCP

Sildenafil is a PDE5 inhibitor and is not comprised of the same class of drugs. Because Sildenafil is chemically dissimilar to drugs that are commonly tested for, it will be unlikely for a false positive to occur.

The World Anti-Doping Agency (WADA) does not consider Sildenafil to be a banned substance. Athletes typically will not fail a sports drug test as the medication itself is not a prohibited substance.

A review in 2023 noted a few cases in which Sildenafil has been associated with the rare occurrence of false-positive amphetamine tests during preliminary immunoassay testing. These cases were derived from limited observational studies instead of controlled clinical studies.

Currently, the evidence is insufficient to conclude that Sildenafil causes false positive drug tests with any regularity.

When and How Can Sildenafil Be Detected?

If a laboratory uses advanced toxicology tests, Sildenafil can then be detected as part of the test.

Two of the best toxicology testing methods are:

• Gas Chromatography-Mass Spectrometry (GC-MS)
• Liquid Chromatography-Mass Spectrometry (LC-MS)

Advanced toxicology tests are much better than routine drug tests, which tend to be a lot less sensitive. Sildenafil is detectable in certain biological samples for certain ranges of time.

Detection Windows for Sildenafil

Different biological samples can detect Sildenafil for varying periods:

Hair drug testing is not that commonly used in routine drug tests and is typically used for testing long-term drug use.

Sildenafil is generally not included in drug tests that are done in the workplace unless there is a suspected use for it.

What Causes False Positive Drug Tests?

False positive tests tend to happen in the first phase of testing called ‘immunoassay screening. ‘ These tests are designed to quickly and broadly classify drugs into certain categories instead of testing for a specific substance.

Since immunoassays depend on antibody reactions, some medicines or foods may provide false immunoassay results by producing similar reactions as antibodies.

Here are some substances that have been noted to cause positive false reactions include.

Decongestants

Medicine containing Pseudoephedrine are amphetamines during preliminary screening.

Antidepressants

A number of these antidepressants, such as:

• Sertraline
• Bupropion
• Trazodone

Have, from time to time, been associated with a positive false response.

Antibiotics

A number of antibiotics such as Rifampin influence opiate screening tests.

Antipsychotic Medications

Some medications such as, Quetiapine and Chlorpromazine may on some occasions influence the test results.

Poppy Seeds

Poppy seeds have some trace levels of opiate substances and are likely to test positive for morphine in some screening.

Studies done from the year 2010 to 2023 found that in some cases, participants who consumed poppy seeds had 20% – 90% positive false results to opiate tests depending on the volume of poppy seeds consumed.

Laboratory Errors and Other Factors

Some false positive results may be as a result of laboratory errors and some sample sources may also include;

• Contamination of the sample
• Poor laboratory practice
• Rare differences in metabolism
• Errors in testing

This is also the reason why a positive response is interpreted provisionally as it is usually.

When a positive discovery is made during screening, laboratories conduct confirmatory testing; GC – MS or LC – MS to detect the precise substance.

In a good number of cases, the sealed records of prescription are also reviewed before disclosing the result.

In the absence of confirming substance, the finding is switched to a negative.

Practical Guidance Before a Drug Test While Taking Sildenafil

Sildenafil is not likely to influence drug test results; however, a number of simple precautions may assist in alleviating the consequences.

Continue Taking Sildenafil as Prescribed

Speak to your doctor first before you discontinue the use of Sildenafil.

Notify the Testing Authority

Always inform test administrators about your prescription drugs.

Keep Your Prescription on Hand

If there are questions about your test, a prescription can aid you and answer some questions.

Disclose Supplements (and Herbs)

Supplements can interfere with a test and may also have undisclosed ingredients.

Beware of Fake ED Drugs

Fake ED drugs can include undisclosed substances that lead to a positive drug test.

Especially in the case of purchasing medications through unverified online vendors, this becomes very important.

Why Sildenafil Is Different from Controlled Substances

Sildenafil class substances rarely show up in drug testing, as unregulated and univested drugs work very differently from substances in other classes.

Sildenafil facilitates the enhancement of blood flow by the unblocking of blood flow control substances. PDE5. Sildenafil has a different purpose and effect than the other classes of drugs that work on the cognitive system, particularly stimulants and narcotic substances.

Sildenafil also has a different molecular structure than other abused and regulated substances.

Therefore, substances that are routine, regulated and unregulated PDE5 inhibitors, are not usually the focus of drug tests.

The Bottom Line

Routine screening tests similar do not show the effects of Sildenafil and Sildenafil will not show as a false in these tests.

Controlled products like cocaine or opioids are tests that PDE5 inhibitors do also show in controlled products.

Even a recent and limited review of 2023 suggested infrequent false-positive results in the drugs screening tests, and no scientific evidence is determined a cause relates back to Sildenafil.

When the tests do show Sildenafil, controlled products similar to Sildenafil, the laboratories opt to advanced testing are confirmatory like LC-MS or GC-MS.

The majority of false positives are related to other drugs, food, like poppy seeds, or laboratory problems. Regarding drug testing, continuing to take Sildenafil as instructed and notifying the testing authorities about all drugs and supplements taken, is likely the best course of action.