Kamagra contains sildenafil, a PDE5 inhibitor used for erectile dysfunction. In general, true “drug tolerance” (needing higher and higher doses over time for the same effect) is not very common with sildenafil, but some people feel it becomes less effective over time. That is usually due to other factors rather than true pharmacological tolerance. 1. Psychological “tolerance” (most common) Performance anxiety increases over time Expectation of “stronger results every time” Stress, relationship issues, or depression These can make the drug seem less effective even if it still works normally. 2. Worsening underlying condition ED can progress due to: Diabetes High blood pressure High cholesterol Obesity Smoking Low testosterone If the root cause worsens, the same dose may feel weaker. 3. Incorrect use Effectiveness can drop if: Taken after a heavy or fatty meal Not enough ***** stimulation Alcohol use before taking it Wrong timing (needs ~30–60 minutes) 4. Reduced responsiveness over time (rare physiological adaptation) Some studies suggest mild desensitization in the nitric oxide–cGMP pathway, but this is not considered true drug tolerance in most patients and is usually not clinically significant. 5. Counterfeit or poor-quality products A very common issue with Kamagra (often sold online): Variable or incorrect sildenafil dose Fake or substandard tablets This can make it appear like “tolerance,” when it’s actually inconsistent drug quality. Important point If someone feels Kamagra is “not working anymore,” doctors usually do not increase the dose repeatedly. Instead, they check: Health conditions (heart, sugar, hormones) Lifestyle factors Correct medication use Alternative PDE5 inhibitors (like tadalafil or vardenafil) If you want, I can also explain how Kamagra compares with Tadalafil (Tadarise/Tadasoft) or what to do if sildenafil stops working properly.