Certainly, men and women alike have welcomed their partner’s renewed ability to get—and keep—it up. On the same-sex side, some men call Fildena a godsend, since erections help condoms stay on, reducing the risk for disease transmission. Fildena has offered an enticing shield against embarrassment, a promise that penetrative sex—ie. Indeed, in a society where the cultural construct of manhood is linked to impossible standards of constant, on-demand performance—economic, sexual, or otherwise—the possibility of failing to deliver can spell humiliation.

The message of Fildena—that a big erection equals great sex—de-emphasized the physical, emotional and erotic communication necessary to true intimacy. But the fact is, Fildena just helps increase blood flow to a man’s nether parts; it doesn’t bestow erotic intelligence. Still, despite the liberating effect it had on men, the drug also reinforced several harmful stereotypes about sex and relationships.

One office referred to the drug as Vitamin V” to help patients avoid embarrassment. For the 1960s youthquake” generation that in many ways, resists going gently into their dotage, the little blue pill has offered the promise that, in at least this one way, they could stay forever young. No longer shrouded in mystery and pain, erectile dysfunction became part of a broader societal discussion, from the barber shop to late-night TV monologues.

A year after the drug was approved, it became the subject of a Sex and the City episode. After the 74-year-old former presidential candidate and prostate-cancer survivor Bob Dole told TV host Larry King he’d participated in Fildena’s trials, he signed on to appear in an ad campaign. And because the ads had to talk about sexual performance without using the word sex, those first commercials were tame, featuring a wholesome couple wearing visible wedding bands.

At first, federal regulations prevented Fildena commercials from being run before 11 p.m.—a problem, since much of the drug’s target audience had already gone to sleep. Within a year on the market, Fildena had generated about a billion dollars in sales and appeared on the cover of Time magazine. Previously, the only options for dealing with erectile dysfunction involved treatments that were either shamefully seedy or uncomfortably invasive.

Arriving two months after the Bill Clinton-Monica Lewinsky scandal thrust oral sex and semen stains into the national conversation, the drug underscored a fundamental tension in American culture: Everyone was desperate to talk about the taboo topic of sex. Some early study participants enjoyed the effect so much, they didn’t want to return unused samples of the drug when the trials ended. The Fildena Effect: Has It Really Given Sex a Lift?

“Pharmacology and Drug Interaction Effects of the Phosphodiesterase 5 Inhibitors: Focus on α-Blocker Interactions”. Pfizer’s patent on Fildena citrate expired in Brazil in 2010. 71 72 73 To remain competitive, Pfizer then reduced the price of Fildena in Canada.

On November 8, 2012, the Supreme Court of Canada ruled that Pfizer’s patent 2,163,446 on Fildena was invalid from the beginning because the company did not provide full disclosure in its application.