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Viagra tablets are seen at Brooks Pharmacy in Montpelier, Vt. A Supreme Court of Canada decision that invalidates a company's multimillion-dollar monopoly on the impotence drug Viagra has sent a tough warning to corporations about playing fast and loose with patent applications. Ruling unanimously against Canada Inc. Patent legislation amounts to a quid pro quo that offers inventors an exclusive monopoly in return for the forthright disclosure of all the ingredients of their product in their patent applications, Mr. Justice Louis LeBel said, writing for the court.

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Common side effects include headaches, heartburn, and flushed skin. Sildenafil acts by blocking phosphodiesterase 5 PDE 5, an enzyme that promotes breakdown of cGMP, which regulates blood flow in the penis. The primary indication of sildenafil is treatment of erectile dysfunction inability to sustain a satisfactory erection to complete intercourse. Its use is now one of the standard treatments for erectile dysfunction, including for men with diabetes mellitus. Tentative evidence suggests that sildenafil may help men who experience antidepressant -induced erectile dysfunction. Sildenafil and other PDE5 inhibitors are used off-label to alleviate vasospasm and treat severe ischemia and ulcers in fingers and toes for people with secondary Raynaud's phenomenon ; these drugs have moderate efficacy for reducing the frequency and duration of vasospastic episodes.

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