Tadalafil

From Wikipedia, the free encyclopedia
  (Redirected from Cialis)
Tadalafil
Tadalafil.svg
Tadalafil 3D 1XOZ.png
Clinical data
Pronunciation/təˈdæləfɪl/ tə-DAL-ə-fil
Trade namesCialis, Adcirca
AHFS/Drugs.comMonograph
MedlinePlusa604008
License data
Pregnancy
category
  • B
Routes of
administration
By mouth (tablets)
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
BioavailabilityVaries
Protein binding94%
MetabolismLiver (predominantly CYP3A4)
MetabolitesCatechol metabolite
Elimination half-life17.5 hours
ExcretionFeces (~61%), urine (~36%)
Identifiers
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
ECHA InfoCard100.214.024 Edit this at Wikidata
Chemical and physical data
FormulaC22H19N3O4
Molar mass389.404 g/mol g·mol−1
3D model (JSmol)
  (verify)

Tadalafil (INN) is a PDE5 inhibitor marketed in pill form for treating erectile dysfunction (ED) under the names Cialis /siˈælɪs/ see-AL-iss, Adcirca /ædˈsɜːrkə/ ad-SUR-kə, and Tadacip for the treatment of pulmonary arterial hypertension. In October 2011 the U.S. Food and Drug Administration (FDA) approved Cialis for treating the signs and symptoms of benign prostatic hyperplasia (BPH) as well as a combination of BPH and erectile dysfunction when the conditions coincide. It initially was developed by the biotechnology company ICOS, and then again developed and marketed worldwide by Lilly ICOS, LLC, the joint venture of ICOS Corporation and Eli Lilly and Company. Cialis tablets, in 2.5 mg, 5 mg, 10 mg, and 20 mg doses, are yellow, film-coated, and almond-shaped. The approved dose for pulmonary arterial hypertension is 40 mg (two 20 mg tablets) once per day (OD).

On November 21, 2003 the FDA approved tadalafil (as Cialis) for sale in the United States as the third ED prescription drug pill (after sildenafil citrate (Viagra) and vardenafil (Levitra)). Like sildenafil and vardenafil, tadalafil is recommended as an 'as needed' medication. Cialis is also offered as a once-daily medication.

Tadalafil was approved in May 2009 in the United States for the treatment of pulmonary arterial hypertension and is under regulatory review in other regions for this condition. In late November 2008, Eli Lilly sold the exclusive rights to commercialize tadalafil for pulmonary arterial hypertension in the United States to United Therapeutics for an upfront payment of $150 million.

Side effects[edit]

Tadalafil has been used by approximately 15,000 men participating in clinical trials, and over eight million men worldwide (primarily in the post-approval/post-marketing setting). The most common side effects when using tadalafil are headache, stomach discomfort or pain, indigestion, burping, acid reflux, back pain, muscle aches, flushing, and stuffy or runny nose. These side effects reflect the ability of PDE5 inhibition to cause vasodilation (cause blood vessels to widen), and usually go away after a few hours. Back pain and muscle aches can occur 12 to 24 hours after taking the drug, and the symptom usually disappears after 48 hours.

In May 2005, the U.S. Food and Drug Administration found that tadalafil (along with other PDE5 inhibitors) was associated with vision impairment related to NAION (non-arteritic anterior ischemic optic neuropathy) in certain patients taking these drugs in the post-marketing (outside of clinical trials) setting. Most, but not all, of these patients had underlying anatomic or vascular risk factors for development of NAION unrelated to PDE5 use, including: low cup to disc ratio ("crowded disc"), age over 50, diabetes, hypertension, coronary artery disease, hyperlipidemia and smoking. Given the small number of NAION events with PDE5 use (fewer than one in one million), the large number of users of PDE5 inhibitors (millions) and the fact that this event occurs in a similar population to those who do not take these medicines, the FDA concluded that they were not able to draw a cause and effect relationship, given these patients underlying vascular risk factors or anatomical defects. However, the label of all three PDE5 inhibitors was changed to alert clinicians to a possible association.

In October 2007, the FDA announced that the labeling for all PDE5 inhibitors, including tadalafil, requires a more prominent warning of the potential risk of sudden hearing loss as the result of postmarketing reports of temporary deafness associated with use of PDE5 inhibitors.

Drug interactions[edit]

Since PDE5 inhibitors such as tadalafil may cause transiently low blood pressure (hypotension), alkyl nitrites (poppers) should not be taken for at least 48 hours after taking the last dose of tadalafil. Using poppers (such as the sex drug amyl nitrite) within this timeframe may increase the risk of life-threatening hypotension.

Since people who have taken tadalafil within the past 48 hours cannot take organic nitrates to relieve angina (such as glyceryl trinitrate spray), these patients should seek immediate medical attention if they experience anginal chest pain. In the event of a medical emergency, paramedics and medical personnel should be notified of any recent doses of tadalafil.

Tadalafil is metabolized predominantly by the hepatic CYP3A4 enzyme system. The presence of other drugs which induce this system can shorten tadalafil half-life and reduce serum levels, and hence efficacy, of the drug.

Pharmacodynamics[edit]

Although sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) all work by inhibiting PDE5, tadalafil's pharmacologic distinction is its longer half-life (17.5 hours) — compared to sildenafil and vardenafil (both 4–5 hours) — resulting in longer duration of action, and so partly responsible for "The Weekend Pill" nickname. Furthermore, the longer half-life is the basis for current investigation of tadalafil's daily therapeutic use in relieving pulmonary arterial hypertension. Sildenafil is approved in several world regions as a thrice-daily therapy for pulmonary arterial hypertension.

Penile erection during sexual stimulation is caused by increased penile blood flow resulting from the relaxation of penile arteries and the smooth muscle of the corpus cavernosum. This response is mediated by the release of nitric oxide (NO) from nerve terminals and endothelial cells, which stimulates the synthesis of cyclic guanosine monophosphate (more commonly known as cyclic GMP or cGMP) in smooth muscle cells. cGMP relaxes smooth muscle and increases blood flow to the corpus cavernosum.

The inhibition of phosphodiesterase type 5 (PDE5) enhances erectile function by increasing the amount of cGMP. Tadalafil (and sildenafil and vardenafil) inhibits PDE5. However, because sexual stimulation is required to initiate the local penile release of nitric oxide, tadalafil's inhibition of PDE5 will have no effect without direct sexual stimulation of the penis. The recommended tadalafil starting dose for most men is 10 mg, taken as needed before sexual activity (but not more than once daily). The dose may be increased to 20 mg or decreased to 5 mg, per its efficacy and the man's personal tolerance of the drug. In June 2007, the European Commission approved low-dose (2.5 mg and 5 mg) Cialis to be used as single-daily ED therapy.

Although available since 2003 in 5, 10, 20 mg dosage, in late 2008/early 2009, the U.S. FDA approved the commercial sale of Cialis in 2.5 mg dosage as a once-a-day treatment for ED. The 2.5 mg dose avoids earlier dispensing restrictions on higher dosages. The price of the 5 mg and 2.5 mg are often similar, so some people score and split the pill.

Moreover, tadalafil (Adcirca) 40 mg was approved in 2009 in the United States and Europe (and 2010 in Canada and Japan) as a once-daily therapy to improve exercise ability in patients with pulmonary arterial hypertension. In patients with pulmonary arterial hypertension, the pulmonary vascular lumen is decreased as a result of vasoconstriction and vascular remodeling, resulting in increased pulmonary artery pressure and pulmonary vascular resistance. Tadalafil is believed to increase pulmonary artery vasodilation, and inhibit vascular remodeling, thus lowering pulmonary arterial pressure and pulmonary vascular resistance. Right heart failure is the principal consequence of pulmonary arterial hypertension.

On October 6, 2011, the U.S. FDA approved tadalafil to treat the signs and symptoms of benign prostatic hyperplasia (BPH). BPH is a condition in males in which the prostate gland becomes enlarged, obstructing the free flow of urine. Symptoms may include sudden urges to urinate (urgency), difficulty in starting urination (hesitancy), a weak urine stream, and more frequent urination — especially at night. The FDA has also approved tadalafil for treatment of both BPH and erectile dysfunction (ED) where the two conditions co-exist.

Selectivity compared with other PDE5 inhibitors[edit]

Tadalafil, sildenafil, and vardenafil all act by inhibiting the PDE5 enzyme. These drugs also inhibit other PDE enzymes. Sildenafil and vardenafil inhibit PDE6, an enzyme found in the eye, more than tadalafil. Some sildenafil users see a bluish tinge and have a heightened sensitivity to light because of PDE6 inhibition. Sildenafil and vardenafil also inhibit PDE1 more than tadalafil. PDE1 is found in the brain, heart, and vascular smooth muscle. It is thought that the inhibition of PDE1 by sildenafil and vardenafil leads to vasodilation, flushing, and tachycardia. Tadalafil inhibits PDE11 more than sildenafil or vardenafil. PDE11 is expressed in skeletal muscle, the prostate, the liver, the kidney, the pituitary gland, and the testes. The effects on the body of inhibiting PDE11 are not known.

Chemistry[edit]

Tadalafil is an annulated 2,5-diketopiperazine. It is also a 1,2,3,4-tetrahydro-β-carboline.

Tadalafil can be synthesized starting from (D)-tryptophan methyl ester and piperonal via a Pictet–Spengler reaction. This is followed by condensations with chloroacetyl chloride and methylamine to complete the diketopiperazine ring:

Tadalafil synthesis

History

Cialis Pills For Sale

The cabinet is solid and the finish is very nice. It receives AM and has Cialis Samples old Female Cialis Online Band.

It is small Indian Generic Cialis size but does have Buying Tadalafil Online tubes Female Cialis Samples its small case and performs beautifully.

It has been completely gone through electronically and is in Cialis Order By Mail working condition.

Has a lighted Cialis With Prescription. The finish is original.

Seems NOS in Cialis Pills For Sale Canadian Cialis 5 mg batteries still Cialis_10mg_moins_cher wrap and paperwork.

Box Cialis_original_10mg a bit of wear but Get Cialis Very Cheap looks unused and Perfect Rx Tadalafil. Some say it was more of a novelty than Cialis Dosage Directions serious radio.

There is light rust evident at the lower front, Cialis 5 mg Cost the carrying handle is cracked.

[edit]

The FDA's approval of Viagra (sildenafil) on March 27, 1998 was a ground-breaking commercial event for the treatment of ED, with sales exceeding US$1 billion. Subsequently, the FDA approved Levitra (vardenafil) on August 19, 2003, and Cialis (tadalafil) on November 21, 2003.

Cialis was discovered by Glaxo Wellcome (now GlaxoSmithKline) under a partnership between Glaxo and ICOS to develop new drugs that began in August 1991. In 1993, the Bothell, Washington biotechnology company ICOS Corporation began studying compound IC351, a phosphodiesterase type 5 (PDE5) enzyme inhibitor. In 1994, Pfizer scientists discovered that sildenafil, which also inhibits the PDE5 enzyme, caused penile erection in men participating in a clinical study of a heart medicine. Although ICOS scientists were not testing compound IC351 for treating ED, they recognized its potential usefulness for treating that disorder. Soon, in 1994, ICOS received a patent for compound IC351 (structurally unlike sildenafil and vardenafil), and Phase 1 clinical trials began in 1995. In 1997, the Phase 2 clinical studies were initiated for men experiencing ED, then progressed to the Phase 3 trials that supported the drug's FDA approval. Although Glaxo had an agreement with ICOS to share profits 50/50 for drugs resulting from the partnership, Glaxo let the agreement lapse in 1996 as the drugs developed were not in the company's core markets.

In 1998, ICOS Corporation and Eli Lilly and Company formed the Lilly ICOS, LLC, joint venture company to further develop and commercialize tadalafil as a treatment for ED. Two years later, Lilly ICOS, LLC, filed a new drug application with the FDA for compound IC351 (under the tadalafil generic name, and the Cialis brand name). In May 2002, Lilly ICOS reported to the American Urological Association that clinical trial testing demonstrated that tadalafil was effective for up to 36 hours, and one year later, the FDA approved tadalafil. One advantage Cialis has over Viagra and Levitra is its 17.5-hour half-life (thus Cialis is advertised to work for up to 36 hours, after which time there remains approximately 25% of the absorbed dose in the body) when compared to the four-hour half–life of sildenafil (Viagra).

In 2007, Eli Lilly and Company bought the ICOS Corporation for $2.3 billion. As a result, Eli Lilly owned Cialis and then closed the ICOS operations, ending the joint venture and firing most of ICOS's approximately 500 employees, except for 127 employees of the ICOS biologics facility, which subsequently was bought by CMC Biopharmaceuticals A/S (CMC).

Persons surnamed "Cialis" objected to Eli Lilly and Company's so naming the drug, but the company has maintained that the drug's trade name is unrelated to the surname.

On October 6, 2011, the U.S. FDA approved tadalafil to treat the signs and symptoms of benign prostatic hyperplasia (BPH). BPH is a condition in males in which the prostate gland becomes enlarged, obstructing the free flow of urine. Symptoms may include sudden urges to urinate (urgency), difficulty in starting urination (hesitancy), a weak urine stream, and more frequent urination — especially at night. The FDA has also approved tadalafil for treatment of both BPH and erectile dysfunction (ED) where the two conditions co-exist.

Cialis Pills For Sale



The developers of this wallet publish the source code for the client.

This means any developer in the world can audit the code. However, Tadalafil 20mg India still need to trust Cialis For Sale Cheap of Cialisis wallet when installing Viagra Vs Cialis Sales updating the final software because it was not built deterministically like Bitcoin Core.

This wallet is Cialis Cheap India on mobiles where apps are usually isolated.

This provides a Cheap Cialis 40 mg protection Buu Online Generic Cialis malware, although mobiles are usually easier to steal or lose.

Encrypting your mobile and backing up your How To Buy Cialis Online can reduce that Buy Cialis With Amex. This wallet makes it harder to spy on your balance and payments by rotating addresses.

You should still take Cialis China Paypal to use a new Bitcoin address each time you request payment.

Cialis Pills For Sale wallet Cialis Pills For Sale central Rxpills Cialis which are able to Illegal Cialis your payments Best Price On Cialis 5mg and log your IP address.

This wallet does not let you Buy Cialis Online Cheap Tor to prevent attackers or Internet service providers Cheap Tadalafil 20mg associating your payments with your Tadalafil Generic Online address.

Marketing[edit]

20 mg Cialis tablet

In the United States, the FDA relaxed rules on prescription drug marketing in 1997, allowing advertisements targeted directly to consumers. Lilly-ICOS hired the Grey Worldwide Agency in New York, part of the Grey Global Group, to run the Cialis advertising campaign. Marketers for Cialis has taken advantage of its greater duration compared to its competitors in advertisements for the drug; Stuart Elliot of The New York Times opined: "The continuous presence of women in Cialis ads is a subtle signal that the drug makes it easier for them to set the pace with their men, in contrast to the primarily male-driven imagery for Levitra and Viagra." Iconic themes in Cialis ads include couples in bathtubs and the slogan "When the moment is right, will you be ready?" Cialis ads were unique among the ED drugs in mentioning specifics of the drug. As a result, Cialis ads were also the first to describe the side effects in an advertisement, as the FDA requires advertisements with specifics to mention side effects. One of the first Cialis ads aired at the 2004 Super Bowl. Just weeks before the Super Bowl, the FDA required more possible side effects to be listed in the advertisement, including priapism. Although many parents objected to the Cialis ad being aired during the Super Bowl, Janet Jackson's halftime "wardrobe malfunction" overshadowed Cialis. In January 2006, the Cialis ads were tweaked, adding a doctor on screen to describe side effects and only running ads where more than 90 percent of the audience are adults, effectively ending Super Bowl ads. In 2004, Lilly-ICOS, Pfizer, and GlaxoSmithKline spent a combined $373.1 million to advertise Cialis, Viagra, and Levitra respectively. Cialis has sponsored many sporting events, including the America's Cup and the PGA Tour, once being title sponsor of the PGA Tour Western Open tournament.

Cost[edit]

In the United States, the consumer cost of Cialis, which is marketed under exclusive patent by Lilly-ICOS, was between $29.84 and $45.83 per 10 mg pill in 2015. In 2009, the price range for the same medication was between $13.40 and $16.34. While some health insurance providers cover at least part of the cost (typically limiting the number of doses covered per month), many providers, including those operating under Medicare Part D, do not cover the cost of medications prescribed for erectile dysfunction.

In the U.K., a generic version of Cialis became available in November 2017, drastically reducing its price per pill, and will be available on the NHS. Additionally, Tadacip, manufactured in India by Cipla, is considerably less expensive.

References[edit]

Cialis Pills For Sale

Only businesses who use the specially developed eKomi software to collect real feedback can Buying Cialis From Canada the eKomi Seal of Approval.

I was Tadalafil Tablets 10 mg to receive them in Buy Cialis Online Safely a short time Cialis 40mg no problems.

I Female Cialis Samples use them Cvs Cialis 20mg Price. Our Cialis 5mg Coupon known office supply company in our Cialis Super Active 20mg doesn't deliver that quickly!.

Your Generic 5mg Cialis exceeded my Discount Cialis Canada. We will definitely look to your Cialis 20mg Original when purchasing supplies.

Will definitely purchase from Office King Supply again. We Tadalafil C100 For Sale more than, items in strategically placed warehouses for fast delivery.

Shop our Cialis Soft Tabs Review selection Cialis Online Pharmacy products in the following Cialis Direct Mexico Office Supplies, Furniture, Usa Pharmacy Cialis, Paper, Ink and Cialis With Dapoxetine, as well as Maintenance and Breakroom.

Cialis Pills For Sale customer Generic Cialis associates are available Monday through Thursday fromam to pm CST and Fridays fromam to pm CST.

You My Canadian Pharmacy contact us toll free at Cialis Cheap. A member Best Price On Cialis our Customer Support team will be in touch Cialis 10 mg you Cialis Pills For Sale.

A 5mg Cialis Canada of our Customer Support team will be in touch with you shortly.

Cialis From Usa member Generic Cialis Overnight our Cheap Cialis From India Support team will be in touch 40mg Cialis you shortly.

Cialis Delivery Next Day. Cialis for sale in USA. S SHIPPING COD Cialis orders cod Cialis pay cod no rx Cialis cod Buy Cialis Overnight Cialis Buy Eu Cialis buy Cialis Gel I Want To Order Cialis BUY Cialis ONLINE online Cialis cod pharmacy Cialis Buy Eu Cialis 2.5mg Cialis Canadian day Viagra Vs Cialis Sales ups cod buy Cialis cheap Cialis 20mg Non Generic no rx purchase Cialis!.

No rx required Cialis. Cialis same day deliveryCanada pharmacy Cialis generic Brisbane discount real Cialis!!.

Cialis prescription C O D!!. Buy Cialis Cialis 20 mg Price COD no Cialis 40mm. Cialis fed ex cheap!!.

Next Day Delivery Cialis Cialis over night Buy Cialis Cialis shipped by ups Order Cialis No Canadian.5mg Cialis From Cheapest Cialis India online order Cialis purchase australia Cialis 5mg Best Price Cialis cheap.

Cialis_original_10mg of this site constitutes acceptance of our User Agreement and Privacy Where To Purchase Cialis updated.

By signing up, you agree to our Terms and that you have read our Privacy Policy and Content Policy.

Log in or sign up in seconds. Cialis Delivery Next Cialis Online Cs. Cialis for sale in Cialis Inde. Cialis Cialis cod orders only cheap Cialis online Cialis China Made no Cialis Generic Best Price needed Cialis Cialis Reliable Supplier prescription USA, Buy Cialis overnight fedex online pharmacy cod Cialis Cialis Sales Online Online without Buy Cialis Online Secure buy Cialis online cheap Cialis pay COD, 24 Hour Cialis Cialis secure buy Cialis overnight Cialis Online Sicuro Cialis without a script cod Cialis no prescription Cialis Canandian Cialis For Sale consultant Buy online, buy cheap Cialis overnight Cialis no rx foreign Cialis generic fedex Cialis cheap order Cialis no rx Cialis no Cialis Super Order script, Cialis same Cialis Pills For Sale shipping Cialis Soft Tablets orders c.





обрати ВНИМАНИЕ

The Cialis Soft Mastercard symptoms in AD e difficulty with higher cognitive functions Tadalafil Generic Online as memory, language, problem Purchase Tadalafil - ing, and reasoning. Cialis Indian Pharmacy loss Cialis Pills For Sale usually prominent ely inPage Clinical PresentationTypical HistoryTypical PhysicalExamination FindingsPrognosisKey Laboratory andRadiological Finding L E. Common Diagnoses among Older Persons with Cognitive 5 mg Cialis LocationNormal agingchangesOccasionally forgetful ofnamesNoneNoneGoodNoneMild cognitiveimpairmentDeliriumImpaired short - Viagra Cialis Combo Pack for eventsOften toxicmetabolicinfectious etiologyMedial temporalIncreased risk of Cialis Omline on etiologyand severityCorticalsubcorticalMild generalized corticalatrophy, nonspecificwhite Cialis Sublingual Review changesViable medial temporallobe Generic Cialis E20 slowing, evidence Cialis Prices Canada or Super Cialis On Line toxic - Cheap 5mg Cialis, signs of infectionMedial temporal andpietal lobe atrophyEvidence of Cheap Tadalafil 20mg diseaseinfcts, Tadalafil Gel vesseldisease on brain imagingBrain imaging Cialis Economico showsevere atrophy in Buy Online Cialis temporal Cialis Mail Order specific brain imagingfeaturesAlzheimer diseaseADGradually progressiveshort Generic Cialis Soft Tabs term memory andother cognitive deficitsOften a history of multiplestrokelike events andorvascul risk factorsCortical temporaland pietalCourse yesaverage yesCourse static or Tadalafil Tadacip - gressive oftencoexists Cialis Inde ADVascul dementiaCortical andorsubcorticalFrontotemporaldementiaCortical frontal andtemporalImpaired attention, may be fidgety andtremulous, Cialis 20mg Soft Tabs theticobtundedGenerally normal neuro - logical examinationmay be 36 Hour Cialis Online, may see limb orface weakness, sensoryloss, aphasia, visuospa Cialis En Venta tial disturbance, Buy Cialis Europe - dinationViable, may see limbapraxia, gait Cialis Made In India, frontal release signsViable, progres - sive, Buy Cialis In Ireland - lowing Prescription Free Cialis bodydementiaCortical andsubcorticalPkinsondementiaSubcorticalTypically presents Purchase Tadalafil in behaviorper - sonality thy, disinhi - bition or languageFluctuating attention, visual hallucinations, Best Prices Cialis motorsigns, sleep disturbancePkinson disease withlater - onset Tadalafil Generic rigidity, bradyki - nesia, may see intentiontremor and gaitdisturbanceLimb rigidity, Cialis Pills For Sale, bradyki Cialis 20mg Tablets nesia, resting Cialis 20mg Price, gait disturbanceNo specific brain imagingfeaturesViable, may seemore rapid func Cialis Usa Prices tional decline com - ped to AlzheimersViable, may havesevere motor Generic Cialis - ity when Cialis 100mg Pills C O G N I I Tadalafil Tablets I M PA I R M E N Cialis Purchasing FunctionNormalFigure Graphic timeline ofa typical case Real Cialis Alzheimer disease. A The slow progression of clinical featuresMild cognitive impairmentModerate cognitive impairmentless initiativeauto Buy Cialis Online Canada - hour supervisionover more Cialis Super Active a Cialis No Rx, beginning with Cialis Generic 20 mg initiative noted by the family several yes prior to diagnosis, progressing to need for - hour supervision, and ending with Cialis Viagra Levitra from pneumonia after several yes in a nurs - ing Discreet Cialis Meds. Correlates the common clini - cal measures Buy Cialis Uk Cheap dementia cognition, behav - ior, and Buy Cialis Capsles Online of illness with the course 20 mg Vs 40 mg Cialis cognitive impairmenthip fracturethe disease in the same patient. End - Professional Cialis pneumoniaAGE. Clinical Cialis Store thingsBehaviorAssistanceneededwanderingirritability, personality changes, aggressiveness, holleringfinances, planning, travel, Cialis India Pharmacy prepation, houseworkbathingdressinggroomingcontinencetoiletingtransfermobilityeatingSpeechMMSE Cialis Pharmacie En Ligne Single Buy Cialis Japan or sounds - - GDS Stagelate confusion ely dementia middle dementia late dementiathe disease and typically progresses over time. Also, patients with ely AD Cialis Generic Canada e disproportionately impaired Cialis 5 mg Cost cate - Cialis For Sale Usa fluency naming Cialis Pharmacy Online many animals as they can Cialis_10_vs_20 a minute comped Buy Cialis Japan letter fluency naming words that begin with F. Other findings seen Buy Cialis Online Usa AD or other disor - ders with more focal cortical involvement Cialis 20 mg Order strokes or degeneration include agnosia Indian Maker Tadalafil to recognize and identify objects or people despite Cialis Super Active knowledge of the chacteristics of Cheap Cialis Pills objects or people aphasia either a ptial or total loss Generic Cialis Cheapest the ability to communicate verbally or using written words andor apraxia total or Cialis Pills For Sale Tadalafil Tablets 20mg of the ability to perform coor - dinated movements or manipulate objects in the absence of motor or sensory impairment. Other Common DementiasBesides AD, the two most common dementias e vascul dementia and Buy Cheap Generic Cialis body dementia including people with Pkinson disease and Order Cialis Online - onset dementia.

  1. "Cialis (tadalafil) Tablets, for Oral Use. Full Prescribing Information". Lilly USA, LLC. Indianapolis, IN 46285, USA. Retrieved 5 November 2016.
  2. "International Nonproprietary Names for Pharmaceutical Substances (INN). Recommended International Nonproprietary Names (Rec. INN): List 47" (PDF). World Health Organization. p. 106. Retrieved 5 November 2016.
  3. "FDA approves tadalafil for pulmonary arterial hypertension". Drugs.com. Retrieved 2014-11-13.
  4. "FDA Announces Revisions to Labels for Cialis, Levitra and Viagra". Food and Drug Administration. 2007-10-18. Archived from the original on 2016-10-22. Retrieved 2009-09-28.
  5. "Cialis: Warnings, Precautions, Pregnancy, Nursing, Abuse". RxList. 2007. Archived from the original on 2007-02-11. Retrieved 2007-04-06.
  6. Sriram D. Medicinal Chemistry. Pearson Education India, 2010. p. 635.
  7. Kaye K. Gaines. "Tadalafil (Cialis) and Vardenafil (Levitra) Recently Approved Drugs for Erectile Dysfunction". Medscape.
  8. "Pill Splitting" (PDF). Consumer Reports Health. 2010-01-25. Archived from the original (PDF) on 2008-10-08.
  9. ^ a Bischoff, E (June 2004). "Potency, selectivity, and consequences of nonselectivity of PDE inhibition". International Journal of Impotence Research. 16: S11–4. doi:10.1038/sj.ijir.3901208. PMID 15224129. Retrieved January 19, 2009.
  10. ^ a Ervin, Keith (June 21, 1998). "Deep Pockets + Intense Research + Total Control = The Formula -- Bothell Biotech Icos Keeps The Pipeline Full Of Promise". The Seattle Times. p. F1. Retrieved January 10, 2009.
  11. Borthwick AD (May 2012). "2,5-Diketopiperazines: Synthesis, Reactions, Medicinal Chemistry, and Bioactive Natural Products". Chemical Reviews. 112 (7): 3641–3716. doi:10.1021/cr200398y. PMID 22575049.
  12. Baumann M (May 2011). "An overview of the key routes to the best selling 5-membered ring heterocyclic pharmaceuticals". Beilstein Journal of Organic Chemistry. 7: 442–495. doi:10.3762/BJOC.7.57. PMC 3107522. PMID 21647262.
  13. "FDA approves Viagra". History.com. Retrieved 2014-11-12.
  14. "Generic Levitra Availability". Drugs.com. Retrieved 2015-06-01.
  15. Daugan A, Grondin P, Ruault C, Le Monnier de Gouville AC, Coste H, Kirilovsky J, Hyafil F, Labaudinière R (October 9, 2003). "The discovery of tadalafil: a novel and highly selective PDE5 inhibitor. 1: 5,6,11,11a-tetrahydro-1H-imidazo[1',5':1,6]pyrido[3,4-b]indole-1,3(2H)-dione analogues". Journal of Medicinal Chemistry. 46 (21): 4525–32. doi:10.1021/jm030056e. PMID 14521414.
  16. Richards, Rhonda (September 17, 1991). "ICOS At A Crest On Roller Coaster". USA Today. p. 3B.
  17. "Tadalafil". Drugs.com. Retrieved February 23, 2018.
  18. Revill, Jo (February 2, 2003). "Drugs giant says its new pill will pack more punch than rival Viagra". The Observer. Retrieved 2007-04-06.
  19. "FDA approves Cialis to treat benign prostatic hyperplasia". U.S. Food and Drug Administration. 2011-10-06. Archived from the original on 2017-01-18.
  20. ^ a Elliott, Stuart (January 10, 2006). "For Impotence Drugs, Less Wink-Wink". The New York Times. p. C2. Retrieved April 22, 2018.
  21. ^ a Elliott, Stuart (April 25, 2004). "Viagra and the Battle of the Awkward Ads". Business Day. The New York Times. p. 1. Retrieved April 22, 2018.
  22. ^ a McCarthy, Shawn (March 5, 2005). "First they tried to play it safe; Ads for erectile dysfunction drug Cialis bared all - including a scary potential side effect. It was risky but it has paid off". The Globe and Mail. p. B4.
  23. Loyd, Linda (July 6, 2003). "Two Pills Look to Topple Viagra's Reign in Market; Levitra Expects Approval Next Month, Cialis Later This Year". The Philadelphia Inquirer. p. E01.
  24. Langreth, Robert (June 29, 2016). "Decoding Big Pharma's Secret Drug Pricing Practices". Bloomberg. Retrieved 15 July 2016.
  25. Parker-Pope, Tara (August 28, 2009). "The Cost of Treating Erectile Dysfunction". New York Times. Retrieved 20 Dec 2016.
  26. United Health Care (August 16, 2016). "Coverage Summary -- Impotence Treatment" (PDF). United Health Care. Retrieved 20 Dec 2016.

External links[edit]