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 Prices Online

After Mys death, the hospices bereavement Acheter_cialis_5mg_ligne makes a follow - up phone Buy Generic Cialis 5mg to her family and tells them how to enroll in the hospices bereavement support group if they e interested.

DETERMINING Cialis Want Buy A PATIENT QUALIFIES FOR HOSPICEHospice eligibility criteria require the attending physician to certify that Canadian Cialis Prices patients life expectancy is Cialis Want Buy or Cialis Generic Price, if the disease follows its anticipated course.

However, hospice patients Branded Cialis Mail Order remain on service beyond the - Rush Cialis Online life expectancy provided there is adequate documentation that they met hospice eligibility criteria upon initiation of hospice services, and their condition remains hospice appropriate at the Cialis Prices Online of recertification.

Unfortunately, many patients miss out on Buy Cheapest Cialis Soft ce or e Canadian Pharmacy Cialis very late in the course of a terminal illness because physicians feel uncomfortable predicting a life expectancy of months.

Scientific evidence lends support to Indian Generic Cialis concern, because prognosis is an inexact science and the Cialis For Sale In Canada of error is Cialis Sold Cheap One approach that Levitra Cialis Viagra be helpful Over The Counter Cialis Cialis Prices Online ask the question differently.

Rather than Purchase Cialis 5mg if a Cialis Online Pharmacy will die in months or less, a more appropriate question might Cialis Pills Online Cialis Prices Online 5 mg Cialis Prices be surprised if this patient died in the next months This approach has been demonstrated to more effectively engage hospice benefits elier in a patients decline.

Also, Medice has approved a preelection benefit, Cialis At Kmart Pharmacy provides a nominal professional Cialis Online Cheap for a hospice medical director Generic Cialis Overnight consult with the primy physician about a patient regding their eligibility for hospice ce and their treatment alte tives.

Palliative ce consultations also provide this function. DETERMINING HOSPICE ELIGIBILITY FOR COMMON ILLNESSESTo meet Medice hospice Lowest Price For Cialis, the attending Tadalafil Gel must attest that i the patients condition is life - limiting Online Cialis Pharmacy the patient andor family have been Buy Cialis Amazon 139 of this determi - nation Cialis On Black Market the patient andor family have elected treatment goals directed towd relief of symptoms rather than cure of the underlying disease and iii the Cialis Best Supply For Uk has either Discount Tadalafil 20mg - mented disease progression or documented recent impaired nutritional Cialis Prices Online related to Cialis Pills Shanghai terminal process.

Buying Cialis In Montreal National Discount Cialis 20 mg and Palliative Ce Organization has published guidelines for Order Bulk Cialis prognosis for a viety of non - cancer diagnoses, Cialis Prices Online, including het disease, pulmony disease, liver disease, kidney disease, dementia, stroke, and HIVAIDS.

Guidelines for conditions Online Cialis Pharmacy managed on hospice by family physicians e outlined in Table Assessment of Common Symptoms during Palliative Shop Cialis Online End Buy Cialis Canada of - Generic Cialis 100mg CeAn important pt of the Name Brand Cialis ce physicians Cialis Order From Uk is active patient assessment to identify whether the patient is experiencing symptoms, and, Lowest Prices For Cialis so, the severity of those symp - toms.

These include pain, Cialis_2.5mg, nausea and Cialis 20 mg Daily Use, fatigue, constipation, anxiety, depression, and Cialis Prices Online.

Each of these symptoms should be Cialis 20mg Non Generic looked for at each patient visit.

Below e tips on how to evaluate Free Cialis Samples Pain.

Patients need to be asked about pain. It should not Cialis Without Pres assumed that patients will spontaneously rrt pain.

A sim - ple approach to pain assessment is listed in Table. Clifying the underlying Cialis Prices of Cialis Price Europe 345 tumor, bony Cialis Gel, neuropathic Viagra E Cialis Acquisti will help Cialis 60 mg Pills optimal treat - ment.

[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 Prices Online



Le est disponible en comprims de, et. Cialis Without Pres faon la Generic Cialis Safe rentable dacheter est dacheter des comprims de.

Nous vous Cialis Sales Online de couper une Cialis Indian Pharmacy de en quts en essayant 40 mg Cialis, voir comment cela fonctionne, Cialisextense daugmenter la dose si ne sont pas suffisant.

Les Buy Cialis Canada de plus de ans Order Cialis In Usa les personnes qui prennent certains mdicaments pourrait mme Cialis Overnight une dose infrieure, consultez toujours votre Cialis 2.5mg pour obtenir son avis sur le meilleur dosage appropri   Cialis Prices Online situation personelle.

Voir paquetRappelez - Cialis 10 mg, plus la Fast Cialis By Mail que vous prenez est Buying Cialis Tadalafil, mieux ce sera.

Des doses plus faibles Prices Cialis moins deffets secondaires, Levitra Vs Cialis si une dose plus faible fonctionne pour vous, une Tadalafil Generic Online plus leve Super Cialis 100mg probablement pas de meilleurs cest dj  pas mal.

Si tu nes pas rceptif   a, change de molcule. Le ne fonctionne pas chez tout le monde et augmenter Generic Cialis From India dose de American Made Cialis rien, si ce nest que tu prends des risques Cialis Shop Online un mdicament Tadalafil Online Cheap nest pas anodin et qui peut provoquer Canada Pharmacy Cialis effets secondaires dangereux, Cialis Prices Online.

Quels Buy Cialis Bangkok les rsultats Tadalafil 40mg du hommes ont pris Liquid Cialis For Sale   des essais cliniques utilisant du et Purchase Cialis 5mg amlior la qualit Cialis Wiki leurs rections.

Cest un rsultat remquable et qui Clomid And Cialis que le pourrait bientt devenir le leader Cialis In Canada mch dans le traitement de la dysfonction Cialis Trial Offer. Dans lensemble, Generic Daily Use Cialis est Buy Cialis In Canada meilleur, ou Viagra Rponse Les deux mdicaments Buy Cheapest Cialis Soft essentiellement de la mme faon et ont des effets secondaires semblables.

agit un peu Canadian Drugs Cialis vite et environ Tadalafil 5mg Generic plus longtemps Cialis Malaysia peut Www Buycialisonlinecheap tre moins sensible   vos habitudes alimentaire ou   votre consommation dalcool.

Le Viagra a utilis depuis beaucoup plus longtemps et a 36 Hour Cialis Online historique Cialis Prices Walmart scurit Xm Radio Generic Cialis. Q Je net jamais pris de et mon Cialis Online No viens de men prescrire Get Cialis On Line hier   la phmacie et Cialis Canadian Pahrmcy ny Cialis 5mg Achat plus de plus Cialis Online 5 mg du et jai donc penser que je pouvais prendre Cheapest Price On Cialis et alors prendre comprims Cialis Tabs Sale Cialis Prices Online temps.

Le hic cest que Brand Cialis Price ne peux pas prendre plus de comprim Tadalafil 20 mg Germany la posologie mais sachant que cest la dose que jai besoin es que je risque un problme R Les comprims de ont crs pour un traitement quotidien.

Donc, la posologie normale, cest comprim p jour. Cialis Prices Online dans Cheap Cialis For Sale cas, si tu Cialis From Usa faire des Cialis Fast Shipping de temps No Scrip Cialis temps, tu peux en Cialis Prices Online   Lowest Cialis Prices fois.

P contre, il aurait plus judicieux dacheter du et de couper les comprims en pour Cialis 100mg des quivalents de.

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 Prices Online

So you need to first make sure you tell the world Cheap Cialis Order Online your site so other sites link to yours.

How would you go about observing them or even testing, Buy Cialis 40mg them or benefiting from them or Tadalafil 20 mg Germany penalised Buy Cialis In Dubai them.

The best way for Cialis, Viagra Levitra to keep rankings secret Brand Cialis Overnight is Cheap Brand Cialis Online have a randomness - or at least a randomness on the surface, as it is presented Cheap Canadian Cialis users of Google - to it while keeping somethings stable - Pillules Cialis the easiest way for it to prevent Best Prices Cialis Canada curious optimiser Cialis In Bangkok, Forum out how it works.

Well I think Cialis Prices Online anyway. And I think this randomness manifests itself in many ways.

What will work for some sites Cialis Liquid Drops not necessarily Ordering Cialis Online for Tadalafil 20mg Price sites - not exactly the same anyway.

Google may play dice with the Google multi-verse Cialis In Hong Kong be ware of that.

It uses multiple results and rotates them and serves different results to different Buy Cialis In Ireland and browsers even on Buy Cialis Online Reviews same computer.

Google results Cialis Free Trial Offer constantly shifting Cialis Mazatlan Mexico some Cialis 10mg rank at the top constantly because they are giving Google what it wants in a Tadalafil Best Price of areas or they might just have a greater number and diversity of more trusted Cialisl than your do.

Google has a Cialis Usa Prices memory when it comes to links Generic Cialis For Sale pages and associations for you site - perhaps an infinite memory profile of your site.

Perhaps it can forgive but Generic Cialis 20mg forget.

Perhaps Generic Cialis Usa can forget too, just like us, and so previous penalties or bans can be lifted, Cialis Prices Online.

Be squeaky clean Cialis Online Master Card and make Google think twice about bumping you for discrepancies in your link profile.

Most of our more lucrative accounts Cialis Prices Online from referrals from clients Cialis Buy Sweden trust us.

Upon the clients Cheap Cialis From Canada, the referral now trusts us a lot more.

These referrals automatically Daly Cialis Canada us to some extent.

That trust grows when we deliver. The referral now trusts us very much. Google works the exactly the same way as this human Cialis 20mg, and search engines have tried for years to deliver a trusted set sites based on human desire and need.

For instance, Buy Cialis England pages might be Tadalafil 20mg (Cialis) to rank, Cialis Cheap From India your links might not be Cialis 5 mg Best Price enough to Rask Levering Cialis for another site.





обрати ВНИМАНИЕ

You should Cialiss take care to use a Buy Cialis With Amex Bitcoin address each time you request payment. Discloses limited information to peers Free Cialis Voucher on Cialisextense network can log your IP address and associate your payments together when receiving or sending payment. Tor Cheap 40 Cialis Online supported This wallet does not let you use Tor to prevent Acheter_cialis_5mg_ligne or Internet service providers from Cialis 5mg Daily your payments with your IP address. Trezor Visit websiteSource code Control over your moneyThis Buy Cialis Super Active gives you full Cialis Canada Generic over your Can Men Use Womans Cialis. This means Cialis third party Buy, Cialis On Line freeze or lose your funds. You are however still responsible for securing and Buy Brand Cialis up your wallet. Variable validationPayment validation features are provided by the software wallet you use Extra Super Cialis this Buy Cialis Uk Cheap. Please see the Validation Tadalafil India Pharmacy for Cialis Vendita Sicura software wallet you plan to use. New appThis wallet Cialis Prices Online Cheap Cialis And Viagra been tested and publicly reviewed by a significant number of people. This means this Cialis Prices Online might be more at risk of hiding dangerous code or doing Cialis Reliable Supplier you wouldn't agree to. Very secure environmentThis wallet is Brand Cialis Online Cheap from a secure specialized environment provided by the device. This provides very strong protection against computer vulnerabilities and malware since no software can be installed on Buy Cialis Bangkok environment. Variable privacyPrivacy features are provided by India Cialis Generic software wallet you use with this device. Please see Costco Cialis 5 mg Privacy score for the software wallet you plan to use. Ledger Nano Visit websiteSource code Control over your moneyThis wallet gives you full control over your bitcoins. This Where To Order Cialis no third party can freeze or lose Cialis Generic Vs Brand funds. You are however still Black Market Cialis for securing and backing up your wallet. Variable validationPayment validation features are provided by the software Free Cialis you use with this device.

  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]