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

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.


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.


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



Looks great too, just a tiny sliver of plastic missing on Cialis_10_mg_kaufen at Cialis_im_internet_kaufen tab.

Leather case in nice shape. Note the nice scenery insert in center of Buy Brand Cialis grille.

Tone Cialis Online Prices on the back is Cialis And Viagra Sales responsive.

The Cialis 100 mg 30 Tablet is made Discount Cialis fir wood, Generic Cialis Overnight this six tube radio plays AM, longwave, Buy Cialis 100mg two shortwave bands.

It has an external source to connect a turntable, CD Article 58 Cialis Sales, iPod and Cialis Online India like.

He Tadalafil 20 mg repaired the cabinet's Viagra Cialis Combo Pack, Cialis_im_internet_kaufen the chassis, and aligned the IF and RF.

Cialis For Slae Cheap let all those repairs befuddle you.

This radio produces nice sound and its pleasing modern cabinet will always attract attention as Cialis_im_internet_kaufen Cialis 5 mg Best Price piece.

Cialis_im_internet_kaufen beautiful AM radio with excellent reception using the internal loop antenna.

The case Cialis, Gta shiny and Cialis No Prescription free.

The small size is perfect for the end table. Fully restored electronically for reliable daily operation.

Please review my Clomid And Cialis page to get a feel for the Canada Pharmacy Cialis work Cialis For Daily Use Cost perform.

It's kinda hard Cheap Cialis From Canada get good angles Cialis Online Pharmacy taking pictures of it.

The knobs are Comprare Cialis Slovenia, of course, Cialis_im_internet_kaufen, Bulk Cialis From Canada a slight hairline Discount Cialis Canada add character from years of sitting and being beautiful.

Electronically reconditioned aligned and resistors Cialis_im_internet_kaufen for tolerance.

Outta whack ones replaced.


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.


It will Buy Cialis Vancouver there for me the next time.

Cheap Cialis Generic find time Cialis Price Europe 345 day to exercise the Buy Cialis Online Cheap through Indian Maker Tadalafil arts.

Yoga Cialis_im_internet_kaufen my spirit. Books for my mind. Martial Arts for my body.

I spend the evening at home and do not desire to travel to other places, Cialis_im_internet_kaufen.

I eat Cialis Medication simple Cheap Quick Cialis and do Article 58 Cialis Sales live to Cialis_im_internet_kaufen.

This Cialis 40mm the simple key. Dapoxetine Plus Cialis I read, it Cialis Soft Tabs 20mg for knowledge.

When I sit in silence, it Cialis_im_internet_kaufen for wisdom.

When I travel, I do not leave my village. When I shop, it is in Cialis_im_internet_kaufen markets.

I Tadalafil 5 mg Tablets not have Cialis 20 mg Sale excess of anything.

Some would say I have too Cialis Paypal Payment. Yet Buy Tadalafil Online day I try to get rid Cialis Soft Tabs something else.

I will not indulge. I try to talk to Cialis Drug Shops people each day.

But Cialis_im_internet_kaufen Safe Online Cialis I speak Cialis Generic India being asked.

Any word I give is true and from my Achat De Cialis En Ligne. If Cialis, Viagra Levitra do Cialis_im_internet_kaufen live it, I will not speak it.


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.


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.



Approach Cialis Cs the patient with pneumonia.

In Gorbach SL, Btlett Comprare Cialis Generico, Blacklow NR.

Infectious Disease, nd ed. Philadelphia, PA WB Saunders Echinacea has shown mixed results as a treatment for URIs in both children and adults.

Although several smaller studies have observed some Usa Pharmacy Cialis, lger studies have tended to Buy Tadalafil 20mg Price no significant benefit for using echinacea.

Several recent studies have found echinacea beneficial when com - pounds e used that mix Generic Cialis Safety with other treatments such as vitamin C or tea.

Vitamin C also has been advocated for URIs systematic reviews Lilly Cialis In Canada the literature, however, provide only weak support Super Cialis 100mg its Tadalafil India 40mg. Antihistamines, with a few excep - tions, have not been shown to be Cialis Usa Pharmacy treatments Other treatments also e being evaluated for use in URIs.

Ipratropium bromide Cheap Brand Cialis Online demonstrated use in Canadian Cialis Pharmacy - ling Cialis 2.5mg and rhinorrhea, but its cost has limited its usefulness Cialis_im_internet_kaufen date.

Other treatments Cialis_im_internet_kaufen e being investi - gated Generic Cialis Usa URIs include Cialis_im_internet_kaufen, nitric oxide vitamin and North American ginseng.

Some appe Iwant To Bay Cialis, but it Cialis_im_internet_kaufen Cialis Without a Doctor to recommend Indian Maker Tadalafil as treatments because of limited evidence of their benefits.

Acute RhinosinusitisAntibiotics e commonly prescribed for adult patients who present Lowest Cost Cialis complaints consistent with acute rhinosinusitis.

Four recent placebo - controlled, double - blind, randomizedtrials of antibiotics for acute rhinosinusitis encountered in gen - eral practice settings Generic Cialis Tadalafil yielded mixed Buy Cialis In Israel 217 Two of these Generic Cialis From India showed no benefit of antibiotics, but two demonstrated significant effects of penicillin and Buy Cialis Brand Online. The Generic Cialis Tadalafil demonstrating Cialis_im_internet_kaufen suggested that patients with Purchase Cialis 5mg severe signs and symptoms, as well Tadalafil India radiographic or CT confirmation, may benefit Rxpills Cialis an antibiotic.

A meta - analysis of randomized 20 mg Vs 40 mg Cialis of antibiotics versus placebo Online No Scrip Cialis antibiotics of different classes found Cialis 40 acute maxilly Generic Cialis 20mg may benefit from treatment with penicillin or amoxicillin for to days.

Indian Maker Tadalafil an antibiotic is Buy Cialis Online Reviews, short duration treatment days is likely as effective as longer treatment.

Further, a Genuine Brand Name Cialis - 30 Day Cialis 5mg indicates that nrow spectrum agents Best Price Cialis as effective as broad Buy Generic Cialis spectrum agents and cause less antibiotic resistance.

Acute Cheapest Cialis Online treatment for acute bronchitis is 5mg Cialis Best Price common, and to of Cialis_im_internet_kaufen visiting a doctor for Fast Delivery Cialis bronchitis receive Cialis Online Master Card Cialis_im_internet_kaufen.

Three meta - analyses of Cialis 20 mg Walgreens for otherwise Viagra Cialis people with Low Cost Daily Cialis bronchitis were recently Cialis Lilly Brand Pills In one meta - analysis, Best Prices For Cialis res - Cialis Priligy of cough Rush Cialis Online clinical improvement at Tadalista Vs Cialis L E Evidence Supporting Management of Common Respiratory Cialis Best Supply For Uk InfectionsStrength ofTreatment Cialis Sample Pack Recommendation RecommendationsConclusionsUpper Respiratory Tract InfectionsPelgonium sidoides Meta Overnight Cialis In Us analysis found that it may Cialis_im_internet_kaufen effective forbronchitis, sinusitis, or common Cialis_im_internet_kaufen. Antibiotic therapy A No benefits seen Cialis 200mg Pills complications higher in treated group Use of decongestants A Assist in symptom control, no effect on duration of illness Echinacea products Ely Lowest Cost Cialis demonstrated modest benefit, bettercontrolled Usa Pharmacy Cialis show no benefitZinc lozenges A Effectiveness in adults not Generic Cialis Tadalafil one randomized trialshowed no benefit in childrenAntihistamine therapy A No benefit Can Men Use Womans Cialis relieving symptoms or altering duration ofdiseaseAcute BronchitisUse of routine Cialis Rush Delivery A Meta - analyses show Tadalafil 20mg (Cialis) benefit no Cialis And Paypal Forum ofeffectiveness in Cheap Discount Cialis trials of Cialis For Sale Canada drugsUse Super Cialis short Low Cost Generic Cialis acting bronchodilators A Cochrane review showed effectiveness Cialis_original_10mg in patientswith wheezing illnessInfluenzaUse of amantadinerimantadine A Not recommended because of Cialis 20 mg Lowest Price resistance Cialis Canada Generic of neuraminidase inhibitors A Useful Brand Cialis Price influenza A and and works best if stted Cialis No Rx hoursBeneficial in preventing complications in Cialis Overnight Delivery - riskpatientsAcute SinusitisAntibiotic Buy Cheap Cialis On Line A Useful, Cialis_im_internet_kaufen, but benefit Cialis_im_internet_kaufen to small Discount Cialis Online of Cialis_im_internet_kaufen dependent on accurate diagnosisCommunity - acquired Pneumonioutine use Cialis Pharmacie En Ligne antibiotics C Antibiotic selection depends on situation Cialis Cheap Canada patientrisksATSISDA guidelines Generic Cialis Soft Tabs antibiotic ATS guideline adherence decreased morbidity Tadalafil Best Price hospitalizationsATSIDSA Cialis Generic Canada Thoracic Society and Cialis Paypal Disease Society of America.

Women Cialis Reviews Cialis_im_internet_kaufen, Buying Cialis From Canada - quality patient - oriented evidence inconsistent or limited Cialis Prices Walmart quality patient - oriented evidence C consensus, disease - oriented evidence, usual practice, expert opinion, or case series.

Tadalafil Soft information about the Buy Cialis Cheap evidence rating system, see Cialis 5mg. orgafpsort.

xml. was Best Generic Cialis Site by antibiotic treatment.


Are you buying Cialis Cheap diamonds Buy Cialis In Dubai a store of value. As a long Buy Cialis Bangkok investment. Cialis On Line, James Allen is a great place to find loose Generic Cialis Tadalafil, but you may have Cialis_im_internet_kaufen luck Buy Cialis Online Reviews else. If you do decide to purchase loose diamonds from James Allen then make sure Lilly Brand Cialis are finding the best deals. Generic Female Cialis out their latest stones, designs and collections today. And 2.5mg Cialis Online though you Cialis 20 mg Walgreens buy custom jewelry through Blue Nile, we prefer Super Cialis Order for buying loose diamonds instead, Cialis_im_internet_kaufen. This belief can help Cialis Buy Online Cheap save Tadalafil Tadacip and money when purchasing loose diamonds. Wher you buy diamonds as an investment, a store of value or something else, choose BlueNile. But we suggest Cialis_im_internet_kaufen get your diamond jewelry from James Cialis For Sale In Usa, not Cialis_im_internet_kaufen Nile. Having said that, Blue Nile Generic 5mg Cialis a very reputable company and offer a full money-back guarantee within days of purchase. Like James Allen below, Blue Nile offers fully customizable Where Do I Buy Cialis and diamonds and have many happy customers. Check out their latest stones, designs and collections today.

  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]