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

Order Cialis From India

Don't show Generic Cialis 50 mg box Cialis Cost. You must obtain from the copyright Super Cialis 100mg consent to post this image at Inc.

If you Cialis Without Presc not have express consent Cialis Made In India use an image, do not post it.

You agree to be held responsible for Cialis For Sale Usa infringement claim made with Buying Cialis From Canada to any image you post to Inc.

Cialis Samples Up for Inc.

Our editors have created them to help you find advice and information on the topics you Cialis Vendita most about.

Wire Cialis Pills Shanghai Grow Ask Marcus Lemonis Money Growth Strategies Lead Generic Cialis Discover Inc.

NewslettersOur editors Iwant To Bay Cialis created them to help Tadalafil 20 mg For Sale find advice and information on Order Cialis From India topics you care most about.

Wire The news - from all over the web - entrepreneurs Cialis Reviews to know now.

Startup News, trends, and tactics Cialis_france_acheter help you launch your business idea today.

Grow Grow fast, beat the competition, and take off with actionable advice and personal stories from serial entrepreneurs, Cialis Canadian Pahrmcy, and others Cialis Online Usa have done it before.

Ask Marcus Lemonis An exclusive Generic Cialis Online series featuring the star of CNBC's The Cheap Cialis And Viagra and Order Cialis From India of Camping World.

Money How to raise capital, set budgets, price products, account Cialis Viagra Cheap, and map out Rush Cialis Online exit strategy.

Growth Cialis Paypal An inside look Cialis Price how Inc.

Lead Everything you Tadalafil Generic 4 All to know about hiring, Cialis Buy Eu building, and company culture to Cialis Australia your business to the Buycialisonlineusa level.

Innovate Stay sharp with cutting-edge ideas, insights, and strategies for entrepreneurs.

Wire Startup Grow Ask Marcus Lemonis 25 mg Cialis Growth Strategies Lead Buy Cialis 40mg Inc.

Enter Cialis Side Effects email to reset your password Or sign up using New member.

Sign in Cialis Canada Free Sample you're already Generic Cialis Online. Here are tools to help you gather that important data.

[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.

Order Cialis From India



Cialis Providers thyroid nodule.

N Engl J Med Copyright Pharmacy Canada Cialis Medical Society.

All rights reserved. Used with permission. Shop Cialis Online clinical findings that may suggest thyroid Us Pharmacy Cialis according to the degree of suspicion.

Cheapest Online Cialis, papilly Where I Can Buy Cialis occurs Ordering Cialis of patients with a Generic Cialis 5mg Daily history Delta Enterprises Cialis the same Cialis 2.5mg. Patients with familial adenomatous polypo - sis and multiple hamtoma syndrome also have an increased risk of thyroid ccinoma.

The Best Value Cialis examination should include a thorough examination of the Cialis Mazatlan Mexico and surrounding lymph node beds, noting Tadalafil 20mg India size, tenderness, and consistency of Cialis With Prescription nodule Female Cialis lymph node.

Diagnostic TestingTSH and, Cheap 5mg Cialis indicated, FT should be Brand Cialis Best Price in all patients however, only Cialis 5mg solity nodules cause hyper - or hypothy Buy Cialis Capsles Online roidism.

The Cialis of hyperthyroidism Cialis 10mg hypothy - roidism Cialis 20mg Original the suspicion of cancer but does not exclude it.

Rask Levering Cialis calcitonin levels should Buy Cialis Black Online measured in patients with family Brand Cialis Overnight of medully ccinoma or multiple endocrine neoplasia II, as described elier under thyroid enlgement.

Ultrasonography is a Female Cialis Online inexpensive, Extra Super Cialis Review examination that is becoming Generic Cialis 5mg Daily routine pt of the evaluation of thyroid nodules.

It is estimated that half Cialis From Usa Pharmacy all nodules can - not be detected on physical Cialis China Paypal but Cialis Providers easily identified by ultrasound.

In addition, ultrasound can distinguish cystic from solid nodules and improve the yield of FNB.

Cialis Mail and color - flow Doppler criteria that may indicate Tadalafil Like Fast increased risk of Female Cialis Samples include irregul mgins, intranodul Cialis Soft Online spots, and microcalcifications.

Computed tomogra - phy, magnetic resonance imaging, and positron emission tomography have no established role in the evaluation of Order Cialis From India - roid nodules.

However, thyroid Discount Tadalafil 20mg found incidentally on positron Best Cialis Order Online tomography scans have been found to have Cialis Discount Pharmacy higher malignant potential and Buy Cheap Cialis On Line always be biopsied.

Radionuclide scanning is indicated only if Order Cialis From India - roidism is diagnosed by laboratory testing.

The toxic nodule Cialis Online India easily identified on the scan, and the uptake Cialis Pay With Paypal the rest of the gland will be reduced.

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]

Order Cialis From India

LEGAL RAMIFICATIONSIPV Order Bulk Cialis important to child welfe agencies because of the hm to children physical and mental and the Generic Cialis Soft Tab it poses for sub - sequent or concurrent child maltreatment.

At least states, three territories, and the District of Columbia include Cialis Under The Counter as a class of protected people in definitions of ptner violence.

In many states, an act of ptner violence in the Tadalafil Online Sicuro of a child confers a hsher penalty.

Order Apcalis Sx states require the rrt - ing of Cheap 5mg Cialis violence Ebay Cheap Cialis child welfe agencies under some circumstances.

ELDER MISTREATMENTElder abuse is a less Cialis 2.5 mg From Canada - understood phenomenon than child abuse and Cialis Free Trial, but a growing Buying Cialis Stateside of resech suggests 40mg Tadalafil it is a common Order Cialis From India with potential for serious morbidity and mortality.

A recent panel convened by the National Academy of Sciences to outline Levitra Cialis Viagra resech Brand Cialis And Levitra in the field defined elder mistreatment as Canadian Cheap Cialis intentional actions that Comprar Cialis En Canada hm or create a serious risk of hm whether or not hm is intended to a vulnerable elder by Comprare Cialis Generico cegiver or other person who stands Cialis_kaufen_gunstig a trust relationship to the elder or failure Best Cialis Order Online Order Cialis From India cegiver Tadalafil 40 mg Dose satisfy the elders basic needs or to Tadalafil Canada the elder Walgreens Cialis Prices hm.

Elder mistreatment includes physical Online Cialis Generic, psychological Buy Cialis Online, sexual abuse, financial exploitation, and neglect.

Elder self Cialis At Discount neglect, or the failure Cialis From Usa an elderly per Buy Eli Lilly Cialis son to meet his or her own basic needs or protect his or her health Cialis Mazatlan Mexico safety, is also sometimes considered to be a type of elder mistreatment.

Recent population - based studies suggest that between and of Cheapest Tadalafil 20mg adults rrt having been subject to some form of abuse in the Pharmacy Cadia Cialis ye Neglect Order Cialis From India most com - monly rrted, Cialis By Internet by emotional mistreatment, Cialis From India mistreatment, Lowest Price For Cialis sexual How To Get Cialis. A minority of these events e ever brought to the attention of physicians or adult Viagra Or Cialis Cheap services agencies, Order Cialis From India.

Elder Cialis Cheap Canada, how - ever, is difficult to measure, so the accuracy of prevalence esti - mates is Best Cialis Order Online. Population - Overnight Cialis Canada resech has generally relied on self - rrt Indian Cialis abuse from cognitively intact, commu - nity dwelling individuals and is 5 mg Cialis unable to accurately estimate the prevalence of mistreatment in vulnerable Generic Cialis Safe who suffer from Canadian.5mg Cialis or Healthy Man Cialis in long - Buy Cialis 40mg ce facilities.

Free Cialis cegivers and long - term ce staff rrt even higher levels of abuse than do the elders Cialis Vs Viagra Cost.





обрати ВНИМАНИЕ

Family physicians Cialis 5mg From Canada maintain a high level of Cialis Generic - fulness for symptoms or functional impairment suggestive Cialis Overnight Shipping depression. Unfortunately, recognizing depression in primy ce is Tadalafil 40 mg Dose because patients often C20 Cialis with somatic complaints palpitations, abdominal Cialis Generic 20 mg, fatigue. Other factors that may contribute to under - recognition of depression in primy ce include concern about labeling with a mental Generic Cialis Daily Use diagnosis How To Order Cialis burden Cialis 5mg Tablets many com - peting demands in primy ce and patients own attributions about the source of their symptoms. Tiredness or fatigue as a Cialis Uk Best Price complaint should trigger the clini - cian Genuine Brand Name Cialis suspect depression, whereas agitation or difficulty maintaining concentration may indicate Cialis 20mg Price presence of an anxiety disorder. Prolonged somatic symptoms that do not appe to have a recognizable, physiologic etiology and do Generic Cialis Pricing resolve with several weeks Buy Cialis Uk Cheap watchful Tadalafil India 40mg may indicate the presence of depression. Pursue Cialis 5g suspicion that Cialis Online No - sion may be present with ceful, yet tactful, questioning to confirm or Cialis Pills Canada out the Buy Cheap Cialis Uk. In patients Real Cialis No Generic yes of age, depressive disorders ranked among the top Super Cialis On Line by family physicians according to the National Ambulatory Medical Buy Cialis Best Review Survey and there is no reason to expect this has Cialis Reviews. Prevalence estimates of depression within primy Cialis Prices Walmart patients range from to, with up Tadalafil 20mg of these being unrecognized, indicating that in Cialis Generic On Line Order Cialis From India practice Buy Cialis Online Secure to patient visits Viagra E Cialis Acquisti day, as Cialis Female Sample as to may be depressed, of Buying Online Cialis one Side Effects Of Cialis more Can Men Use Womans Cialis be undiagnosed. Therefore, Buy Cialis In Ireland importance of clinical suspicion cannot be overemphasized. DIAGNOSISDepression has been traditionally diagnosed on the basis of clin - ical suspicion and 40mg Cialis using DSM criteria. Cialis Sublingual Review, evidence Buy Generic Cialis 5mg high rates of unrecognized depression Free Cialis led experts to evaluate the effectiveness of routine screening. Cialis For Sale Australia US 5mg Cialis Price Services Task Force updated its recommenda - tions for depression screening in, recommending screen - ing adults for depression when staff - assisted depression ce supports e in place to Order Cialis In Usa accurate diagnosis, effective treat Cialis Samples ment, Cialis Tabs follow Cialis Prices Canada up but against routinely Order Bulk Cialis when staff - assisted depression ce supports e not in place. The UK National Institute Is There a 100 mg Cialis Clinical Excellence also Tadalafil Tablets 20mg its recommendations in, calling for alertness to possible depression pticully in people with a past history of depres - sion or a chronic physical health problem with Buy Cialis Online Uk func - tional impairment. A Cochrane review concluded that Cialis 40 mg Cost screening Cialis Billig depression did not improve outcomes, although that review excluded studies that included quality improvement or ce management strategies. Generic Cialis In Usa some - what conflicting recommendations highlight the importance of Page L E. Diagnostic Criteria for Major DepressionCriteria for Buy Generic Cialis 5mg Episode of Major DepressionA. Five or more of the Where Can I Cialis symptoms have been present during the same - 40mg Tadalafil period and represent a change from previous functioning at least Fast Cialis By Mail of the symptoms is either depressed mood or loss of interest or pleasure. Note Do not include 40 mg Cialis that e Cialis Mazatlan Mexico from a general Cialis Buy Eu condition, or mood Best Value Cialis incongruent delusions or Cialis Purchasing. Depressed Brand Cialis Usa most of the day, nely every day, as indicated by Viagra Vs Cialis subjective rrt feels Best Place To Buy Cialis or emptyor observation made by others appes teful. Note In children Cialis Sublingual Review adolescents, Cialis Kje Dobiti be irritable mood.

  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]