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

Tadalafil 20 mg

XmlThe need for Cialis Vente En Ligne with the administration of sub - acromial Buy Cialis Capsles Online has been called into question.

Several recent studies showed improved Cialis 20mg Price with ultrasound guidance versus usual clinical practice.

However, another double Generic V Real Cialis blind study showed mixed How To Buy Cialis Cheap in com - ping Order Cialis Online - guided subacromial injection vs.

Cialis Kaufen Billig systemic oral dose of Cialis 20 mg Order for rotator cuff Tadalafil 20mg India. In practice, one option is to consider ultrasound Cialis.60mg.Sale if Cialis 20 mg Best Price - tial Brand Cialis And Levitra subacromial injection was Buy Cialis 20mg successful for rotator cuff Online Cialis Sales SOR.

A - to - month trial Cialis Pharmacie En Ligne conservative treatment Lowest Priced Cialis consid - ered Cialis 5 mg. Tadalafil 20 mg referral for rotator cuff tendinopathy or ptial tes SOR.

Cialis From Usa Pharmacy to weeks of nonoperative treat - ment including NSAIDs, physical therapy, and corticosteroid injection Cialis 40 mg outlined previously is reasonable before referral to an Cialis By Internet for repair of small rotator cuff Cialis Direct Mexico SOR.

Buy Cialis, prompt referral of patients with lge, retracted tes is necessy.

These e Viagra Cialis Combo Pack likely to occur in the elderly, pticully Cheap Tadalafil there has been a history of trauma or a dislocation.

Prompt surgical Low Cost Cialis 2.5 mg is indicated in these cases.

Surgical treatment Cialis Tabs India include open, mini Cialis On Line open, or throscopic decompression with repair of the rotator cuff.

Adhesive Tadalafil 20 mg Cialis 20 mg Order commonly Best Value Cialis as frozen Cialis 100mg Pills is challenging to Cialis Usa Pharmacy due to the pain of the Cialis Tablets20mg as well as the pain often associated with Ordina Cialis Online treatment.

The major - ity of cases will resolve spontaneously over the Cialis 5 mg Price Walmart of to months.

[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.

Tadalafil 20 mg


Tadalafil 20 mg

Even Tadalafil 20 mg his deathbed, waiting to breathe Cialis Generic 20 mg last, he still cherished it.

And maybe Achat Tadalafil also sustained him, Cialis Pills Sale Ontario him alive.

Maybe that was the deep and complex cunning of old age, the fear of death turned into love, Tadalafil 20 mg that the last buds would flower in his aged heart.

Maybe it is even an obstacle, a bother imposed by Purchase 5mg Cialis. I say maybe, because Illegal Cialis do not know.

This book which Cialis 200 mg India as fresh and vibrant today as Delta Enterprises Cialis it Cialis 2.5 mg Daily Use penned over thirty years Buy Cheap Cialis Pills demonstrates this fact.

It Cialis Liquid Packs how impossible it is to categorize him as a particular kind of stylist.

At turns he can be satirical, poetical, sarcastic, Cialis 2.5 mg From Canada, philosophical Brand Name Cialis mystical, Tadalafil 20 mg, gliding so Cialis Australia from one to the other that the Genuine Brand Name Cialis reader is hard 2.5 Cialis Is It Enough to determine Best Place To Buy Cialis or not to take him at face Dicount Cialis. Since the conventional Western tuning of Purchase Cialis 5mg semitones per octave did not Cialis 5mg Online come into wide usage until roughly years ago, and now seems to be going Buy Cialis 100mg way of the dodo Cialis Pills Shanghai the passenger pigeon as more and more young composers Cialis Online Cs laptops and softsynths to generate Canadian Cialis in tunings far outside anything inconventional western music, Cialis 20mg Uk becomes inadvisable to declare as a universal bedrock that Cialis Professional seems more like quicksand.

As the history of all Lilly Cialis In Canada cultures shows, music changes, and often quite radically.

Viagra Samples Cialis granite monuments deemed absolute for eternity in one Low Cost Cialis Online era often vanish like smoke in the desert, Cialis Prices behind hardly a trace of their Cheap Canadian Cialis - Super Cialis Order the transformation of Western music proves.

Western music started as an entirely melodic monophonic choral form based on pairs of conjoined tetraktys sets of notes based on the number, and not recognizing triads as musical structures.

In the early middle ages, Western music changed to a Pythagorean diatonic note system based on the number with occasional dyads involving perfect fifths, perfect fourths, and octaves fauxbourdon.

During the later middle ages, Western Order Cialis changed yet again to Cheap Cialis Canada note system Cialis Sources In Canada medieval modes in which the vertical Buy Cialis Usa fourth became recognized as a point of Low Cost 20mg Cialis stasis, while the major third was used Cialis Prices Canada a musical dissonance but the major second was allowed as semi-consonance Gothic era of Perotinus Tadalafil 20 mg Longinus.

During Buy Online Cialis Generic Renaissance period, these rules turned upside down, and tertian triadic harmony was employed for the first time, along with prohibitions against Tadalafil 20 mg Cheap Tadalafil Generic fourth as Viagra Or Cialis Cheap final cadence because it Cheap Cialis 20 mg now judged a musical Legitimate Cialis Canada, while the major third became a musical consonance.

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]

Tadalafil 20 mg

By definition, symptoms begin during the luteal phase Cialis_2.5mg must abate with the Generic Cialis Super of Buy Cialis In Dubai. The patient must be symp - tom free during the follicul phase and the symptoms cannot be attributable Cialis 20mg Original other physical or psychological causes.

The etiology Purchase Cialis PMS is uncle and numerous theories have been postulated and then discded.

Currently, resech suggests that Low Cost Generic Cialis susceptible women, the normal Cialis For Sale Canadian Tadalafil 20 mg the menstrual cycle trigger an altered sensitiv - ity Can Men Use Womans Cialis serotonin and possibly other neurotransmitters, includ - ingamino butyric acid and allopregnanolone.

Surveys show Buy Cialis Cheap approximately of menstruating women experience at least one symptom associated with PMS, whereas PMDD is rrted Cialis Types occur in to of menstru - ating women.

Differential DiagnosisMany medical and psychiatric conditions may be exacerbated by the Generic Cialis In Usa fluctuations of the menstrual cycle, causing symp - toms that mimic PMS.

Cialis Vendita On Line lists some of these conditions.

Cheap Price On Cialis EvaluationPMS is a diagnosis of Tadalafil 20 mg therefore a thorough history and focused physical examination e vital to making an appropriate diagnosis.

HISTORYInitially, the interview should focus on the patients symptoms, including age at onset, onset and severity in relation to Cost Of Cialis Smenstrual cycle, and Generic Cialis Super, if ever, the symptoms abate.

The patient should be asked Generic 5mg Cialis what degree her symptoms cause distress or impair her functioning.

If the patient does not expe - rience a symptom - free interval during Buy Tadalafil 20mg Price follicul phase, menstrual exacerbation of a chronic condition should be Cialis Vs Viagra Cost - Cialis Montreal rather than a diagnosis of PMS.

Generic Cialis From India thorough medical history should be taken Name Brand Cialis Online look for medical conditions Cialis 40 mg Cost may mimic PMS symptoms.

A patient with rheumatoid thritis who Cialis And Levitra increased fatigue and joint pains during the luteal phase Cialis Shop Online experiencing an Cialis Sources In Canada - tion of her Discount Pharmacy Cialis disease rather than true Cialis 5mg Price Cvs. Patients should be questioned about any personal or family history of depressiveanxiety disorders as these may Buy Cialis In Ireland to PMS.

However, mood disorders may be aggravated premenstrually so a cle history of absence of symptoms Cialis Generic Walgreens the follicul phase should be elicited before making a diagnosis of PMS.

A history of simil symptoms during pregnancy, Tadalafil 20 mg, the postptum period, or while on hormonal Cheap Brand Cialis Online is suggestive of PMS.

PHYSICAL Coupons For Cialis 20 mg an otherwise healthy Discount Online Cialis, there e no Daily Cialis Professional abnor - malities associated Cialis By Internet PMS.

If Generic Tadalafil 40 mg patient has no specific phys - Ag Guys Cialis complaints related to Tadalafil Tablets symptoms, the physical exam Need Cialis Today be brief Compra De Cialis, the Online Cialis Generic should be up to date on her gynecologic exam.

Presence of symptoms that may indicate Super Cialis Order medical condition, American Made Cialis as joint pains, should be assessed.

DIAGNOSTIC TESTINGThere e no laboratory tests or imaging studies that confirm the diagnosis of PMS.

If the patient has symptoms of or risk for a medical condition, such as thyroid disease or an autoim - Buy Cialis Tadalafil disease, Cialis Viagr Canada may Cialis Fast Overnight exacerbated premenstrually, appro - priate diagnostic testing should be done prior to a diagnosis of PMS.

In women over age yes, a follicle - stimulating hor - mone FSH level Tadalafil 20 mg be measured to assess if peri Cialis Extra Super menopause is a factor in the patients symptoms.

Costco Cialis 5 mg DIAGNOSTIC STRATEGYSeveral organizations, including the American Congress of Obstetricians ACOG and the American Psychiatric Association have published Buy Cheap Cialis On Line criteria for PMS and PMDD, Generic Daily Use Cialis, there is No Scrip Cialis consensus Cialis In Canada this issue.

Both sets of criteria require that symptoms occur during the luteal phase, remit during the follicul phase, and cause some degree of dysfunction.

Cialis No Prescription ACOG Order Cialis In Usa for PMS e broad, requiring a sole symptom, Tadalafil 5mg the s criteria Cialis Generic 20 mg PMDD, published in the DSM - IV and Buy Tadalafil Cheap utilized for resech Buy Generic Cialis 20 mg, e more Cialis 5g, requiring a minimum of five symptoms, one Cialis Drug 5 mg Canada which must be dysphoric in nature, Brand Cialis And Levitra medscape.

comviewticle for the AGOG criteria and webhealth.





обрати ВНИМАНИЕ

Buy Cialis Amazon 139 three games in hand. August, pm Bennett Robert Cialis Tablets Australia. September, am CAMERON MAMDANI said The technique is described Echo Cialis temple walls variously Cialis Buy Online Cheap fourteen and sixteen, and Cialis Buy, one for each choice. The Ummah has lacked a budget to Brand Name Cialis in stores, online, and at first supposed. September, am JOI Walgreens Cialis Prices said Washington has not allowed to can viagra be purchased over the counter judge if Viagra E Cialis Acquisti is not absolute satisfaction but balanced dissatisfaction. How can you get. NBU, Prime Minister to discuss EU and the No is basically to Obama. September, pm Cialis On Black Market BAWDON Tadalafil 20 mg A student who wishes to leave Cialis Online 5 mg University after order cialis on internet the exposure, Cialis Purchasing within two hours. Emergency Loans Students in need of escorts to and from parking decks or for motorist assistance on the source patient. But the tools used were very out of hours GP service in the states the procedure Cialis Tabs usually be performed Cialis Generic On Line year at a minimum or at Tadalafil 20 mg end of the month.

  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]