BUY CIALIS ONLINE
Cialis redirects here. For the Central Asian kingdom, see Karasahr. Tadalafil Systematic ( IUPAC) name (6 R- trans)-6-(1,3-benzodioxol-5-yl)- hexahydro-2-methyl-pyrazino pyrido indole dione Clinical data Trade names Cialis AHFS/ Drugs.com monograph MedlinePlus a604008 Prescription only Routes Oral Pharmacokinetic Cialis redirects data Bioavailability varies Protein binding 94% Metabolism CYP3A4 (liver) Half-life 17.5 hours Excretion feces (60%), urine (30%) Identifiers CAS number 171596-29-5
Y ATC code G04 BE08 PubChem CID 110635 DrugBank DB00820 ChemSpider 99301

Y UNII 742SXX0ICT

Y KEGG D02008

Y ChEBI CHEBI:71940

Y ChEMBL CHEMBL779

Y PDB ligand ID CIA ( PDBe, RCSB PDB) Chemical data Formula C 22 H 19 N 3 O 4

Molecular mass 389.404 g/mol

SMILES
O=C1N(CC(N2[C@@H]1CC3=C([C@H]2C4=CC5=C(OCO5)C=C4)[N]C6=C3C=CC=C6)=O)C
v InChI
InChI=1S/C22H19N3O4/c1-24-10-19(26)25-16(22(24)27)9-14-13-4-2-3-5-15(13)23-20(14)21(25)12-6-7-17-18(8-12)29-11-28-17/h2-8,16,21,23H,9-11H2,1H3/t16-,21-/m1/s1
Generic

Y
Key:WOXKDUGGOYFFRN-IIBYNOLFSA-N
Y Y (what is this?) (verify)
Tadalafil is PDE5 inhibitor marketed in pill form for treating erectile dysfunction (ED) under the name Cialis, and under the nameGeneric Cialis

Adcirca 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 SpherGeneric Cialsical cells trapped air travel.

Generic Cialisa combination of BPH and erectile dysfunction (ED) when the conditions coincide. It initially was developed by the biotechnology company ICOS, and then again developed and marketed world-wide by Lilly ICOS, LLC, the joint venture of ICOS Corporation and Eli Lilly and Company. Cialis tablets, in 2.5В mg, 5В mg, 10В mg, and 20В mg doses, are yellow, film-coated, and almond-shaped. The approved dose for pulmonary arterial hypertension is 40В mg (two 20-mg tablets) once daily.

ED
kyphosis kyphosis as Cialis Cials
BUY CIALIS ONLINE BUY CIALIS ONLINE
rights to commercialize tadalafil for pulmonary arterial hypertension in the Buy Cialis United States to United Therapeutics for an upfront payment of $150 million.
Contents
1 Side effects
2 Drug interactions
3 Pharmacodynamics
3.1 Selectivity Buy Cialis compared with other PDE5 inhibitors
4 History
4.1 Marketing
5 References
6 External links

Tadalafil has been used in 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 Buy Cialiseffects 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 Buy Cialis 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, Buy Cialisthe U.S. Food and Drug Administration found that tadalafil (along with other PDE5 inhibitors) was associated with vision impairment related to NAION ( nonarteritic 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 Buy Cialisthat they were not able to draw a cause and effect relationship, given these patients underlying vascular risk factors or anatomical Buy Cialisdefects. 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 deafness associated with use of PDE5 inhibitors.
[2 ] Drug interactions [ edit ]

Since PDE5 inhibitors such Buy Cialis as tadalafil may cause transiently low blood pressure ( hypotension), organic nitrates (poppers)

should not be taken for at least 48 hours after taking the last dose of tadalafil. Using organic nitrites (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.
[3 ] In the event

of a medical emergency, paramedics and medical personnel should be notified of any recent doses of tadalafil.
Tadalafil is metabolized Buy Cialis 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

This section does not cite any references or Buy Cialis sources. Please help improve this section by adding citations to reliable sources. Unsourced material may be challenged and removed. (February 2011)

Although sildenafil ( Viagra), vardenafil ( Levitra), and tadalafil (Cialis) all work by inhibiting PDE5, tadalafil's pharmacologic distinction is its longer half-life (17.50 hours)

resulting in longer duration of action, Buy Cialis and so partly responsible for The Weekend Pill sobriquet. Furthermore, the longer half-life is the Buy Cialis 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.
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