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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. Tadalafil was approved in 2009 in the United States for the treatment of pulmonary arterial hypertension[29] 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.

CGMP levels are kept in check by an enzyme called phosphodiesterase 5, or PDE5. Erectile dysfunction can occur when PDE5 breaks down cGMP faster than it can be produced. Urologists say their patients tend to report fewer side effects with Cialis than Viagra, and our January 2024 survey backs up this claim. Zero side effects were reported by nearly 83% of survey respondents taking Cialis or generic tadalafil, but only 28.5% of those taking Viagra or generic sildenafil reported no side effects.

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