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When it blocks PDE-5, Cialis helps an erecting pass off by allowing certain muscles in the penis to slow down and the phallus to filling with blood. The FDA's favourable reception of sildenafil citrate in 1998[26] was a ground-break commercial message case for the handling of ED, with gross sales surpassing US$1 million. Subsequently, the FDA sanctioned both vardenafil[27] and tadalafil in 2003.