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In December 2003, the Food and Drug Administration approved Cialis for sale in the United States as the third ED prescription drug pill (after Viagra and Levitra). Cialis`es 36-hour effectiveness earned it the nickname, "The Weekend Pill"

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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 cGMP in smooth muscle cells. Cyclic GMP relaxes smooth muscle and increases blood flow to the corpus cavernosum.

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