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In a clinical trial, tadalafil administration was associated with enhanced oxygenation of the cerebral microvasculature, indicating an improvement in perfusion within this vascular network among patients with stroke with cerebral small-vessel disease

So, we cant just put it into one category or another

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[11] The trials included a total of 911 participants

For example, C16-carnitine (10 M) may impair mitochondrial function in rat ventricular myocytes by accelerating ROS production and increasing the probability of mitochondrial permeability transition pore (mPTP) opening, whereas low concentrations (1 and 5 M) of C16-carnitine lightly hyperpolarize the m but do not open the mPTP [293]