NAD+
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell, where it helps turn food into energy and supports DNA repair. It is not a peptide. Vials are given by IV drip or injection, often in wellness clinics. This page covers injected NAD+ itself. Oral "NAD boosters" such as nicotinamide riboside (NR) and NMN are different compounds with their own, larger set of trials.
Approval status
Not an approved drug in the US or EU. NAD+ is in FDA’s compounding Category 1 (substances under evaluation), so while FDA reviews it, the agency does not intend to act against pharmacies that compound it under its interim policy. Reviews in 2026 call IV NAD+ experimental, supported mainly by small, uncontrolled studies.8923
What it’s used or studied for
- Human studies
Small pilot studies of IV NAD+ in adults mainly measured blood and urine levels, lab markers and tolerability, not clinical benefits.45
- Human studies
One randomized trial in China added a short IV course to standard care in ischemic heart failure; ejection fraction improved modestly, but clinical events did not differ significantly.6
- Human studies
Promoted for addiction and withdrawal; published data are limited to uncontrolled case series in which NAD+ was mixed with other infusions.7
- No studies
Promoted for anti-aging, energy and wellness; a 2026 systematic review found no outcome trials of injected NAD+ for these uses.32
Each label shows how strong the evidence is: an approved use, human studies, animal or lab studies only, or a popular claim with no published studies. Being studied is not the same as being proven safe or effective.
Side effects
Common
- Nausea
- Stomach cramps
- Flushing
- Chest pressure or discomfort
- Faster heart rate during the infusion
From small IV studies and clinic records. Symptoms happened during infusions, were worse with faster drips, and stopped when the infusion ended. Long-term safety has not been studied.25
Cautions
- Faster infusion rates were linked to more nausea, flushing and chest pressure.2
- Safety data are very sparse for people with kidney or liver disease or active cancer.2
- Athletes: WADA bans IV infusions or injections of more than 100 mL in any 12-hour period at all times (M2.2), except during hospital treatment, surgery or clinical tests.10
Sources
- PubChem: Nicotinamide adenine dinucleotide (NAD, CID 5892)
- Alangari A et al. Narrative review of intravenous NAD+ and NAD+ precursors in wellness and translational medicine. Front Aging. 2026
- Gallagher C, Emmanuel OO. NAD+ supplementation for anti-aging and wellness: a PRISMA-guided systematic review. Ageing Res Rev. 2026
- Grant R et al. A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD+. Front Aging Neurosci. 2019
- Reyna K et al. Intravenous infusion of NAD+ versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. Front Aging. 2026
- Yu X et al. Effect of nicotinamide adenine dinucleotide on heart failure caused by ischemic cardiomyopathy: a randomized, placebo-controlled trial. Am J Cardiovasc Drugs. 2026
- Blum K et al. Complex NADASE infusions improve clinical outcome in substance use disorder: descriptive annotation in fifty cases. J Addict Psychiatry. 2024
- FDA: Bulk drug substances nominated for use in compounding under section 503A (categories, updated May 14, 2026)
- FDA: Bulk drug substances used in compounding under section 503A of the FD&C Act
- WADA 2026 Prohibited List
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