Compounds / NAD+

NAD+

Nicotinamide adenine dinucleotide · nadide · coenzyme I · NAD

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme, a helper molecule that enzymes need, and it's found in all living cells1,9. It isn't a peptide. Peptides are made of amino acids, and NAD+ is a dinucleotide with no amino acids in it2–3.

NAD+ injections and IV drips aren't FDA-approved6. On FDA's May 14, 2026 compounding list, NAD is in Category 1, "under evaluation"4. The human studies of IV NAD+ are few and small, and the best dose hasn't been worked out11–12.

Status
Not FDA-approved
Type
Coenzyme, not a peptide
Human evidence (IV)
A few small studies
Human half-life
Not published

By PeptideTracker editorial team · Updated November 9, 2026 · 19 sources

What is NAD+?

NAD+ (nicotinamide adenine dinucleotide) is a helper molecule, or coenzyme, found in every living cell. In metabolism it carries electrons from one chemical reaction to the next1. It's often sold next to peptides, but it isn't one, because it contains no amino acids2–3.

Your body makes NAD+ from smaller building blocks (precursors), including nicotinamide riboside (NR), a form of vitamin B316. Interest in topping it up comes from the idea that NAD+ falls with age, but a 2026 review notes that recent large human studies found whole-blood NAD+ doesn't fall with healthy aging on its own11.

Clinics and wellness businesses increasingly sell NAD+ as IV drips, even though those drips have had little testing for safety or effect10.

What have studies of NAD+ injections actually tested?

Studies of IV NAD+ show that blood levels go up, but none has shown an anti-aging or wellness benefit. A 2026 systematic review of 33 human studies found no outcome trials of IV or intramuscular NAD+ for those uses12.

Studies of NAD+ given directly into the body
StudyWhoWhat was givenWhat it found
Grant 2019, pilot98 healthy men (3 more got saline)750 mg IV over 6 hours, onceBlood NAD+ didn't change for 2 hours, then was up 398% at 6 hours. No adverse events
Reyna 2026, records review106 clients of a US clinic500 mg IV a day for 4 daysAll 6 had stomach and chest symptoms during the drip. Liver, kidney and inflammation tests stayed in the normal range
Yu 2026, randomized13180 adults with heart failure, China10 mg IV a day for 7 days, or placeboHeart pumping strength (ejection fraction) 45% vs 42% at 1 month. Heart events over 6 months not clearly different
Yu 2026, randomized14120 adults after a heart attack, China10 mg IV a day for 7 days, or placeboEjection fraction 56% vs 53% at 30 days. No difference in heart events over 6 months
Gallagher 2026, review1280 rodent studies, 33 human studiesMostly oral precursorsRodents often improved. In people, results were mixed or null, and no IV or intramuscular NAD+ outcome trials were found

The 750 mg dose was picked to match a common clinic routine9, and the 500 mg course was the compounding pharmacy's suggested "loading dose"10. Study doses, not recommendations.

Who ran the studies matters here. The 2019 pilot was funded partly by an NAD+ company9, and the 2026 records review was designed and run by the clinic company that employed the researchers, which the authors say may have caused bias10.

Is NAD+ safe? What isn't known

The long-term safety of NAD+ injections isn't known. A 2026 review says long-term safety data are lacking, and that the best dose can't be worked out from current evidence11. We found no published human half-life, and no studies of NAD+ injected under the skin.

Side effects during IV drips are well described. The same review lists nausea, cramping, flushing and chest discomfort11. In the clinic records review, all 6 people reported cramps, diarrhea, nausea, vomiting, a faster heart rate and chest pressure during the drip. The symptoms stopped when it ended, but they made the drips take longer, about 97 minutes on average10.

FDA has flagged contamination twice. In October 2024 it warned compounders not to use food-grade NAD+ for IV products, after reports of severe chills, shaking, vomiting and tiredness that fit with bacterial toxins (endotoxins)7. In January 2026 it told one outsourcing facility that three patients given its NAD+ from one vial were sent to the emergency room with low blood pressure and uncontrollable shaking, and that a vial from the same batch had too much endotoxin8.

Are NMN and NR the same as NAD+ injections?

No. NMN (nicotinamide mononucleotide) and NR (nicotinamide riboside) are precursors your body turns into NAD+, and they're swallowed as supplements, not injected15–16. They've been tested in more people than NAD+ drips, with mixed results.

Trials of oral NAD+ precursors
TrialWhoWhat was givenWhat it found
Yoshino 20211525 women with prediabetesNMN 250 mg a day or placebo, 10 weeksMuscle responded better to insulin
Dollerup 20181640 men with obesityNR 1,000 mg twice a day or placebo, 12 weeksNo better insulin sensitivity or body composition. No serious side effects
NOPARK 202618410 people with early Parkinson diseaseNR 500 mg twice a day or placebo, 52 weeksSymptom scores slightly worse than placebo
Yang 2026, review1915 NMN trialsNMN 250 mg to 2,000 mg a day, 14 days to 24 weeksNo rise in side effects. No clear change in weight, blood sugar or cholesterol

How do you work out the strength of a mixed vial?

The strength of a mixed vial is the mg of powder divided by the mL of water added. On a U-100 insulin syringe, 100 units is 1 mL, so 10 units is 0.1 mL. There's no approved NAD+ product or verified vial label to base an example on, so this page has no NAD+ calculator and no dose.

If you're checking the math on a vial you already have, the general reconstitution calculator turns vial mg, water and an amount into units. It does the arithmetic only.

NAD+ fact sheet

Also called
Nicotinamide adenine dinucleotide, nadide, coenzyme I, NAD or beta-NAD (β-NAD)2
Type
A coenzyme found in all living cells. In metabolism it carries electrons from one reaction to another1. It's a dinucleotide, not a peptide, because peptides are chains of amino acids2–3.
Status (US)
Not FDA-approved. We found no NAD+ product in Drugs@FDA6. For pharmacy (503A) compounding, NAD and NADH are in Category 1, "under evaluation" (list updated May 14, 2026)4. FDA says it doesn't intend to take action against compounders who use Category 1 substances, as long as they meet the conditions in its guidance5. That isn't approval.
FDA warnings
In October 2024, FDA warned compounders not to use food-grade NAD+ for IV products. It had reports of severe chills, shaking, vomiting and fatigue after NAD+ injections, some needing medical treatment, which fit with bacterial toxins (endotoxins)7. In a January 20, 2026 warning letter, FDA said NAD+ isn't on the 503B list for outsourcing facilities. Three patients given NAD+ from one vial were sent to the emergency room, and a vial from the same batch had too much endotoxin8.
Status (UK)
No NAD+ medicine is listed on the UK electronic medicines compendium (eMC), searched November 8, 2026.17
Doses used in studies
IV only: 750 mg over 6 hours, once, in 8 healthy men9. 500 mg a day for 4 days in 6 clinic clients10. 10 mg a day for 7 days in heart patients in China13–14. A 2026 review found no outcome trials of NAD+ injected into muscle12, and we found none of NAD+ injected under the skin. These are study doses, not recommendations.
Side effects reported during IV drips
A 2026 review lists nausea, cramping, flushing and chest discomfort11. In one clinic's records, all 6 people given NAD+ by IV reported stomach cramps, diarrhea, nausea, vomiting, a faster heart rate and chest pressure during the drip, which stopped when it ended10. The 8 men in the 750 mg study had no adverse events9.
In the blood
No human half-life has been published that we could find. With 750 mg over 6 hours, blood NAD+ didn't rise for the first 2 hours, was up 398% at 6 hours, and was still raised 2 hours after the drip ended.9

Questions

Is NAD+ a peptide?

No, NAD+ is not a peptide. Peptides are made of two or more amino acids. NAD+ (nicotinamide adenine dinucleotide) is a dinucleotide, a coenzyme with no amino acids in it, and it's found in all living cells. Your body makes NAD+ itself, and niacin (vitamin B3) is one of the building blocks it uses.

Is NAD+ FDA-approved?

No. We found no NAD+ product in FDA's Drugs@FDA database (searched November 8, 2026). On FDA's 503A compounding list updated May 14, 2026, NAD and NADH are in Category 1, under evaluation. FDA says it doesn't intend to take action against pharmacies that compound with Category 1 substances if they meet the conditions in its guidance, but that isn't approval. In a January 20, 2026 warning letter, FDA said NAD+ isn't on the separate 503B list used by outsourcing facilities.

What did studies of NAD+ IV find?

Studies of NAD+ IV drips show that blood levels go up, but they don't show wellness or anti-aging benefits. In a 2019 pilot study, 8 healthy men got 750 mg of NAD+ over 6 hours. Blood NAD+ didn't change for the first 2 hours, then was up 398% by the end, and no adverse events were seen. The study was funded partly by an NAD+ company, and one author ran the clinic that offers the drips. In China, two randomized trials gave heart patients 10 mg of NAD+ a day by IV for 7 days. After a month, heart pumping strength (ejection fraction) was a little higher than with placebo (45% vs 42% in 180 people with heart failure, 56% vs 53% in 120 people after a heart attack), but heart events over 6 months weren't clearly different. A 2026 systematic review found no outcome trials of IV or intramuscular NAD+ for anti-aging or wellness.

What side effects are reported with NAD+ IV drips?

The side effects reported during NAD+ IV drips are mostly stomach and chest symptoms. A 2026 review lists nausea, cramping, flushing and chest discomfort. In one clinic's records, all 6 people given 500 mg of NAD+ by IV reported stomach cramps, diarrhea, nausea or vomiting, a faster heart rate, throat pain and chest pressure during the drip. The symptoms stopped when the drip ended, but people slowed their drips down, so they took about 97 minutes on average. FDA has also had reports of severe chills, shaking and vomiting after NAD+ injections, which FDA said fit with bacterial toxins (endotoxins) from contamination.

Is there an NAD+ injection dosage chart?

There's no NAD+ dosage chart from an approved label, because no NAD+ injection is FDA-approved. The doses online come from clinics and pharmacies. The 750 mg dose in the 2019 IV study was 'derived empirically' and reflects a common clinic routine, and the 500 mg four-day course in a 2026 records review was a 'loading dose' suggested by the compounding pharmacy. A 2026 review said the best dose can't be worked out from current evidence. We found no study that set different NAD+ injection doses for women. That's why this page has no NAD+ calculator.

Are oral NMN or NR the same as NAD+ injections?

No. NMN (nicotinamide mononucleotide) and NR (nicotinamide riboside) are building blocks (precursors) that your body turns into NAD+, and they're swallowed, not injected. In a 10-week trial, 13 women with prediabetes took 250 mg of NMN a day. Their muscles responded better to insulin, but weight, body fat, blood pressure, blood sugar and cholesterol didn't change. In 40 men with obesity, 1,000 mg of NR twice a day for 12 weeks didn't improve insulin sensitivity or body composition. In a 2026 trial of 410 people with early Parkinson disease, 500 mg of NR twice a day for a year left symptom scores slightly worse than placebo. A 2026 review of 15 NMN trials found no rise in side effects and no clear change in weight, blood sugar or cholesterol.

Sources

  1. 1ChEBI (EMBL-EBI). NAD+ (CHEBI:15846). Definition: 'found in all living cells', carries electrons in redox reactions
  2. 2PubChem (NIH). Nadide, compound CID 5892. Synonyms (nadide, coenzyme I, beta-NAD) and structure (IUPAC name)
  3. 3National Cancer Institute. NCI Dictionary of Cancer Terms: peptide
  4. 4FDA. Bulk drug substances nominated for use in compounding under section 503A of the FD&C Act (Categories 1, 2 and 3). Updated May 14, 2026. NAD and NADH in Category 1. Beta-NAD disodium salt trihydrate in Category 3
  5. 5FDA. Bulk drug substances used in compounding under section 503A of the FD&C Act. Content current as of May 14, 2026. 'Interim Policy on Compounding Drugs Using Bulk Drug Substances', Category 1
  6. 6FDA. Drugs@FDA database, searched through openFDA for the active ingredient nicotinamide adenine dinucleotide (also nadide and NADH). No approved product found, searched 8 Nov 2026
  7. 7FDA. FDA reminds compounders to use ingredients suitable for sterile compounding. Content current as of October 30, 2024
  8. 8FDA. Warning letter to GenoGenix LLC (MARCS-CMS 718739), January 20, 2026. NAD+ not on the 503B bulks list; endotoxin-contaminated NAD+ lot
  9. 9Grant 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;11:257. 8 men given NAD+, 3 given saline. Funded partly by NAD+ Research Inc. Full text: PMC6751327
  10. 10Reyna K, et al. Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. Front Aging. 2026;7:1652582. Records review, 6 NAD+ and 8 NR clients. Authors employed by the clinic company. Full text: PMC12907335
  11. 11Alangari A, et al. Narrative review of intravenous NAD+ and NAD+ precursors in wellness and translational medicine. Front Aging. 2026;7:1887175. Review. Abstract (adverse effects, dosing)
  12. 12Gallagher C, Emmanuel OO. NAD+ supplementation for anti-aging and wellness: a PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Res Rev. 2026;116:103057. Systematic review, 33 human studies
  13. 13Yu 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;26(1):97-106. 180 patients
  14. 14Yu X, et al. Effect of intravenous nicotinamide adenine dinucleotide on left ventricular function after primary percutaneous coronary intervention in ST-segment elevation myocardial infarction: a randomized controlled trial. Am J Cardiovasc Drugs. Published online October 30, 2026. 120 patients
  15. 15Yoshino M, et al. Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science. 2021;372(6547):1224-1229. 25 women completed (13 NMN, 12 placebo). Full text: PMC8550608
  16. 16Dollerup OL, et al. A randomized placebo-controlled clinical trial of nicotinamide riboside in obese men: safety, insulin-sensitivity, and lipid-mobilizing effects. Am J Clin Nutr. 2018;108(2):343-353. 40 men
  17. 17eMC (electronic medicines compendium, UK). Search for nicotinamide adenine dinucleotide. No results, also none for nadide, searched 8 Nov 2026
  18. 18Brakedal B, et al. Nicotinamide riboside for patients with early-stage Parkinson disease: the NOPARK randomized clinical trial. JAMA. Published online October 8, 2026. 410 randomized
  19. 19Yang W, et al. Safety and metabolism-related outcomes of oral nicotinamide mononucleotide supplementation in adults: a systematic review and meta-analysis. Nutrients. 2026;18(14):2251. 15 trials

This page explains what labels and published studies say. It isn't medical advice and doesn't replace your prescriber or pharmacist.

Spotted a mistake or something out of date? Tell us. We aim to fix factual errors within two working days.