NAD+ (Injectable)

NAD+ is the energy-currency molecule behind hundreds of reactions in every cell, and injectable NAD+ is how people raise it directly instead of waiting on a pill-form precursor to convert. Levels are reported to decline with age, which is the pitch behind the energy, anti-aging, and detox drips built around it. It's one of the most requested IV therapies in wellness and longevity clinics today, alongside a smaller subcutaneous-shot version for home use. Sessions run anywhere from a quick shot to several hours on a drip, and how fast it goes in matters more than almost anything else about the experience.

Energy · Anti-Aging · Detox

What it does

What a session feels like

The single most useful thing to know before a session: speed matters more than the dose. Push it in fast and people get cramping, nausea, a racing heart, and chest tightness, sometimes bad enough to stop the infusion, and it resolves almost as soon as the drip is slowed down. A slow session at a wellness clinic can run from under an hour for a shot to several hours for a full drip. Ask your provider to run it slow from the start rather than finding out the hard way.

Sources: PMC12907335 / Frontiers, 2026

Energy, anti-aging, and detox

This is the drip people book for flagging energy, general anti-aging support, and detox, sometimes framed as a hangover fix. The premise is straightforward: NAD+ runs the reactions that make cellular energy and repair DNA, and levels measurably rise in the blood after an infusion. What hasn't been shown is that raising blood levels this way translates into more energy or slower aging; no trial has tied the rise to a specific felt benefit.

Sources: Grant R, Berg, 2019, PubMed 37971292, Evaluation

Dosing, and where it's made

In practice, dosing ranges widely: wellness clinics run 100 to 1000 mg a session, one to three times a week, while people doing it themselves at home often start at a small subcutaneous dose, 50 mg, and build up to about 100 mg daily over a few weeks. Every injectable NAD+ product sold is compounded rather than an approved drug, so quality depends entirely on who made it. That's not hypothetical: a batch was recalled in 2025 after patients on it developed hypotension and uncontrollable shivering from a contamination issue.

Sources: peptidedosages.com, NAD+ 1000, HMP Global Learning, FDA, GenoGenix LLC, 2025

Dosing

Vendor reportedCommercial/wellness-clinic IV protocols100-1000 mg, 1-3x weekly, 1-6 hrs/session

Commercial/wellness-clinic IV protocols
Timeframe	Dosage	Frequency	Note
Per session	100-1000 mg	1-3x weekly, 1-6 hrs/session	Not peer-reviewed¹

Vendor and clinic-marketing sources, not peer-reviewed, and not validated clinical dosing.

Community reportedCommunity subcutaneous titration (peptidedosages.com)50 mg to 100 mg, once daily

Community subcutaneous titration (peptidedosages.com)
Timeframe	Dosage	Frequency	Note
Week 1	50 mg	once daily	Starting dose¹
Week 2	75 mg	once daily
Weeks 3-16	100 mg	once daily	Maintenance²

Vial sizes in community circulation vary widely (100 mg, 484.62 mg, 1000 mg); the mg-per-dose numbers here are what matters, not a specific reference vial. Multiple community members report difficulty finding NAD+ dosing guidance at all, and reconstitution-math errors are common for this compound (one poster's own math implied a 25 mg draw versus this 50 mg starting point).
Doses above 200-300 mg/day are described as reserved for supervised clinical use; inject slowly (5-10 seconds) to reduce site irritation.

Primary structure

Not a peptide, so no residue sequence applies. See the class above for what this compound is.

Full research

Evidence tier

Early human data only

Several small pilot RCTs and pharmacokinetic/tolerability studies of IV NAD+ exist in humans, including at least one direct head-to-head tolerability comparison against IV nicotinamide riboside, but none constitute a confirmatory efficacy trial for any indication, and no formulation is approved anywhere. No FDA-approved injectable, intramuscular, or subcutaneous NAD+ drug product exists; all injectable NAD+ sold in the United States is compounded off-label under prescription, and FDA proposed in 2019 not to include NAD on the 503A bulk drug substances list.

Original dosing schedule

The Dosing table above this section now shows a community- or vendor-sourced schedule (peptidedosages.com). The regulatory-label or clinical-trial dosing this entry was originally built on is kept here, unchanged, rather than removed.

Clinical trial

Grant et al. (2019) pharmacokinetic study (intravenous)
Timeframe	Dosage	Frequency	Note
Single dose	750 mg	single infusion over 6 hours (~2 mg/min)	Intravenous

Clinical trial

Retrospective tolerability pilot (intravenous)
Timeframe	Dosage	Frequency	Note
Per session	500 mg	4 daily infusions	Intravenous¹

Averaging approximately 97 minutes per infusion (roughly 5.2 mg/min).

Identity

Full name	Nicotinamide adenine dinucleotide (NAD+)
Class	Dinucleotide coenzyme (not a peptide)
Molecular weight	663.4 g/mol

Mechanism of action

Plain language

NAD+ is a cellular "currency" molecule needed for hundreds of energy-producing and DNA-repair reactions. Cellular NAD+ levels are reported to decline with age, and the therapeutic premise is that raising NAD+ from outside the cell restores mitochondrial and cellular function. This premise is proposed, not established as a mechanism for any specific clinical benefit.

Technical

NAD+/NADH is the central redox couple for glycolysis, the tricarboxylic acid cycle, and oxidative phosphorylation, and NAD+ is a required substrate for sirtuin deacetylases (SIRT1-7) and PARP DNA-repair enzymes. An important, frequently glossed-over mechanistic uncertainty for the injectable/IV route specifically is whether infused extracellular NAD+ is taken up intact by cells, or is instead substantially broken down extracellularly to nicotinamide and other metabolites and then re-synthesized intracellularly via the salvage pathway; this is not settled in the literature accessed during this research, so the mechanistic basis for any effect of IV NAD+ itself should be described as proposed rather than established.

What it’s used for

Human trials, not approved for this use

Grant et al. (2019), a pilot pharmacokinetic study, infused 750 mg NAD+ intravenously over 6 hours (approximately 2 mg/min) in a small cohort and measured plasma and urinary NAD+ metabolome changes and liver-function markers; plasma NAD+ rose starting around 2 hours after infusion start, with increased urinary NAD+ measured at 6 hours. Small, statistically significant but not clinically relevant changes in bilirubin, GGT, LDH, and AST were noted at 8 hours post-infusion. This is a descriptive PK/tolerability study, not an efficacy RCT.
Sources: Grant R, Berg, 2019
A retrospective tolerability study directly compared four consecutive daily 500 mg IV infusions of NAD+ versus NR in a real-world clinic setting. NAD+ IV infusions averaged 97 +/- 56 minutes for 500 mg (approximately 5.2 mg/min average rate) and all six NAD+ recipients reported moderate to severe abdominal cramping, diarrhea, nausea, vomiting, increased heart rate, throat pain, congestion, and chest pressure during infusion, resolving immediately once the infusion stopped; NR IV infusions averaged 37 +/- 13 minutes and caused only minor tingling or cramping in some of the eight recipients. This is a directly sourced illustration that infusion rate and formulation materially affect tolerability for IV NAD+.
Sources: PMC12907335 / Frontiers, 2026
A broader systematic review of NAD and NADH (mixed precursor and direct forms, mixed routes) across chronic fatigue syndrome, Parkinson's disease, Alzheimer's disease, overweight, and postmenopausal prediabetes populations (10 studies, 489 participants total) found generally good tolerability and some positive secondary signals, with minimal difference in side effects versus placebo, but did not establish confirmatory efficacy for any single indication.
Sources: PubMed 37971292, Evaluation
The NADAPT study, a randomized, double-blind trial of NAD replenishment therapy for atypical Parkinsonism, is registered and ongoing (start March 2024, estimated completion December 2028) with no results available at the time of this research.
Sources: ClinicalTrials.gov NCT06162013, The

Off-label / community use

IV and subcutaneous NAD+ "drips" are extensively marketed direct-to-consumer for energy, anti-aging, detoxification, and hangover recovery. FDA does not recognize NAD+ infusions as approved treatments for fatigue, aging, or detoxification, and has received adverse event reports associated with injectable NAD+ use.

Pharmacokinetics

Route	Clinical trial Intravenous is the route with published human PK/tolerability data. Subcutaneous administration is commercially common but no published human PK data specific to that route was identified. Sources: Grant R, Berg, 2019
Elimination half-life	Not established No citable figure. No clean, citable elimination half-life for IV NAD+ in humans was identified in the sources accessed during this research. Grant et al. (2019) describes a rise in plasma NAD+ beginning around 2 hours after infusion start and increased urinary NAD+ at 6 hours, but does not report a conventional elimination half-life figure. Do not treat any half-life figure for IV NAD+ found elsewhere as validated without checking it against the primary paper directly.

Route

Clinical trial

Intravenous is the route with published human PK/tolerability data. Subcutaneous administration is commercially common but no published human PK data specific to that route was identified.

Sources: Grant R, Berg, 2019

Elimination half-life

Not established

No citable figure. No clean, citable elimination half-life for IV NAD+ in humans was identified in the sources accessed during this research. Grant et al. (2019) describes a rise in plasma NAD+ beginning around 2 hours after infusion start and increased urinary NAD+ at 6 hours, but does not report a conventional elimination half-life figure. Do not treat any half-life figure for IV NAD+ found elsewhere as validated without checking it against the primary paper directly.

Reconstitution

Reconstitution does not apply to this compound: Administered as an IV infusion, not a syringe-metered subcutaneous dose, in essentially all sourced clinical and commercial use. NAD+ is chemically reactive and prone to degradation with heat, pH shifts, and light exposure; both the published PK study and the retrospective tolerability study delivered it as a dilute solution via slow, controlled IV infusion specifically because rapid delivery is associated with acute GI and cardiovascular symptoms.

Storage and post-reconstitution stability

Unopened storage

One 503A compounding pharmacy (Empower Pharmacy) lists NAD+ injection as a 500 mg lyophilized powder per vial, unreconstituted powder stored at room temperature (20-25 degrees C) protected from heat, moisture, and light.

Post-reconstitution stability – Vendor claim

One compounding pharmacy (Empower Pharmacy) states a beyond-use date of approximately 90 days refrigerated, discarded approximately 28 days after first puncture. Other vendors describe 7-28 days, inconsistent across sources and unresolved.. Refrigerated at 2-8 degrees C.

Sources: Empower Pharmacy, NAD+

No citable figure. This research could not resolve the inconsistency across commercial sources (7-28 days versus approximately 90-day beyond-use with 28-day in-use discard) against a pharmacopeial reference; treat any specific post-reconstitution stability-day figure as a commercial claim requiring pharmacy-specific verification, not a settled fact.

Safety

Notable risks

Acute, infusion-rate-dependent adverse effects: chest tightness, flushing, nausea, GI cramping (abdominal cramping, diarrhea, vomiting), palpitations/increased heart rate, and throat or chest pressure, most pronounced with faster infusion rates and resolving promptly when the infusion is slowed or stopped.
Sources: PMC12907335 / Frontiers, 2026
FDA has received adverse event reports of severe chills, shaking, vomiting, and fatigue associated with injectable NAD+ products, some requiring medical treatment, and has reminded compounders that food-grade NAD+ raw material is unsuitable for sterile injectable compounding without appropriate processing due to contamination risk.
FDA classified a Class I recall, its most serious classification, in October 2025 for NAD+ Injection manufactured by GenoGenix LLC (Boca Raton, FL), 100 mg/mL and 200 mg/mL concentrations in 10 mL multi-dose vials, due to elevated endotoxin levels; three patients were reported to have developed hypotension, uncontrollable shaking, shivering, and body aches after administration from the affected lot.
Sources: HMP Global Learning, FDA, GenoGenix LLC, 2025
No formulation is FDA-approved; all injectable NAD+ use is off-label under compounding-pharmacy prescription, which means product quality (sterility, endotoxin control, potency) varies by compounder and is not centrally guaranteed the way an approved drug's manufacturing is. FDA proposed in September 2019 not to include NAD on the Section 503A bulk drug substances list, with secondary sources describing the rationale as centering on NAD's chemical reactivity and instability.
Sources: Federal Register 2019-18951, 2019

Sources

This is a research and educational reference, not medical advice. Nothing on this site is a recommendation to use any compound.