NAD+ (Injectable)
NAD+ is the cellular energy currency behind hundreds of metabolism and DNA-repair reactions, and injectable or IV NAD+ is used to restore levels that decline with age. It's marketed for energy, anti-aging, and detoxification, delivered as a slow infusion or subcutaneous injection to raise NAD+ levels directly rather than relying on precursor supplements. It's one of the most popular IV therapies in longevity and wellness clinics today.
$200 / 1000 mg vial
Dosing
Vendor reported
| 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- Vendor and clinic-marketing sources, not peer-reviewed, and not validated clinical dosing.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 reported
| 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.
Batches on hand
Availability
20 vials on hand.
Full research
Evidence tier
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
| Timeframe | Dosage | Frequency | Note |
|---|---|---|---|
| Single dose | 750 mg | single infusion over 6 hours (~2 mg/min) | Intravenous |
Clinical trial
| 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.
Why: Early human PK data
IV NAD+ has genuine human pharmacokinetic and tolerability data, including a 2019 pilot study infusing 750 mg over 6 hours and a retrospective study directly comparing it against IV nicotinamide riboside. None of this constitutes a confirmatory efficacy trial for any indication, and no formulation is FDA-approved for any use.
Sources: Grant R, Berg, 2019, PMC12907335 / Frontiers, 2026
Why: Infusion rate drives tolerability
A direct head-to-head retrospective comparison found that 500 mg IV NAD+ infused at an average rate of approximately 5.2 mg/min caused moderate to severe abdominal cramping, diarrhea, nausea, vomiting, increased heart rate, and chest pressure in all six recipients, resolving once the infusion stopped, while the same dose of nicotinamide riboside delivered over a shorter average time caused only minor tingling or cramping in some recipients. This is the clearest sourced evidence that infusion rate, not just total dose, drives acute tolerability for IV NAD+.
Sources: PMC12907335 / Frontiers, 2026
Why: FDA safety scrutiny, unapproved
No FDA-approved injectable NAD+ product exists; all injectable NAD+ sold in the United States is compounded off-label under prescription. FDA proposed in 2019 not to include NAD on the 503A bulk drug substances list, and in October 2025 FDA classified a Class I recall, its most serious classification, for a specific manufacturer's NAD+ injection due to elevated endotoxin levels, with three patients reported to have developed hypotension and uncontrollable shaking after administration from the affected lot.
Sources: Federal Register 2019-18951,, 2019, HMP Global Learning, FDA, GenoGenix LLC, 2025
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. |
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
- Grant R, Berg J, Mestayer R, Braidy N, Bennett J, Broom S, Watson J. 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 Sep 12;11:257. (2019)
- PMC12907335 / Frontiers in Aging (2026), Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting (2026)
- PubMed 37971292, Evaluation of safety and effectiveness of NAD in different clinical conditions: a systematic review. Am J Physiol Endocrinol Metab.
- ClinicalTrials.gov NCT06162013, The NADAPT Study: a Randomized Double-blind Trial of NAD Replenishment Therapy for Atypical Parkinsonism
- Federal Register 2019-18951, Amendments to the List of Bulk Drug Substances That Can Be Used to Compound Drug Products in Accordance With Section 503A (2019)
- FDA, GenoGenix LLC Form 483 (Boca Raton, FL, issued 07/18/2025) (2025)
- HMP Global Learning Network, FDA Issues Class I Recall for NAD+ Injection Due to Elevated Endotoxin Levels
- Empower Pharmacy, NAD+ Injection product/handling page
- peptidedosages.com, NAD+ 1000 mg vial dosage protocol
This is a research and educational reference, not medical advice. Nothing on this site is a recommendation to use any compound.