NAD+: what it is, what the studies show and where it stands
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme, a pyridine nucleotide rather than a peptide, that cells use in energy metabolism. This page covers NAD+ itself given by infusion or injection, not the oral precursors NR and NMN.
At a glance
US Not approved
Canada Not authorized
Group Longevity
Sources 11
Checked 10 Oct 2026What is NAD+?
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme, a pyridine nucleotide rather than a peptide, that cells use in energy metabolism. This page covers NAD+ itself given by infusion or injection, not the oral precursors NR and NMN. [1]
Other names: nicotinamide adenine dinucleotide, NAD.
How it has been given to people: intravenous infusion in every human study found; no human study of NAD+ injected under the skin or into muscle was found.
Looking for doses? NAD+ dosage chart and vial math
Is NAD+ approved in the US and Canada?
United States: No FDA-approved NAD+ drug product. Nicotinamide Adenine Dinucleotide (NAD) is on FDA's 503A Category 1 list of bulk drug substances under evaluation for use in compounding. [6]
Canada: No injectable NAD+ product in the Health Canada Drug Product Database. Health Canada names NAD+ among unauthorized injectable products it has seized, and a 2025 recall covered NAD+ solutions sold without market authorization. [8]
Both were checked on 10 Oct 2026 against the regulators' own product databases.
Which approved products contain NAD+?
No approved medicine containing NAD+ was found in the US or Canada. Anything sold under this name is not a regulated product, so there is no label to check a dose against.
What human studies of NAD+ exist?
The 4 findings listed here: 2 from randomized human trials and 2 from smaller or observational human studies.
In a randomized placebo-controlled trial in 180 adults with heart failure, 7 days of intravenous NAD+ gave a larger improvement in ejection fraction at 1 month than placebo. Differences in clinical events over 6 months did not reach statistical significance. [3]
Oral precursors are a separate matter: in a 2026 systematic review, oral NR and NMN reliably raised NAD-related markers, but effects on health outcomes were mixed and often null. [4]
During a 6-hour infusion in 8 healthy men, plasma NAD+ and its metabolites did not change until after the first 2 hours. [1]
A 2026 narrative review found the human evidence on intravenous NAD+ to be sparse: mostly small uncontrolled studies, observational work and single case reports. [5]
What are the side effects of NAD+?
Reported in human studies or on a label:
- In a clinic record review, all 6 people given 500 mg NAD+ by infusion reported moderate to severe stomach and bowel symptoms, a faster heart rate and chest pressure during the infusion. The symptoms stopped when the infusion ended. [2]
- Because of those symptoms the NAD+ infusions were run more slowly, averaging 97 minutes against 37 minutes for nicotinamide riboside. [2]
- The 8-man pharmacokinetic study, with a slower 6-hour infusion, saw no adverse events. [1]
- A 2026 review lists nausea, cramping, flushing and chest discomfort as reported effects and says long-term safety data are lacking. [5]
How does NAD+ compare with others in its group?
These are the peptides filed under longevity. The last column says whether a randomized human trial is on record for each.
| Peptide | US | Canada | Half-life | Randomized human trial |
|---|---|---|---|---|
| MOTS-c | Not approved | Not authorized | Not found | No |
| Epitalon | Not approved | Not authorized | Not found | No |
| NAD+ | Not approved | Not authorized | Not found | Yes |
| SS-31 (elamipretide) | Approved for one use | Not authorized | Not found | Yes |
| Cardiogen | Not approved | Not authorized | Not found | No |
| Livagen | Not approved | Not authorized | Not found | No |
What could not be found
These were searched for and did not turn up. They are listed so a missing number is not mistaken for a hidden one.
- No human study of NAD+ given under the skin or into muscle. PubMed searches for subcutaneous or intramuscular NAD+ in humans returned no dosing study.
- No human half-life figure. The one pharmacokinetic study reports plasma levels during and 2 hours after a 6-hour infusion but gives no half-life.
- No approved label, so no official dose, contraindications, interaction list or storage instructions.
- The Health Canada Licensed Natural Health Products Database was not searched, so oral NAD or NADH supplements licensed in Canada are not covered here.
- Not named on the WADA Prohibited List (page checked 2026-10-10, [11]). The list also has an open class, S0, for substances with no current approval by any governmental health authority for human therapeutic use; whether it applies to this compound was not determined here.
NAD+ questions
Is NAD+ approved in the US?
No FDA-approved NAD+ drug product. Nicotinamide Adenine Dinucleotide (NAD) is on FDA's 503A Category 1 list of bulk drug substances under evaluation for use in compounding.
Is NAD+ authorized in Canada?
No injectable NAD+ product in the Health Canada Drug Product Database. Health Canada names NAD+ among unauthorized injectable products it has seized, and a 2025 recall covered NAD+ solutions sold without market authorization.
Has NAD+ been tested in a randomized human trial?
Yes. At least one randomized human trial is listed on this page.
Sources
Each one was opened on 10 Oct 2026 and matched to the line it supports.
- 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. PubMed 31572171.
- Reyna 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. PubMed 41704678.
- 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. PubMed 40954388.
- Gallagher C et al. NAD+ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Res Rev 2026. PubMed 41655607.
- Alangari A et al. Narrative review of intravenous NAD(+) and NAD(+) precursors in wellness and translational medicine. Front Aging 2026. PubMed 42787547.
- US Food and Drug Administration Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act 2026. fda.gov.
- US Food and Drug Administration Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act 2026. fda.gov.
- Health Canada Think twice before injecting peptides bought online: unauthorized products can seriously harm you 2026. recalls-rappels.canada.ca.
- Health Canada Skycare Compounding Laboratories Products recall; No market authorization 2025. recalls-rappels.canada.ca.
- Health Canada Health Canada Drug Product Database, active ingredient search: nad 2026. health-products.canada.ca.
- World Anti-Doping Agency The Prohibited List 2026. wada-ama.org.
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NAD+ dosage500 mg vialLongevityStatus in Canada
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