NAD+ IV therapy

Overview

Mechanism

NAD+ is a coenzyme cells use in energy metabolism, and enzymes involved in DNA repair consume NAD+. [3] The role of NAD+ in cell biochemistry is not evidence that NAD+ IV therapy changes energy, DNA repair or any other process in the body.

In the 2019 pilot study of 8 healthy men, plasma NAD+ did not rise during the first 2 hours of the infusion, and by hour 6 two breakdown products of NAD+ had risen along with NAD+ itself, which the authors say strongly suggests that breakdown is one of the main things that happens to infused NAD+. [1] The 2019 pilot study measured NAD+ in plasma and urine only, and in searches of PubMed and Europe PMC on October 1, 2026, we found no published result in people showing that an NAD+ infusion raises NAD+ inside cells or tissues. [1]

Why people use it

NAD+ IV therapy is also called an NAD IV drip. Commercial clinics and wellness settings increasingly offer NAD+ infusions, according to the authors of a 2026 study from one commercial wellness setting. [2] This page checks five uses against the research: energy, thinking, slowing aging, recovery after exercise and addiction recovery.

In searches of PubMed, Europe PMC and ClinicalTrials.gov on October 1, 2026, we found no controlled trial in healthy adults showing that NAD+ IV therapy helps with energy, thinking, aging or recovery after exercise.

We did not find an FDA-approved NAD+ drug product for any use, including anti-aging, longevity, energy or cognition (checked September 27, 2026).

Evidence: Does NAD+ IV therapy work?

Apart from uncontrolled case series on addiction, two trials in people with heart failure and one trial of injections in people with sudden sensorineural hearing loss, the studies of NAD+ by IV or injection that we were able to read reported blood NAD+ levels, other blood markers, infusion times or side effects in small groups of people, not health benefits. [1][2][4][5][6][7][8]

Apart from case reports and case series, the human studies of NAD+ given by IV infusion or injection that we read were in healthy adults, adults with mild to moderate fatigue or clinic clients, where they reported blood NAD+ levels, other blood markers, infusion times or side effects, or in people with a medical condition. [1][2][4][5][6][7][8] We also read a one-page 2018 conference abstract, which we read only as an abstract and which PubMed and Europe PMC lookups by DOI and title on October 1, 2026 did not return: it describes a study in which 8 healthy adults aged 70 to 80 received repeated IV doses of NAD+ over 6 days with no control group described, and it reports changes in the blood NAD+ metabolome, in markers of oxidative stress and inflammation, and in gene activity in blood cells, without giving figures. [9]

We have not been able to read some reports, so they are not among the studies described here: the three alcohol-related trials from 1966 to 1971, controlled trials of NAD from 1967 to 1969 in schizophrenia and acute hepatitis, and two Chinese-language reports of injectable NAD+ in heart failure that the 2026 heart-failure trial cites. [6] Also not among the studies described here are studies of NADH, which is a different molecule, and two 2004 trials in chronic heart failure of a combination product that PubMed indexes under NAD, of which we read only the abstracts.

A peer-reviewed pilot trial that we found in searches of PubMed and Europe PMC on October 1, 2026 measured blood NAD+ after an NAD+ infusion: in 8 healthy men, a single 6-hour, 750 mg infusion raised plasma NAD+ by 398% at hour six, with no change in the first two hours. [1]

A non-peer-reviewed preprint pilot in healthy adults gave single 500 mg infusions and found that 3 hours after the infusion blood NAD+ was higher after a nicotinamide riboside infusion than after an NAD+ infusion. [4] The authors of the 2024 preprint report that the NAD+ infusion did not significantly raise whole-blood NAD+ within 24 hours: the average rise at 24 hours was 2%, from dried blood spot samples that were usable for 6 to 9 of the 10 people given NAD+ at each time point. [4]

Human studies of NAD+ given by IV infusion or injection

The studies in healthy adults, adults with mild to moderate fatigue or clinic clients, other than the 2018 conference abstract, which gives no funding or conflict statement and lists an organization as one author's affiliation, were each funded, co-funded or authored by people or companies that sell IV NAD+ services or nicotinamide riboside products. The three trials in people with a medical condition each name a Knature company as a funder and used NAD+ from Kaifeng Knature Pharmaceutical, and the two heart-failure papers say a Knature company supplied or provided the NAD+; the papers do not say how the Knature companies they name are related. [6][7][8]

None of the studies in healthy adults, adults with mild to moderate fatigue or clinic clients in the study table reported a health benefit from NAD+ compared with placebo.

A 2026 randomized, placebo-controlled trial at a single hospital tested IV NAD+ in 180 adults with heart failure caused by ischemic cardiomyopathy: half received 10 mg of NAD+ a day by IV infusion for 7 days and half received a placebo infusion, all on top of standard heart-failure treatment. [6]

One month after treatment, the heart's pumping measure (left ventricular ejection fraction), which was the trial's main outcome, had risen on average from 41.0% to 45.4% in the NAD+ group and from 40.2% to 42.4% in the placebo group, and the difference between the groups at 1 month was statistically significant. [6] The trial's other results did not differ significantly between the groups: the blood marker NT-proBNP, symptom class, heart size on ultrasound, and cardiac events and heart-failure hospital stays over 6 months, and the authors say the trial was too small to detect differences in those events. [6]

The 2026 heart-failure trial received a research grant and its study drug from Kaifeng Knature Pharmaceutical. [6] A smaller 2024 trial at one hospital randomized 60 hospitalized adults older than 60 with heart failure to 50 mg of NAD+ a day by IV or to saline for 7 days, on top of usual treatment; the paper says the trial was registered retrospectively, on August 3, 2023, and lists Knature Company as a funder and thanks the company for providing the NAD+. [8]

The authors of the 2024 trial report that left ventricular ejection fraction and the blood marker NT-proBNP improved more in the NAD+ group but that the differences in improvement rates were not statistically significant; their comparison of NT-proBNP levels across the follow-up visits found a statistically significant difference between the groups, and survival and hospital readmissions over 1 year did not differ significantly. [8]

These two trials do not establish NAD+ as a treatment for heart failure, and trials of 10 mg and 50 mg a day in people with heart failure do not show what NAD+ IV therapy does in healthy adults or at the higher doses given in the studies of healthy adults and clinic clients. [1][2][4][6][8][9] We grade the heart-failure and hearing-loss results as emerging evidence, for people with those conditions only: each trial was run at a single hospital, all three name a Knature company as a funder, the heart-function measurement that differed between groups in the larger heart-failure trial showed no significant difference in the smaller one, and the hearing-loss trial gave its comparison group no placebo injection.

We did not find an FDA-approved NAD+ drug product for any use (checked September 27, 2026).

NAD+ infusions have been promoted for addiction recovery since the 1960s, but the reports we were able to read are uncontrolled case reports and case series. [10][11] In searches of PubMed and Europe PMC on October 1, 2026, we found no controlled trial of NAD+ for a substance use disorder or withdrawal that we could read. PubMed lists three controlled trials of NAD in people with alcohol-related conditions, published in 1966, 1969 and 1971; the records have no abstracts and we have not been able to read the papers, so we cannot say how NAD was given or what the trials found. Anyone going through withdrawal should be under the care of a licensed clinician.

More detail: NAD+ IV therapy research →

Potential benefits: What are the benefits of NAD+ IV therapy?

In searches of PubMed, Europe PMC and ClinicalTrials.gov on October 1, 2026, we found no controlled trial in healthy adults showing a health benefit from NAD+ IV therapy. We did not find an FDA-approved NAD+ drug product for any use (checked September 27, 2026). Trials of oral nicotinamide riboside and NMN tested different products taken by mouth, so their results do not show whether NAD+ IV therapy works.

Claimed benefits of NAD+ IV therapy and what the research shows

A higher blood NAD+ level is a lab measurement, not a health outcome, and none of the trials we read showed that raising blood NAD+ makes people healthier.

In searches of PubMed and Europe PMC on October 1, 2026, we found no study in people of NAD+ IV therapy for hangovers, immunity or jet lag. Our review did not search for studies of NAD+ IV therapy for skin or hair, so this page makes no claim either way about skin or hair.

Limitations: What are the limits of the evidence?

Outside the uncontrolled addiction case series, the peer-reviewed studies of NAD+ infusions in healthy adults or clinic clients that we found in searches of PubMed and Europe PMC on October 1, 2026 are a pilot randomized trial that gave NAD+ to 8 men once and a chart review in which 6 people received NAD+ for 4 days. [1][2] The 2019 NAD+ infusion study was co-funded by NAD+ Research Inc., and one author directs that company and is medical director of a clinic that provides IV NAD+. [1]

Two of the studies in the study table are preprints, which have not been peer reviewed, and we could not tell whether the conference abstract in the table was peer reviewed. [4][5] In its first study, in which 10 of the 37 people were given NAD+, the 2024 preprint reports that white blood cell counts rose after NAD+ infusions, that blood NAD+ 3 hours after the infusion was higher after a nicotinamide riboside infusion than after an NAD+ infusion, and that the NAD+ infusion did not significantly raise whole-blood NAD+ within 24 hours. [4] The authors of the 2026 injection preprint report that the injections were associated with some discomfort but did not produce any concerning safety signals. [5] In the authors' tally of symptom descriptions during the injections, which they call descriptive only and which covers all three injection days, the totals for NAD+ and nicotinamide riboside were 14 and 5 by IV push (5 people in each group), 5 and 9 by injection into muscle (4 and 6 people) and 7 and 8 by injection under the skin (6 and 4 people); the placebo groups, of 5 people each, had totals of 2, 6 and 5. [5] Five minutes after the injections the totals for NAD+ and nicotinamide riboside were 8 and 2 by IV push, 6 and 6 into muscle and 7 and 5 under the skin, and the placebo totals were 3, 2 and 4. [5]

ClinicalTrials.gov lists trials of NAD+ by infusion or injection that had posted no results in the registry when we searched on October 1, 2026: comparisons with nicotinamide riboside in adults the records describe as in good general health, including the registration of the 2024 preprint's trial, which lists an energy scale and a tolerable infusion rate among its outcomes, and the registration of the first trial in the 2026 injection preprint; a 7-day infusion course for blood-vessel aging that had not started recruiting; and trials in people with medical conditions, one of which has since been published. The 2024 preprint reports infusion times for its trial and gives no result for the energy scale, and the 2026 injection preprint says its fatigue and sleep results will be reported elsewhere. [4][5]

Where this page says we found no study or no published result, the statement rests on searches of PubMed, Europe PMC and ClinicalTrials.gov run on October 1, 2026 and on earlier Europe PMC searches run on September 27, 28 and 30, 2026; we did not search Embase, the Cochrane Library, Chinese-language databases or the Chinese clinical trial registry.

Risks

Placing any peripheral IV line carries risks at the insertion site: a StatPearls clinical reference lists bleeding or a hematoma, fluid leaking into nearby tissue if the catheter slips out of the vein (infiltration), and inflammation of the vein (phlebitis), which can progress to a local infection. [19] These general risks come from a clinical reference on placing peripheral IV lines, and the NAD+ studies on this page are too small to show how often they happen with NAD+ infusions. [1][2][19]

The same reference says allergic reactions during IV treatment are more often related to the medicine or fluid given than to the line itself, and that fainting is more likely in people who are seated, have fainted before or are very anxious about blood or needles. [19]

In a notice titled 'FDA reminds compounders to use ingredients suitable for sterile compounding' (FDA page content current as of October 30, 2024), FDA said it 'is aware of compounders using food-grade nicotinamide adenine dinucleotide (NAD+) sold by repackagers to make intravenous products,' and that food-grade ingredients 'are not suitable for compounding sterile drugs without appropriate processing, due to the high risk of contamination with microbes and endotoxins, which can harm patients.' FDA also said it 'has received adverse event reports following use of NAD+ injectable drugs, including severe chills, shaking, vomiting and fatigue with some requiring medical treatment.' FDA added: 'These reactions are consistent with excessive levels of endotoxins.'

Compounded NAD+ products, including IV infusions and injections, are not FDA-approved. FDA states: 'Compounded drugs are not FDA-approved. This means that FDA does not verify the safety, effectiveness or quality of compounded drugs before they are marketed.' As of FDA's list updated May 14, 2026, NAD and its reduced form, NADH, are on FDA's list of substances still under evaluation for use in pharmacy compounding, and another form, beta-nicotinamide adenine dinucleotide disodium salt trihydrate, is on FDA's list of substances nominated without adequate support. These listings are not FDA approval, and they are not a finding that NAD+ is safe or effective.

Side effects

In a chart review of clients at one commercial wellness setting, all 6 people who received 500 mg NAD+ infusions daily for 4 days reported moderate to severe abdominal cramping, diarrhea, nausea, vomiting, increased heart rate, throat pain, congestion and chest pressure during infusion. [2] The authors of the chart review report that all symptoms resolved when the infusion was completed. [2] In the same chart review, NAD+ infusions averaged 97 minutes because symptoms forced slower infusions, while nicotinamide riboside infusions at the same 500 mg dose averaged 37 minutes. [2]

In the 2024 preprint pilot, nicotinamide riboside infusions caused fewer and less severe reactions than NAD+ infusions, and white blood cell and neutrophil counts rose after NAD+ infusions, which the authors say suggests an inflammatory response. [4] In the 2024 preprint, which has not been peer reviewed, the authors say most of the people given NAD+ rated their comfort during the infusion as low and reported anxiety, headaches, nausea and sudden urges to have a bowel movement or diarrhea; they give no count, and 10 people in the first study and 8 men in the second were given NAD+. [4] The authors say the symptoms resolved once the infusion was completed, and they report no adverse events attributed to treatment during follow-up of 14 days in the first study and 7 days in the second. [4]

In the 2019 pilot study, no adverse events were observed in 8 healthy men given a slow NAD+ infusion of about 2 mg per minute over 6 hours. [1] In the 2026 heart-failure trial, which used 10 mg a day, one person in the NAD+ group had minor dizziness that passed in about an hour and one person in the placebo group had chest discomfort; the authors did not attribute the dizziness directly to NAD+ but stopped the NAD+ as a precaution. [6]

If you have severe symptoms, call 911 or seek emergency care. Report side effects to FDA MedWatch.

Read the full NAD+ IV therapy side effects breakdown →

Contraindication considerations

We did not find an FDA-approved NAD+ drug product for any use (checked September 27, 2026). The cautions in this section come from the published NAD+ studies and from general precautions.

Laboratory studies have raised a theoretical concern that raising NAD+ could affect cancer cells, and our searches did not look specifically for studies of that concern in people. [20] Anyone with a current or past cancer diagnosis should discuss NAD+ with their oncology team first. Our searches did not look specifically for studies of NAD+ IV therapy in pregnancy, breastfeeding or children, and none of the studies on this page reports results for those groups. The 2019 infusion study of 8 healthy men excluded people with a history of liver or kidney failure and people taking lipid-lowering or anti-inflammatory drugs, so that study says nothing about safety in those groups. [1] Talk to a licensed clinician about whether NAD+ IV therapy is appropriate for you.

Administration methods

In the studies we read, NAD+ was given by IV infusion, by IV push, or by injection into muscle or under the skin. [1][2][4][5][6][7][21]

How NAD+ was given in the studies

NAD+ IV vs injection →

Typical appointment

The NAD+ infusion times reported in the studies of healthy adults or clinic clients that we read include 6 hours in a 2019 research study (8 men given NAD+), 97 minutes on average at one commercial wellness setting (6 clients given NAD+), and, in a 2024 preprint that has not been peer reviewed, 3 hours and 3 minutes on average in its first study (10 people given NAD+) and about 99 minutes on average in its second (8 men given NAD+). [1][2][4] The research study gave a single infusion, the commercial wellness setting gave an infusion on each of 4 days in a row, and each person given NAD+ in the preprint received a single infusion. [1][2][4]

At the commercial wellness setting, symptoms during NAD+ infusions forced the infusions to run slower, and nicotinamide riboside infusions at the same dose averaged 37 minutes. [2] In searches of PubMed, Europe PMC and ClinicalTrials.gov on October 1, 2026, we found no published study that established a safe infusion rate or dose for NAD+ IV therapy.

Cost

The price of NAD+ IV therapy can differ by clinic, dose and number of sessions. We have not yet collected dated, sourced prices for NAD+ IV therapy, so this page shows no price. Ask the clinic for the total price before you schedule.

Compounded NAD+ is not FDA-approved. See FDA's statement.

Insurance

Coverage for NAD+ IV therapy varies by plan and can depend on the reason it is ordered. Confirm coverage, and any prior authorization, with your insurer.

FDA and regulatory status

We did not find an FDA-approved NAD+ (nicotinamide adenine dinucleotide) drug product. FDA's compounding lists (updated May 14, 2026 and March 21, 2025) treat it as a substance that is not part of an approved drug.

Compounded NAD+ products, including IV infusions and injections, are not FDA-approved. FDA states: 'Compounded drugs are not FDA-approved. This means that FDA does not verify the safety, effectiveness or quality of compounded drugs before they are marketed.' As of FDA's list updated May 14, 2026, NAD and its reduced form, NADH, are on FDA's list of substances still under evaluation for use in pharmacy compounding, and another form, beta-nicotinamide adenine dinucleotide disodium salt trihydrate, is on FDA's list of substances nominated without adequate support. These listings are not FDA approval, and they are not a finding that NAD+ is safe or effective.

Read the full NAD+ IV therapy FDA status breakdown →

Regulatory status checked September 27, 2026. Sources: www.fda.gov/…/download; www.fda.gov/…/download; www.fda.gov/…/download; www.fda.gov/…/fda-reminds-compounders-use-ingredients-suitable-sterile-compounding; www.fda.gov/…/compounding-and-fda-questions-and-answers

Prescription requirements

We could not confirm whether a prescription is required for NAD+ from FDA sources as of September 27, 2026.

A licensed clinician decides whether NAD+ IV therapy is appropriate for a specific person after reviewing their health history. Completing an intake form or making a payment does not guarantee treatment.

Provider questions

Before starting NAD+ IV therapy, consider asking a licensed provider:

1. Which pharmacy or facility makes the NAD+ this clinic uses, and can the clinic show a certificate of analysis for the batch?
2. Who supervises the NAD+ infusion, what license do they hold, and will they be on site during it?
3. Does a licensed clinician evaluate me before the first NAD+ infusion?
4. How does the clinic handle symptoms such as nausea, cramping or a racing heart during an NAD+ infusion?
5. How fast does the clinic run an NAD+ infusion, how long does a session take, and why?
6. Do I have any health conditions, including a current or past cancer diagnosis, that should be discussed before NAD+ IV therapy?
7. What happens if I have a reaction during the infusion, and how is that handled at this location?

Alternatives

Nicotinamide riboside (NR) and NMN are taken by mouth, and the body can turn them into NAD+. [18][22] Findings from oral NR and NMN trials do not transfer to NAD+ IV therapy, because the products and routes are different. In searches of PubMed, Europe PMC and ClinicalTrials.gov on October 1, 2026, we found no published result comparing health outcomes after NAD+ IV therapy with health outcomes after oral NAD+ precursors.

We did not find an FDA-approved NAD+ drug product for any use (checked September 27, 2026).

NAD+ IV therapy compared with oral precursors and NAD+ injections

A 2026 trial at one hospital added a daily 5 mg NAD+ injection into muscle to standard treatment for adults with sudden sensorineural hearing loss; among the 38 people analyzed, hearing improved more in the NAD+ group, but the comparison group received no placebo injection, 7 of the 45 people randomized were lost to follow-up, and the trial received a research grant from Knature Biopharmaceutical. [7] We grade this result as emerging evidence, for people with sudden sensorineural hearing loss only.

NAD+ vs NMN vs NR comparison →

NAD+ vs NMN vs NR comparison →

Providers who list NAD+ IV therapy

In a notice titled 'FDA reminds compounders to use ingredients suitable for sterile compounding' (FDA page content current as of October 30, 2024), FDA said it 'is aware of compounders using food-grade nicotinamide adenine dinucleotide (NAD+) sold by repackagers to make intravenous products,' and that food-grade ingredients 'are not suitable for compounding sterile drugs without appropriate processing, due to the high risk of contamination with microbes and endotoxins, which can harm patients.' FDA also said it 'has received adverse event reports following use of NAD+ injectable drugs, including severe chills, shaking, vomiting and fatigue with some requiring medical treatment.' FDA added: 'These reactions are consistent with excessive levels of endotoxins.'

We did not find an FDA-approved NAD+ drug product for any use (checked September 27, 2026).

Compounded NAD+ is not FDA-approved. See FDA's statement.

Find a Provider

A licensed clinician decides whether treatment is appropriate. Treatment is not guaranteed.

Related diagnostics and treatments

• NAD+ IV vs injection →
• NAD+ IV therapy research →
• More about IV therapy →