NAD+ IV vs. Injection: How They Compare

Quick comparison

The table compares NAD+ IV infusion with NAD+ injection on how each is given, session length, the human studies we read, blood NAD+ results and side effects. Where a cell in this table reads 'Not reported', the studies we read did not report that point.

Each column describes separate studies, with their own doses and participants, so the table does not show which route works better or causes fewer side effects.

NAD+ IV infusion compared with NAD+ injection, in the studies we read

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.

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.'

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

NAD+ IV therapy FDA status

NAD+ IV therapy side effects

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

NAD+ IV infusion in depth

NAD+ IV therapy is an infusion of NAD+ (nicotinamide adenine dinucleotide) into a vein.[1][2] The evidence for NAD+ IV therapy in healthy adults is experimental: in Europe PMC searches through October 1, 2026, we found no controlled trial showing that an NAD+ infusion improves energy, thinking or any other health outcome in healthy adults. We did not find an FDA-approved NAD+ drug product for any use (checked September 27, 2026).

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.[5] 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.[5] 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.

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.[7]

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] The 2024 trial's paper calls its dose an intravenous injection of 50 mg of NAD+ with 50 mL of saline and does not say how long each dose took to give, so we cannot say whether it was given as a drip or as a push.[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][5][6][7][8] 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).

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.[5] 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+.[5] 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.[5]

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 same 2019 pilot study, blood levels of the liver enzymes GGT, LD and AST were lower, and bilirubin was higher, 8 hours after the NAD+ infusion started than at baseline in the 8 men given NAD+; the authors write that none of the changes were considered clinically significant.[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] 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.

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.[1][2][3][5][7] 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] 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.[4][6][8]

NAD+ injection in depth

An NAD+ injection gives NAD+ by IV push or as a shot into muscle or under the skin.[3][4] 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][3][4][5][6][9] We did not find an FDA-approved NAD+ drug product for any use (checked September 27, 2026).

A small safety analysis with NAD+ injection groups that we found in searches of PubMed, Europe PMC and ClinicalTrials.gov on October 1, 2026 has not yet been peer reviewed, was funded by the maker of nicotinamide riboside, and reports two early trials of injections into a muscle, under the skin or into a vein.[3] In the first trial of the 2026 injection preprint, 45 adults received NAD+, nicotinamide riboside or placebo by IV push, intramuscular or subcutaneous injection, so each NAD+ group had only 4 to 6 people.[3] The 2026 injection preprint describes the people in its first trial as sedentary adults aged 40 to 65 with a BMI of 25 to 34.9, no diagnosed chronic illness and mild to moderate fatigue at screening, and each NAD+ or nicotinamide riboside injection contained 100 mg.[3]

The authors of a 2026 injection preprint report that injections of NAD+, nicotinamide riboside (NR) or placebo were associated with some discomfort but did not produce any concerning safety signals.[3] 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.[3] 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.[3] The injection-site pain and soreness rates reported in the 2026 preprint come from its second trial, which tested nicotinamide riboside only, so those rates do not describe NAD+ injections.[3] The first trial in the 2026 injection preprint gave NAD+ by IV push, into muscle or under the skin and had no infusion group, and its authors say their symptom tallies support no statistical comparison between groups.[3]

In searches of PubMed, Europe PMC and ClinicalTrials.gov on October 1, 2026, we found no published blood NAD+ results or pharmacokinetic data for NAD+ injections, and no published result from a health-outcome trial of NAD+ injections in adults with no diagnosed illness.

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.[4] We grade this result as emerging evidence, for people with sudden sensorineural hearing loss only.

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

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. 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.

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

Factors that may matter, depending on your situation

In searches of PubMed, Europe PMC and ClinicalTrials.gov on October 1, 2026, we found no published result comparing an NAD+ IV infusion with an NAD+ injection.

• 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][5]
• Neither the 2026 injection preprint nor the 2026 hearing-loss trial reports how long an NAD+ injection took to give; the only injection time in the preprint, about 60 seconds for 1 mL, is in an adverse event note about a nicotinamide riboside injection in its second trial.[3][4]
• 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][3][4][5][6][7][8]
• 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.

Nicotinamide riboside (NR) and NMN are taken by mouth, and the body can turn them into NAD+. Findings from oral NR and NMN trials do not transfer to NAD+ IV therapy, because the products and routes are different.

NAD+ vs NMN vs NR

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.[3][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.

Talk to a licensed clinician about whether NAD+ IV therapy or an NAD+ injection is appropriate for you.

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 therapy (overview)
• NAD+ IV therapy research
• NAD+ IV therapy side effects
• NAD+ IV therapy FDA status
• More about IV therapy