NAD+ IV Therapy Side Effects

Side effects reported in studies

NAD+ IV therapy is also called an NAD IV drip. This page describes NAD+ infusions and NAD+ injections separately, because different studies tested each. The 500 mg and 750 mg infusion studies we read gave NAD+ to groups of 6 to 10 people, so they cannot show how often side effects happen.

During an IV infusion

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. [1] The authors of the chart review report that all symptoms resolved when the infusion was completed. [1] Five of the 8 clients in the 2026 chart review who were given nicotinamide riboside at the same 500 mg dose had minor tongue, jaw and arm tingling and minor cramping during infusion. [1] 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. [1]

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. [2] In the 2024 preprint, which has not been peer reviewed, the authors say most of the people given NAD+ rated their comfort during the infusion as low and reported anxiety, headaches, nausea and sudden urges to have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+. [2] 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. [2]

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. [3] In the same 2019 study, blood tests 8 hours after the start of the NAD+ infusion showed lower activity of three enzymes the authors use as liver function markers and a rise in bilirubin, and the authors did not consider any of the changes clinically significant; the 3 men given saline showed no significant change, which the authors say may reflect the small number of samples. [3] 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. [4] On side effects, the 2018 conference abstract says only that no major adverse effects were reported; it gives no counts and does not say how side effects were recorded. [4]

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. [5] 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. [5] Each 100 mL infusion in the 2026 heart-failure trial started at a set rate that was raised in steps every 15 to 30 minutes when no adverse reaction was seen, so an infusion took about 40 to 60 minutes, and the authors report no notable adverse effects on liver, kidney or blood sugar tests. [5] That trial randomized 90 people to each group. Its table of secondary outcomes and safety lists, over those 6 months, cardiac death in 1 person in each group, a myocardial infarction in 2 people given NAD+ and 1 given placebo, and a stroke in 1 person given NAD+ and none given placebo, and the authors report no significant differences between the groups (p > 0.05). The paper's flow diagram shows 89 people in each group completing the 6-month follow-up, and its text says that one person in each group was classified as a dropout during that period. By our reading, which the authors do not state, the table's percentages correspond to 89 people in each group. Groups of this size are too small to show whether NAD+ changes the number of these events. [5] 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+. [6] The authors of the 2024 heart-failure trial write that patients had no obvious complaints after 7 days of NAD+. The paper also reports that 4 of the 58 hospitalized patients with heart failure in the trial died during follow-up, 1 of the 29 given NAD+ and 3 of the 29 given saline, between 42 and 120 days after treatment. The paper says all four deaths were judged to have occurred during the natural course of the disease and not to have been caused by the medication, and it reports that survival over 1 year did not differ significantly between the groups (p = 0.300). [6] Side-effect reports from hospital trials of 5 to 50 mg a day in people with a medical condition do not show how people tolerate the higher doses given in the studies of healthy adults and clinic clients. [5][6][7] The heart-function and hearing results of the hospital trials described on this page are on the NAD+ IV therapy page and the NAD+ research page.

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

After an injection

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. [8] 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. [8] 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. [8]

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. [8] 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. [8] 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. [8]

In the preprint's table of symptom descriptions during the injections, pain or discomfort was described in all nine groups, the placebo groups included; the descriptions recorded for NAD+ also included burning (into muscle and under the skin) and, by IV push, anxiety, chest tightness or heaviness, shortness of breath, nausea, cramping, headache, itchiness, stinging and tingling. [8] In the table for five minutes after the injections, the descriptions recorded for NAD+ included pain or discomfort by each route, burning, nausea, headache, itchiness, chest tightness or heaviness, shortness of breath and, once after IV push and once after injection under the skin, an entry the authors coded as 'Paralysis/can't move'; we found no explanation of that entry in the preprint's text. [8] The preprint reports that no participant in its first trial withdrew because of discomfort, and that the one adverse event recorded in that trial, an infection in a person given NAD+ that followed contact with a contagious person at work, was judged unrelated to the injections. [8] 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. [8]

A 2026 trial at one hospital randomized 45 adults with sudden sensorineural hearing loss to standard treatment alone or standard treatment plus a daily 5 mg NAD+ injection into muscle, analyzed 38 of them, and received a research grant from Knature Biopharmaceutical. [7] The authors of the 2026 hearing-loss trial write that no adverse events were reported in the NAD+ group; the comparison group received no placebo injection, and the text we read gives no adverse-event count for the comparison group. [7]

Side effects reported in 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. [1][2][3][4][8] 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. [5][6][7] 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.

The studies described on this page gave NAD+ at different doses and speeds to different kinds of people, and none of them compared one NAD+ dose or infusion speed with another, so they cannot show how side effects change with dose or speed. 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.

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. [2][8]

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 of an IV line, an FDA notice and FDA status

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. [9] 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. 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. [9]

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.

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.

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

Compounded Medications Explained covers the subject in plain language. The NAD+ FDA status page shows how FDA's lists name each form of NAD+.

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

Who should avoid this

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. [10] Anyone with a current or past cancer diagnosis should discuss NAD+ with their oncology team first.

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. [3] The first trial of the 2026 injection preprint excluded people with a current diagnosis of a seizure disorder, diabetes or insulin resistance, kidney, liver or cardiovascular disease, anemia, cancer or Parkinson's disease, so that trial says nothing about NAD+ injections in those groups. [8] The 2026 chart review included only records of clients who were over 18, not pregnant and had no family or recent history of cancer, which its authors describe as contraindications of IV therapy at that commercial setting. [1]

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. ClinicalTrials.gov lists a trial of IV NAD+ in children with reduced heart function; the record, as saved on October 1, 2026, showed that the trial had not started recruiting and had posted no results. [11] Talk to a licensed clinician about whether NAD+ IV therapy is appropriate for you.

What to do if you experience side effects

Tell the staff giving the infusion right away if you feel unwell during an NAD+ infusion. Nurses in the 2026 chart review recorded infusion times and symptoms, and clients controlled their own infusion rate based on what they could tolerate. [1] In searches of PubMed, Europe PMC and ClinicalTrials.gov on October 1, 2026, we found no published study that compared a slower NAD+ infusion with a faster one to test whether slowing the infusion eases symptoms.

After an NAD+ injection, tell the clinic about any pain, soreness or other symptoms so they can be recorded.

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

How NAD+ IV side effects compare to NAD+ injection

The side-effect reports for NAD+ infusions and for NAD+ injections on this page come from different studies that gave different doses to different people, so they do not show which route has fewer side effects. The 2026 injection preprint gave 100 mg of NAD+ by three routes, IV push, injection into muscle and injection under the skin, in groups of 4 to 6 people, and its authors call their symptom tallies descriptive only. [8] The NAD+ IV vs injection page compares the two routes in more detail.

Providers who list NAD+ IV therapy

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
• NAD+ IV vs injection
• Is NAD+ IV therapy FDA approved?
• Compounded Medications Explained