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NAD+: what the studies show, status and safety

Status at a glance

MarketStatusDate
United StatesNot approved—
European UnionNot approved—
GermanyNot approved—
United KingdomNot approved—
AustraliaNot approved—
CanadaNot approved—
SwitzerlandNot approved—
Development stage
Phase 2
Strongest evidence
Phase 2 randomised trial
WADA status
Not listed
Last verified
2026-10-09
Version
1.1

Sold as a supplement. No injectable form is approved in any market.

NAD+: what the studies show, status and safety

Summary

NAD+ is not a peptide but a coenzyme every living cell makes itself. It is listed here because it is sold as an injection beside peptides. China is the only country found to approve it as a medicine, as an injection for supportive treatment. Almost all human evidence concerns the swallowed building blocks NR and NMN. During the one measured drip, blood NAD+ did not rise for two hours.

Key findings at a glance

  • It is a dinucleotide, not a peptide. The formula is C21H27N7O14P2 and the mass 663.43 g/mol, with no amino acid and no peptide bond anywhere in it [1]. It is listed here because it is sold as an injection through the same shops as research peptides.
  • An infusion did not raise blood NAD+ at first. Eleven healthy men took part, eight of them infused over six hours and three of them controls. Neither NAD+ nor its breakdown products rose in the blood during the first two hours [2].
  • The good evidence is about a different substance. A review published in 2026 screened the years 2010 to 2025 and found 113 eligible studies, of which 33 were human trials. Nearly all tested swallowed NR or NMN, and none was an outcome trial [3].
  • Swallowed NR does raise blood NAD+. Whole blood NAD+ rose by 22, 51 and 142 percent at three ascending dose levels. The rise appeared within two weeks and held for the rest of the eight-week trial [4].
  • The route may run through the gut. In 65 healthy adults given NR, NMN or nicotinamide for 14 days, gut bacteria turned NR and NMN into nicotinic acid. In blood tested outside the body, only nicotinic acid raised NAD+ strongly [5].
  • The infusion was tolerated poorly. In a provider's own record review, all six people given NAD+ slowed their drips because of gut symptoms, a faster pulse and chest pressure. The drips took 97 minutes on average against 37 minutes for NR [6].
  • Injections under the skin or into a muscle are unstudied in people. No published human study reports pain, burning or blood levels after either route. A registered trial with injection pain as its main outcome has posted no results [54].
  • Approved only in China, and the drip is a banned method in sport. China approves an NAD+ injection for supportive treatment [49], [53]. Two searches of the American approval database returned "No matches found" [7]. The 2026 doping list does not name the substance, but it bans infusions above 100 millilitres per 12 hours as a method [8].

What it is

NAD+ stands for nicotinamide adenine dinucleotide. It is a coenzyme: a small helper molecule that enzymes need in order to work. Two nucleotides sit joined by a bridge of two phosphate groups, one carrying adenine and the other nicotinamide, each on a ring of the sugar ribose [1].

Every cell makes it and uses it. The body builds NAD+ along three routes: one from the amino acid tryptophan, one from nicotinic acid, and one that reuses nicotinamide, a form of vitamin B3 [9].

Nobody invented the molecule. It was described in 1906 in yeast extract, under the name cozymase, and its older names still sit in the chemical databases [1].

No single company developed it. The substance carries an international non-proprietary name, "nadide", granted in the American, international, British and Japanese naming systems [1]. A name of that kind is a naming convention, not an approval, and the international drug index that assigns codes to medicines returns no match for it [10].

There is, however, one approved medicine. In China, NAD+ is sold under the name "Coenzyme I for Injection" (注射用辅酶Ⅰ) as a freeze-dried powder for injection, approved for the supportive treatment of low white-cell counts, coronary heart disease and inflammation of the heart muscle [49], [50], [52], [53].

Quick facts

FieldValueRef
Common nameNAD+, also NAD or beta-NAD; free name nadide[1]
ClassCoenzyme, a dinucleotide. Not a peptide, not a hormone[1]
Amino acid sequenceNone. It contains no amino acids[1]
Formula and massC21H27N7O14P2, 663.43 g/mol[1]
Water and fat solubilityVery water-loving, practically not fat-soluble; XLogP -6[1]
What it acts onNot a receptor. It is the shared helper and raw material of several enzyme families[9]
How long it lasts in the bodyNever measured as a half-life; during a six-hour drip, blood NAD+ stayed flat for two hours and was still raised two hours after the drip ended[2]
StatusApproved as an injection in China only; the swallowed building blocks are regulated as food[53], [7], [11]
CAS registry number53-84-9[1]
PubChem CID5892[1]
UNII0U46U6E8UK[1]
ATC codeNone[10]

One property decides most of the argument about injections. The molecule is large, carries two negative charges and is extremely water-loving, so it does not slip through cell membranes on its own [1].

NAD+: what the studies show, status and safety

How it works

NAD+ has two jobs at once, and both are established biochemistry rather than a hypothesis about a product. It carries electrons back and forth between two states, NAD+ and NADH, in the reactions that release energy from food. It is also eaten up as raw material by several enzyme families [9].

  • It is consumed, not just used. Several enzyme families break NAD+ apart as part of their work. Among them are the sirtuins, the DNA-repair enzymes called PARPs, the surface enzymes CD38 and CD157, and the nerve enzyme SARM1 [9].
  • Levels fall with age, and the meaning of that is unsettled. Reviews describe the decline in tissue NAD+ as a possible contributor to age-related disease. They say plainly that this is a hypothesis, not a proven cause in people [9], [12].
  • Raising it might raise the activity of those enzymes. That is the idea behind every product in this field. Whether it translates into anything a person would notice is exactly what the human studies have not shown [3].
  • The swallowed building blocks may work through gut bacteria. A study published in 2026 found that gut microbes turn NR and NMN into nicotinic acid. That acid then feeds one of the three building routes [5].
  • Injected NAD+ appears to be taken apart first. During the only human infusion measurement, the pattern of substances appearing in urine matched cleavage by two enzymes that split NAD+ outside cells [2].

What reaches the inside of a cell, on current evidence, are the fragments rather than the whole molecule. This is the point at which NAD+ differs from a peptide medicine, which is designed to dock onto a receptor and trigger a signal.

What the studies found

The evidence splits cleanly in two. Swallowed NR and NMN have been through around three dozen controlled trials [3]. NAD+ given into a vein has one pilot measurement, one record review, one unpublished company study and two small Chinese trials in heart failure behind it [2], [6], [51], [49], [50].

Blood levels and what a drip actually does

Human pilot study Eleven healthy men aged 30 to 55 took part: eight in the treated group and three in a control group. Those eight received NAD+ dissolved in salt solution as a slow drip running over six hours, at a fixed speed the researchers took over from clinics.

Through the first two hours, neither NAD+ nor any breakdown product rose in the blood. The authors read this as rapid and complete removal from the plasma at that infusion rate [2].

Later the picture changed. At the end of the six hours, plasma NAD+ was 398 percent above its starting value (p < 0.0001), and it was still raised two hours after the drip had stopped. In the urine, methylnicotinamide and NAD+ rose, but nicotinamide did not [2].

The infusion solution itself came from a compounding pharmacy, not from an approved manufacturer [2].

How long it stays in the body

Nobody has measured a half-life for NAD+ given as a drip or an injection, in people or in animals. The only human time course is the six-hour drip above, and its sampling ended two hours after the drip stopped, while NAD+ was still raised [2].

In healthy people, the NAD+ circulating outside the cells is normally present only in tiny amounts, between 0.1 and 0.5 micromoles per litre. Several enzymes on cell surfaces, among them CD38 and CD73, break it down and so decide how much is available [60].

Cell experiments show how fast that can happen. With human cells present, less than 40 percent of added NAD+ remained after 12 hours and none could be detected after 48 hours. Without cells and serum, only about 10 percent was split in 24 hours [61].

The same work found that NAD+ outside the cell has to be cut into smaller pieces before the cell can use it. That fits the pattern of breakdown products in the human drip study [61], [2].

Two practical points follow. A blood test some days after a drip says little about the drip itself, and there is no measured basis for claims that an injection "lasts" a given number of days.

Heart failure: the Chinese injection trials

Randomised trial In a single Chinese hospital, 180 adults with heart failure after heart-muscle damage from narrowed arteries were given the approved Chinese NAD+ injection or a dummy drip for seven days, on top of standard treatment. The main measure, the share of blood the heart pumps out with each beat, was 45.44 percent against 42.44 percent after one month (p = 0.024) [49].

Serious heart and brain events over six months were 14.6 against 24.7 percent, a difference too small to rule out chance (p = 0.089). The manufacturer supplied the drug and part of the funding [49].

Randomised trial In 60 older patients with heart failure, seven days of the same injection against a salt-water drip improved two heart markers slightly more, but the difference was not statistically significant. This trial was also partly funded by the manufacturer and was registered only after it had started [50].

A company comparison of two drips

Randomised preprint A study funded by the maker of an NR product compared drips of NAD+, NR and salt water in healthy adults aged 40 and over. It has not been peer-reviewed. Blood NAD+ three hours later was higher after the NR drip than after the NAD+ drip (p < 0.01) [51].

Human pharmacokinetic study A phase I study in 2026 measured NAD+ in blood and, with a scanner, in the brain. Six healthy people and six with Parkinson's disease took NR or NMN daily. Blood NAD+ took about two weeks to plateau. Brain NAD+ rose measurably only after four weeks, and individuals differed widely [13].

Metabolism: the NR and NMN trials

Randomised trial In overweight but otherwise healthy adults, whole blood NAD+ rose by 22, 51 and 142 percent at the three ascending dose levels. The rise appeared within two weeks and held for the remaining six of the eight weeks. That is proof the substance hit its biochemical target, not proof of a health benefit [4].

Whole-blood NAD+ after eight weeks of swallowed NR
Lowest dose level
22 percent increase
Middle dose level
51 percent increase
Highest dose level
142 percent increase

Randomised, double-blind, placebo-controlled trial in overweight adults, three ascending dose levels over eight weeks. The study was run for the manufacturer of the product. Source [4].

Randomised trial In 40 obese men, twelve weeks of NR did not improve insulin sensitivity, glucose production, glucose uptake or glucose burning. Resting energy use, fat release, fat burning and body composition were unchanged too. The authors concluded that the dose was safe but did not improve glucose metabolism [14].

Randomised trial Twenty-five postmenopausal women with prediabetes took NMN for ten weeks, and muscle glucose uptake under insulin rose. The finding is disputed.

A published comment notes that the 13 women on NMN began with 6.3 percent liver fat against 14.8 percent in the 12 on placebo. That difference is unlikely to be chance (p = 0.003), so the groups were not comparable at the start [15], [16].

Randomised trial Thirty overweight or obese adults aged 45 and over took a crystalline form of NMN for 28 days. Body weight fell by 1.9 kg more than on placebo (p = 0.008), the lower of the two blood pressure readings by 7.0 mmHg (p = 0.034), total cholesterol by 26.9 mg/dl (p = 0.004) and LDL cholesterol by 18.7 mg/dl (p = 0.007).

Muscle strength, muscle fatigability, stair-climbing power, aerobic capacity, insulin sensitivity, liver fat and belly fat did not change [17].

Randomised trial In 13 overweight people, six weeks of NR raised the markers of NAD+ production in muscle and slightly raised lean mass, from 61.32 to 62.65 percent. Insulin sensitivity, mitochondrial function, liver fat, blood pressure and inflammation markers were unaffected [18].

Parkinson's disease

Randomised phase I trial In the NADPARK study, 30 newly diagnosed and untreated patients took NR or placebo for 30 days. Brain NAD+ rose, but unevenly. Only in those whose brain level actually rose did brain glucose handling change, alongside a mild clinical improvement. Inflammation markers in blood and spinal fluid fell [19].

Randomised safety trial The NR-SAFE study gave 20 patients the highest daily amount tested in people to date, over four weeks. No moderate or severe side effects occurred, and blood NAD+ rose up to fivefold. Serum homocysteine rose slightly at first.

The apparent improvement in symptom scores coincided with a shorter gap since the last levodopa dose. The authors name that confounder themselves [20].

Muscle, walking and ageing

Randomised trial In healthy older men, daily NMN raised blood NAD+ significantly. Walking speed and left-hand grip strength improved, but the authors describe the result as only nominally significant and in need of confirmation. Body composition did not change [21].

Randomised trial In 90 people with poor leg circulation, six months of NR changed the six-minute walking distance by +7.0 metres, against -10.6 metres on placebo. The difference was 17.6 metres, and 31.0 metres among those who took at least 75 percent of their capsules. Adding resveratrol gave 26.9 metres in that group, so it brought no advantage over NR alone.

The main result was reported with a one-sided 90 percent confidence interval whose lower bound was 1.8 metres, and the authors call for a larger confirmatory trial [22].

Randomised trial In 80 healthy middle-aged adults, blood NAD+ rose at all three dose levels against placebo and against the starting value (p ≤ 0.001 throughout), most strongly at the two higher levels. Six-minute walking distance improved more than on placebo, while insulin resistance did not differ.

Biological age was estimated with a free online calculator rather than a validated marker [23].

Missed and negative endpoints

Randomised trial In 20 older adults with mild cognitive problems, ten weeks of NR raised blood NAD+ 2.6-fold and left the cognitive score unchanged. Blood flow in one brain network fell under NR, a finding the authors say would not have survived correction for multiple testing. Walking speed improved in the placebo group, not the NR group [24].

Randomised trial One primary endpoint was met. In 40 people with COPD, sputum levels of the inflammation signal interleukin-8 were 52.6 percent lower on NR than on placebo, and the gap persisted 12 weeks after treatment ended. This is an inflammation marker, not a clinical outcome [25].

Open-label trial In 30 people with heart failure, NR roughly doubled whole-blood NAD+ and appeared safe. The individual rise correlated with respiration in blood cells and with lower activity of an inflammation switch. These are mechanistic correlations rather than clinical results [26].

Randomised trial In healthy middle-aged and older adults, NR was taken for two six-week periods in a crossover design. It was well tolerated and measurably stimulated NAD+ metabolism.

For blood pressure and arterial stiffness the authors claim nothing. They write only that future trials should assess whether NR might reduce them, which is a question rather than a finding [27].

Systematic review The overall picture from 33 human trials is consistent. Swallowed NR and NMN reliably hit their biochemical target and were generally well tolerated over weeks to months. Effects on function, metabolism, blood vessels and other health-relevant endpoints were mixed, and often absent or confined to a single measure [3].

Safety findings that point the other way

Observational study One discovery group of 1,162 people and two validation groups of 2,331 and 832 were studied. Higher blood levels of 2PY and 4PY, the final breakdown products of surplus niacin, went with a higher risk of serious cardiac events within three years.

For 4PY the adjusted risk was 89 and 99 percent higher in the two validation groups (hazard ratios 1.89 and 1.99) [28].

That study looked at heart patients and at niacin, not at NAD+ products. It matters here because 2PY and 4PY are also the final breakdown products of NR and NMN [28].

Human pharmacokinetic study In 14 healthy men, a dose of NMN placed under the tongue produced significantly more of those same breakdown products than the swallowed dose. Blood levels of NMN, nicotinamide and NAD+ did not differ between the two routes [29].

Animal data In a mouse model of triple-negative breast cancer, giving NR significantly increased both the frequency of tumours and their spread to the brain. The authors conclude that use of such supplements needs weighing up in particular patient groups [30].

Preclinical review The direction of cancer research runs the opposite way. Tumour cells turn NAD+ over quickly and depend on one enzyme that recovers it. Blockers of that enzyme, which lower NAD+, are being developed as cancer drugs [31].

What is still unknown

  • Whether infused NAD+ does anything for the uses it is sold for. No randomised, placebo-controlled trial of intravenous NAD+ for wellness or ageing exists; the only placebo-controlled trials are two small Chinese studies in heart failure [32], [33], [49], [50].
  • What amount would be right. The quantities used in clinics do not come from a dose-finding study [2].
  • How long injected NAD+ stays in the body. No half-life has been measured by any route [2].
  • Whether swallowed NAD+ is absorbed intact. There are no human data either way, and the size, charge and water-loving character of the molecule argue against it [1].
  • Whether a blood level says anything about tissue. Brain NAD+ rose only after four weeks, and individual differences were large [13].
  • What happens beyond a year. The longest treatment period in the literature is 26 weeks per arm, in a rare inherited disease [34].
  • Nasal sprays, patches and injections under the skin. No results have been published on any of them, although registered trials exist [3], [54].

Side effects and safety

There is no side-effect profile for NAD+ drips or injections in the sense a licensed medicine in Europe or America has one, because the studies that would produce it have not been done. What exists are a few small reports on drips and nothing at all on injections under the skin.

What is known about tolerability

  • Drip symptoms were common enough to slow the infusion. In a provider's review of its own records, all six people given NAD+ reported moderate to severe stomach cramps, diarrhoea, nausea, vomiting, a rising heart rate, a sore throat, congestion and chest pressure during the drip. All of it stopped as soon as the drip ended. NR drips caused mild tingling in tongue, jaw and arm, and mild cramps, in five of eight people [6].
  • That report is weak evidence in both directions. It was retrospective, had no control group, no blinding, no symptom scale, and was written by employees of the company selling the infusions. Liver values, kidney values, thyroid stimulating hormone and the inflammation marker hsCRP did not change [6].
  • A company study saw the same pattern. In a preprint funded by the maker of an NR product, most people on the NAD+ drip rated their comfort as low and described nausea, headache, anxiety, an urge to empty the bowels, chest tightness and hot flashes. Their white blood cell counts rose after the drip, which did not happen with NR or salt water [51].
  • The drips were slowed by the people receiving them. In both reports, those receiving NAD+ could set the drip speed themselves. Their drips took 97 minutes on average against 37 for NR in the record review, and 182.9 minutes against 127.2 in the preprint [6], [51]. No study has compared fixed speeds, so the common claim that a faster drip causes more symptoms rests on this self-adjustment, not on a test.
  • The six-hour infusion study saw nothing. No side effects were observed in eight healthy men given a slow drip at fixed speed. One infusion in eight people, with no follow-up beyond eight hours, is not a safety result [2].
  • The Chinese heart-failure trial reported almost nothing. Among 90 patients on the approved injection, one reported mild dizziness that passed within about an hour; in the placebo group one reported chest discomfort [49]. The Chinese label lists occasional dry mouth, nausea, dizziness and palpitations [50], [53].
  • The swallowed forms were well tolerated. Across 33 human trials, NR and NMN were generally well tolerated over weeks to months, at the amounts and durations tested [3].
  • High-dose NR nudged one blood value. At the highest daily amount tested in people, serum homocysteine rose slightly at the start. Breaking down nicotinamide consumes methyl groups, so a steady high intake draws on that budget [20].
  • Reports are accumulating in the American side-effect database. Under the product name "NAD" there were 44 reports, 28 of them classed as serious. Nicotinamide riboside had 36, of which 21 were serious. They concentrate in 2025 and 2026 [35].

Those reports prove nothing on their own. They are voluntary, carry no proof of cause and have no known denominator. In most of them NAD+ is listed as something else the person was taking, not as the suspected cause: that applies to 64 of 76 reports under the three names checked. The reverse also holds: substances sold outside the regulated medicines system rarely generate reports at all [35].

Two further concerns come from the regulators' own files. The European food safety assessors wrote in 2021 that experimental data suggest several routes by which nicotinamide or its building blocks could have unwanted effects at intakes well above what the body needs [36].

In the rat study underlying the 2026 NMN opinion, effects on the reproductive organs were seen. Pregnant and breastfeeding women are excluded from both positive European assessments [37], [11].

Finally, a drip carries risks that have nothing to do with what is in it: infection at the puncture site, vein inflammation, fluid load, and errors in preparing and sterilising the solution [33].

Injection-site pain, burning and flushing

Many people ask why an NAD+ injection burns or stings. The honest answer is that no study has looked. No published human study reports pain, burning or stinging after NAD+ is injected under the skin or into a muscle [54].

One registered trial is designed to measure exactly this. It compares NAD+, NR and plain bacteriostatic water given under the skin, into a muscle or straight into a vein, with a standard pain questionnaire one minute after the injection as its main outcome. It was due to finish in June 2025 and had posted no results by 9 October 2026 [54].

The American side-effect database holds three reports with injection-site complaints among people who listed NAD+. In each of them, another injected medicine was named as the suspected cause, and NAD+ only as something else being taken [35].

The only direct tissue findings come from animals. In safety tests for the Chinese product, repeated injections into the muscles of rats caused damage at the injection site and to the nearby sciatic nerve, which healed after the injections stopped. In the same programme, the higher single doses raised the heart rate and lowered the blood pressure of dogs [55].

Flushing is reported only from drips. People on NAD+ drips described hot flashes in the company preprint [51]. In the American database, the most frequent reactions listed under "NAD" include skin reddening (5 reports) and hot flushes (2 reports), without proof of cause [35]. In the preprint, the words "burning" and "slightly painful" came from people on the NR drip, not the NAD+ drip [51].

Colour of the solution

A faint yellow tint in an NAD+ solution is often read as a sign that it has gone off. No published study could be found that links a yellow colour of NAD+ solution to breakdown [56], [57], [59].

A manufacturer of laboratory NAD+ specifies that a solution of its product may be "colorless to faintly yellow", so a faint tint can be within specification. The reduced form, NADH, is a different substance: its powder is white to light yellow, and it absorbs light at a wavelength where NAD+ does not [58], [59]. More on this question is on the page about NAD+ turning yellow.

Storage of the reconstituted solution

No stability data could be found for NAD+ prepared for injection, whether in sterile or bacteriostatic water, and no source states that such a vial must be kept in the fridge [57]. What is known comes from laboratory-grade NAD+ and from chemistry papers.

  • Acid and alkali. NAD+ breaks down slowly and at a steady rate between pH 2 and pH 7, and thousands of times faster in strongly alkaline conditions [56].
  • Heat and buffer. Heat speeds the breakdown, by about 11 percent for each degree in the range measured, which ran from 60 to 100 °C. Phosphate speeds it up as well [56]. In a 43-day test in slightly alkaline solution at 19 °C, NAD+ in Tris buffer lost about 4 percent, while in HEPES buffer it broke down almost completely [59].
  • Cold storage of laboratory solutions. Kept in dilute acid, NAD+ showed no loss after a week at 4 °C or at −85 °C, but about 15 percent was lost at −20 °C [56]. A manufacturer gives at least two weeks at 0 °C for neutral or slightly acidic solutions, and at least six months at −70 °C for single-use portions between pH 2 and 6 [57].
  • Light and moisture. The same manufacturer describes solutions as sensitive to light and the powder as strongly water-attracting [57].

These figures describe laboratory reagents in defined solutions, which their makers label as not for use in medicines. They do not tell how long a vial prepared for injection stays sterile or intact [57].

Why this page lists no doses

NAD+ is an approved prescription medicine in China, as an injection [49], [50], [53]. Where a medicine is approved, its dosing belongs to the official product information and to the doctor or pharmacist handling it, not to a reference page.

No study has worked out a dose of NAD+ for injection or infusion, and the amount in the one human measurement of a drip was taken over from clinics [2]. There is therefore no dosing chart for NAD+ injections that rests on evidence. The amounts used in the studies above were chosen for those studies and do not transfer to a healthy reader. This page gives no amounts, strengths, schedules or instructions, in any direction.

Subcutaneous, intramuscular or intravenous: what the studies used

  • Into a vein. Almost all human data on NAD+ itself come from drips: the six-hour pilot study, the record review, the company preprint and the two Chinese heart-failure trials [2], [6], [51], [49], [50]. Several Chinese hospital trials registered in recent years also use drips [54].
  • Into a muscle. The approved Chinese product is labelled for injection into a muscle [53]. One registered Chinese trial in sudden hearing loss planned that route and has posted no results [54]. The animal safety tests of the same product also used it [55].
  • Under the skin. No published human study has given NAD+ this way. The only registered trial is the injection-pain study described above, and it has not reported [54].
  • By mouth. The swallowed route belongs almost entirely to the building blocks NR and NMN, described under the studies above. There are no human data on whether swallowed NAD+ itself is absorbed intact [3], [1].

No study has compared these routes for any effect a person would notice. The one direct comparison of two drips found more NAD+ in the blood after the NR drip than after the NAD+ drip [51].

Development and approval status

From cozymase to the 2026 review

  1. 1906Described in yeast extract as cozymaseThe historical names still sit in the chemical databases, ref [1]
  2. 2010China approves the label of an NAD+ injectionFor supportive treatment of low white-cell counts and heart disease, ref [53]
  3. 2016First human pharmacokinetics of swallowed NRThree ascending single doses, ref [38]
  4. 2018Twelve weeks of NR fail to improve insulin sensitivity in 40 obese menThe clearest negative result in the field, ref [14]
  5. 2019The only human measurement of an NAD+ drip is publishedNo rise in blood NAD+ in the first two hours, ref [2]
  6. 2020Europe authorises NR chloride as a novel foodSupplements only, with a daily ceiling set in law, ref [11]
  7. 2021-2023The NMN trials appear, with mixed and disputed resultsRefs [15], [16], [21], [23], [17]
  8. 2026A systematic review, a positive European opinion on NMN, the gut-bacteria finding and a Chinese heart-failure trialRefs [3], [37], [5], [49]
  • 1906 — the molecule is described in yeast extract as cozymase [1].
  • 2010 — the label of the Chinese NAD+ injection is approved, on 8 December 2010 [53].
  • 2016 to 2020 — the first controlled trials of swallowed NR are published, including the negative insulin result [38], [14].
  • 2019 — the single human pharmacokinetic study of an NAD+ infusion appears [2].
  • 2020 — the European Union authorises NR chloride as a novel food, for supplements only [11].
  • 2021 to 2023 — the NMN trials arrive, one of them publicly disputed on the grounds that its groups were not comparable [15], [16].
  • 2026 — four landmarks: a systematic review of 113 studies, a positive European opinion on NMN, evidence that the swallowed forms work through gut bacteria, and a placebo-controlled Chinese trial of the approved injection in heart failure [3], [37], [5], [49].
MarketSwallowed NR and NMNNAD+ injectionRef
United StatesSold as supplementsNot approved[7], [40]
European UnionNR authorised, NMN assessedNot approved[11], [37]
GermanyFood law appliesMedicine, unauthorised[11]
United KingdomOn saleNot approved[7]
AustraliaNot scheduledNot scheduled[41]
CanadaNot checkedNot checked[7]
JapanWidely soldNot checked[39]
ChinaNot checkedApproved prescription injection[49], [50], [52], [53]

The table was first checked on 7 September 2026. Where it says not checked, no national register was searched and no claim is made. The American position is the firmest point: two searches of the approval database returned "No matches found", and the search was repeated with the same result on 9 October 2026 [7].

The Chinese row was added on 9 October 2026. The product is a freeze-dried NAD+ powder for injection under the approval numbers H41024721 and H41025094. Its label lists the supportive treatment of low white-cell counts, coronary heart disease and inflammation of the heart muscle [52], [53].

The Chinese regulator's own database could not be queried automatically. The entry therefore rests on two published trials that quote the approval number, the manufacturer's product index and the label as shown in a professional drug database [49], [50], [52], [53].

The 44 American labels that list "nadide" as an ingredient are homeopathic over-the-counter preparations. Each carries the notice that its claims have not been evaluated [40].

One more point belongs here, because it is often presented the wrong way round. NAD+ is not on the American list of bulk substances that may pose a significant safety risk. It is not on the list of substances permitted for compounding either [42], [43].

Being absent from both means it was never assessed, not that it was assessed and cleared.

Anti-doping

The substance is not named on the 2026 Prohibited List. A full-text search for nicotinamide, NAD, riboside, mononucleotide, niacin and dinucleotide returns nothing [8].

The method is another matter. Section M2.2 bans, at all times, "intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period except for those legitimately received in the course of hospital treatments, surgical procedures or clinical diagnostic investigations" [8].

Ordinary NAD+ drips are far larger than that, and a wellness infusion is not covered by the exception.

Class S0, the catch-all clause, covers only substances with no current approval by any government health authority for human therapeutic use. NAD+ is not named on the list, and with the Chinese approval it no longer meets that condition [8], [53]. For swallowed NR and NMN the method rule does not apply: a tablet is not an infusion [8]. More detail sits under peptides banned in sport.

Compared with related peptides

SubstanceWhat it isPoint of attackHuman evidenceStatus
NAD+Dinucleotide coenzyme, 663.43 g/mol [1]Shared helper and raw material of several enzyme families [9]A few small drip studies, two of them Chinese trials in heart failure; the rest concerns NR and NMN [2], [49], [3]Approved only in China, as an injection [53]
GlutathioneTripeptide of three amino acids, 307.33 g/mol [44]Not comparable; assessed on its own pageAssessed on its own pageAssessed on its own page
5-Amino-1MQSmall synthetic molecule, 159.21 g/mol [45]Blocks NNMT, the enzyme that methylates nicotinamide [46]None at all; assessed on its own pageApproved nowhere; assessed on its own page
MOTS-cPeptide of 16 amino acids, 2174.6 g/mol [47]Not the same targetAssessed on its own pageNamed on the American safety-risk list [43]

Glutathione is the closest neighbour in practice. It is the other body-made substance sold as a cosmetic or wellness drip beside research peptides, and like NAD+ it is a molecule the body already makes in every cell.

5-Amino-1MQ is the interesting opposite. It sits on the same vitamin B3 pathway, but works from the other end: it blocks the enzyme that methylates nicotinamide, rather than adding a building block [46].

MOTS-c is the neighbour NAD+ is most often shelved beside, and the two have little in common. One is a chain of 16 amino acids the body encodes in its mitochondria [47]; the other has no amino acids at all [1].

Common misconceptions

  • "NAD+ is a peptide." It contains no amino acid and no peptide bond. It is two nucleotides joined by a phosphate bridge, 663.43 g/mol. The confusion comes purely from the sales channel: it is offered in the same catalogues as research peptides, and the label travels with it [1].
  • "NAD+, NMN, NR and niacin are much the same." They form a chain, but differ in size, route and legal standing, at 663, 334, 255 and 122 g/mol. NADH, the reduced form, is a fifth substance. Almost all the human evidence concerns NR and NMN, so a trial of those proves nothing about a drip [48], [3].
  • "A drip fills the cells with NAD+." The one human measurement says otherwise. Blood NAD+ did not rise at all during the first two hours of a six-hour infusion, and the substances appearing in urine matched the molecule being cut apart [2].
  • "A drip beats a tablet because it skips the gut." The data pull the other way. Gut bacteria turn NR and NMN into nicotinic acid, and only nicotinic acid raised NAD+ strongly in blood tested outside the body. If that holds, skipping the gut skips the mechanism [5].
  • "More NAD+ must be better." Biology says not necessarily. Tumour cells depend on the enzyme that recovers NAD+, and blockers of it are being developed as cancer drugs. In one mouse model, NR increased tumour frequency and spread to the brain. None of this proves harm in people, but it undercuts the assumption [31], [30].
  • "It is not on the doping list, so it is fine in sport." The substance is not listed. The method is. Infusions above 100 millilitres per 12 hours are banned at all times outside hospital treatment, surgery and clinical diagnosis, whatever is dissolved in them [8].

Frequently asked questions

Is NAD+ a peptide?

No. NAD+ is a dinucleotide, a coenzyme built from two nucleotides joined by a phosphate bridge, weighing 663.43 g/mol. It contains no amino acids and no peptide bonds. It appears beside peptides because it is sold as an injection through the same channels, not because it belongs to the same chemical class.

What happens to NAD+ when it is infused into a vein?

In the only human measurement, eight healthy men were given NAD+ as a drip running over six hours. Blood NAD+ did not rise at all in the first two hours, which the authors read as the molecule being removed as fast as it arrived. By the end of the drip it was 398 percent above the starting value, and it was still raised two hours later. The substances in the urine matched NAD+ being cut apart by enzymes.

Is there a trial showing that NAD+ infusions work?

Not for the uses they are sold for. No randomised, placebo-controlled trial has tested NAD+ drips for wellness or ageing. Two small Chinese trials gave an approved NAD+ injection to people with heart failure alongside their usual treatment: one reported a slightly better pumping measure after a month, the other found no significant difference. A 2026 review classes intravenous longevity therapy as experimental.

Are NAD+, NMN and NR the same thing?

No. They are links in one chain but differ in size, route and legal status: NAD+ at 663 g/mol, NMN at 334 and NR at 255. Nicotinamide, a form of vitamin B3, is smaller still at 122. Almost all the controlled human evidence concerns NR and NMN taken by mouth.

Do NAD+ precursors raise NAD+ levels in the body?

Yes, the swallowed ones do. Whole-blood NAD+ rose by 22, 51 and 142 percent at three ascending NR dose levels during an eight-week trial. The rise is slow: blood levels take about two weeks to plateau, and brain levels only rose measurably after four weeks, with wide differences between individuals.

Did the NAD+ precursor trials improve anything people would notice?

Rarely and inconsistently. A review of 33 human trials found reliable biochemical effects but mixed results on function, metabolism and blood vessels, often with no effect at all. Twelve weeks of NR did not improve insulin sensitivity in 40 obese men, and ten weeks did not improve cognition in 20 older adults.

What are the side effects of NAD+ injections and infusions?

Published reports exist only for drips. In a provider's record review, all six people given NAD+ had moderate to severe gut symptoms, a faster pulse and chest pressure, which stopped when the drip ended; they slowed their drips to 97 minutes on average against 37 for NR. A company-funded preprint describes nausea, headache, chest tightness and hot flashes. Nothing has been published on injections under the skin or into a muscle.

Why does an NAD+ injection burn or sting?

No study has measured it. There are no published human data on pain, burning or stinging after NAD+ is injected under the skin or into a muscle, and the American side-effect database holds no injection-site report that names NAD+ as the suspected cause. A registered trial with injection pain as its main outcome has posted no results. In rats, injections into muscle caused local tissue damage that healed.

How long does NAD+ stay in the body after an injection or a drip?

Nobody knows exactly, because no half-life has been measured, after a drip or after an injection. During a six-hour drip, blood NAD+ stayed flat for two hours, then rose, and was still raised two hours after the drip ended, when sampling stopped. In cell experiments, enzymes outside the cells cut NAD+ into smaller pieces before the cells take it up.

Is NAD+ given under the skin, into a muscle or into a vein in studies?

Almost all human data concern drips into a vein. The approved Chinese product is labelled for injection into a muscle, and one registered Chinese trial planned that route but has reported nothing. No published human study has given NAD+ under the skin; one registered trial compares all three routes for injection pain and has not reported either.

Does NAD+ need to be refrigerated?

No study of ready-made NAD+ injection vials could be found, so there is no tested shelf life for them. For laboratory-grade NAD+ the chemistry is known: it keeps best in neutral or slightly acidic solution, breaks down quickly with heat and in alkaline solution, and is sensitive to light. One manufacturer gives at least two weeks at 0 °C and at least six months frozen at −70 °C.

Why has my NAD+ solution turned yellow?

No published study links a yellow tint in NAD+ solution to breakdown. One manufacturer's specification for laboratory NAD+ allows a solution that is colourless to faintly yellow, so a faint tint on its own says little. The reduced form, NADH, is a different substance and is itself yellowish. A separate page on NAD+ turning yellow goes into this in more detail.

Is NAD+ approved as a medicine anywhere?

Only in China, as far as could be found. There an NAD+ injection is approved for the supportive treatment of low white-cell counts, coronary heart disease and myocarditis. Searches of the American approval database for "nadide" and "nicotinamide adenine dinucleotide" returned "No matches found" on 9 October 2026, and no approval was found in Europe, the United Kingdom, Canada, Australia or Switzerland.

Can you measure your NAD+ level to see whether it is working?

What such a test measures is NAD+ in blood. Whether that reflects the amount in muscle, brain or liver is unresolved. In one study brain levels rose only after four weeks while blood levels plateaued after two, and in the Parkinson's trial brain metabolism changed only in those whose brain level actually rose.

Is NAD+ banned in sport?

The substance is not named on the 2026 Prohibited List. The method is caught: infusions and injections of more than 100 millilitres per 12 hours are banned at all times, except when legitimately received during hospital treatment, surgery or clinical diagnosis. Ordinary NAD+ drips exceed that volume. Tablets of NR or NMN are unaffected.

Sources

  1. PubChem. Compound CID 5892, nadide (nicotinamide adenine dinucleotide). Formula C21H27N7O14P2, 663.43 g/mol, exact mass 663.10912256, XLogP -6, CAS 53-84-9, UNII 0U46U6E8UK, InChIKey BAWFJGJZGIEFAR-NNYOXOHSSA-N; 199 synonyms including the historical names cozymase I, codehydrase I and diphosphopyridine nucleotide, and the free names nadide (USAN, INN, BAN, JAN) and nadidum (homeopathic pharmacopoeia). Retrieved 7 September 2026. https://pubchem.ncbi.nlm.nih.gov/compound/5892
  2. Grant R, Berg J, Mestayer R, Braidy N, Bennett J, Broom S, Watson J (2019). A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD+. Frontiers in Aging Neuroscience 11:257. PMID 31572171. PMC6751327. DOI 10.3389/fnagi.2019.00257. Full text checked on 7 September 2026 for group size, dose and infusion rate, and again on 9 October 2026 for the plasma time course: no rise in the first 2 h, plus 398 percent at 6 h, still raised at 8 h; sampling ended at 8 h and no half-life was calculated. The dose was "derived empirically" from a clinic regimen; funded jointly by NAD+ Research Inc.
  3. Gallagher C, Emmanuel OO (2026). NAD+ supplementation for anti-aging and wellness: a PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Research Reviews 116:103057. PMID 41655607. DOI 10.1016/j.arr.2026.103057. January 2010 to October 2025, 113 eligible studies, of which 33 human intervention studies (28 randomised) and 80 rodent studies; no eligible outcome trial.
  4. Conze D, Brenner C, Kruger CL (2019). Safety and metabolism of long-term administration of NIAGEN (nicotinamide riboside chloride) in a randomized, double-blind, placebo-controlled clinical trial of healthy overweight adults. Scientific Reports 9(1):9772. PMID 31278280. DOI 10.1038/s41598-019-46120-z. Run for the manufacturer of the product.
  5. Christen S et al. (2026). The differential impact of three different NAD+ boosters on circulatory NAD and microbial metabolism in humans. Nature Metabolism 8(1):62-73. PMID 41540253. DOI 10.1038/s42255-025-01421-8. Registered as NCT05517122; 65 healthy adults, 14 days.
  6. Reyna K, Heinzen G, Patel N, Ritter M, Siojo A, Legere H, Pojednic R (2026). Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. Frontiers in Aging 7:1652582. PMID 41704678. DOI 10.3389/fragi.2026.1652582. Seven of the authors were employed by the company providing the infusions. Full text (PMC12907335) checked on 9 October 2026: 6 people received NAD+ and 8 received NR, on 4 consecutive days; all 6 in the NAD+ group reported symptoms; clients controlled their own infusion rate; mean infusion time 97 ± 56.33 min against 37 ± 13.08 min.
  7. openFDA, Drugs@FDA endpoint. Queried on 7 September 2026 for the active ingredients "nadide" and "nicotinamide adenine dinucleotide"; both queries returned "No matches found". https://api.fda.gov/drug/drugsfda.json
  8. World Anti-Doping Agency. The 2026 Prohibited List, in force from 1 January 2026, sections S0 and M2. Full text searched on 7 September 2026 for "nicotinamid", "NAD", "riboside", "mononucleotide", "dinucleotide" and "niacin", with no match. M2.2 is classed as a specified method. https://www.wada-ama.org/en/prohibited-list
  9. Covarrubias AJ, Perrone R, Grozio A, Verdin E (2021). NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology 22(2):119-141. PMID 33353981. DOI 10.1038/s41580-020-00313-x
  10. WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index 2026, index status 20 January 2026. Queried on 7 September 2026 for "nadide" and for "nicotinamide riboside"; both returned "No match found". Nicotinamide itself is coded A11HA01. https://atcddd.fhi.no/atc_ddd_index/
  11. Commission Implementing Regulation (EU) 2020/16 of 10 January 2020 authorising the placing on the market of nicotinamide riboside chloride as a novel food. In force from 20 February 2020. Food supplements only, with a maximum daily intake for the general adult population and a lower one for pregnant and breastfeeding women. Applicant ChromaDex Inc. Full text checked on 7 September 2026. https://eur-lex.europa.eu/eli/reg_impl/2020/16/oj
  12. Bhasin S, Seals D, Migaud M, Musi N, Baur JA (2023). Nicotinamide adenine dinucleotide in aging biology: potential applications and many unknowns. Endocrine Reviews 44(6):1047-1073. PMID 37364580. DOI 10.1210/endrev/bnad019
  13. Berven H et al. (2026). The NAD-brain pharmacokinetic study of NAD augmentation in blood and brain using oral precursor supplementation. iScience 29(3):114764. PMID 41858901. DOI 10.1016/j.isci.2026.114764. Two authors are named on pending patent applications.
  14. Dollerup OL et al. (2018). A randomized placebo-controlled clinical trial of nicotinamide riboside in obese men: safety, insulin-sensitivity, and lipid-mobilizing effects. American Journal of Clinical Nutrition 108(2):343-353. PMID 29992272. DOI 10.1093/ajcn/nqy132. Registered as NCT02303483.
  15. Yoshino M, Yoshino J, Klein S et al. (2021). Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women. Science 372(6547):1224-1229. PMID 33888596. DOI 10.1126/science.abe9985. Registered as NCT03151239. One author receives a share of patent licence income; another is named on an NMN patent application.
  16. Brenner C (2021). Comment on "Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic women". Science 373(6554):eabj1696. PMID 34326206. DOI 10.1126/science.abj1696. The authors' reply is PMID 34326209.
  17. Pencina KM et al. (2023). Nicotinamide adenine dinucleotide augmentation in overweight or obese middle-aged and older adults: a physiologic study. Journal of Clinical Endocrinology and Metabolism 108(8):1968-1980. PMID 36740954. DOI 10.1210/clinem/dgad027
  18. Remie CME et al. (2020). Nicotinamide riboside supplementation alters body composition and skeletal muscle acetylcarnitine concentrations in healthy obese humans. American Journal of Clinical Nutrition 112(2):413-426. PMID 32320006. Registered as NCT02835664.
  19. Brakedal B et al. (2022). The NADPARK study: a randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease. Cell Metabolism 34(3):396-407.e6. PMID 35235774. DOI 10.1016/j.cmet.2022.02.001. Registered as NCT03816020. Two authors have filed a patent application on the use of NR in Parkinson's disease.
  20. Berven H et al. (2023). NR-SAFE: a randomized, double-blind safety trial of high dose nicotinamide riboside in Parkinson's disease. Nature Communications 14(1):7793. PMID 38016950. DOI 10.1038/s41467-023-43514-6. Registered as NCT05344404.
  21. Igarashi M et al. (2022). Chronic nicotinamide mononucleotide supplementation elevates blood nicotinamide adenine dinucleotide levels and alters muscle function in healthy older men. npj Aging 8(1):5. PMID 35927255. DOI 10.1038/s41514-022-00084-z. Three authors are employees of Mitsubishi Corporation Life Sciences.
  22. McDermott MM et al. (2024). Nicotinamide riboside for peripheral artery disease: the NICE randomized clinical trial. Nature Communications 15(1):5046. PMID 38871717. DOI 10.1038/s41467-024-49092-5. Erratum: Nature Communications 15(1):6890.
  23. Yi L, Maier AB et al. (2023). The efficacy and safety of beta-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomised, multicentre, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial. GeroScience 45(1):29-43. PMID 36482258. DOI 10.1007/s11357-022-00705-1. Biological age was estimated with the free online calculator Aging.Ai 3.0.
  24. Orr ME et al. (2024). A randomized placebo-controlled trial of nicotinamide riboside in older adults with mild cognitive impairment. GeroScience 46(1):665-682. PMID 37994989. DOI 10.1007/s11357-023-00999-9
  25. Norheim KL et al. (2024). Effect of nicotinamide riboside on airway inflammation in COPD: a randomized, placebo-controlled trial. Nature Aging 4(12):1772-1781. PMID 39548320. DOI 10.1038/s43587-024-00758-1
  26. Wang DD et al. (2022). Safety and tolerability of nicotinamide riboside in heart failure with reduced ejection fraction. JACC: Basic to Translational Science 7(12):1183-1196. PMID 36644285. DOI 10.1016/j.jacbts.2022.06.012. Registered as NCT03423342.
  27. Martens CR, Denman BA, Mazzo MR, Armstrong ML, Reisdorph N, McQueen MB, Chonchol M, Seals DR (2018). Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications 9(1):1286. PMID 29599478. DOI 10.1038/s41467-018-03421-7. Abstract checked on 7 September 2026: blood pressure and arterial stiffness are named as a question for future trials, not as a result.
  28. Ferrell M, Hazen SL et al. (2024). A terminal metabolite of niacin promotes vascular inflammation and contributes to cardiovascular disease risk. Nature Medicine 30(2):424-434. PMID 38374343. DOI 10.1038/s41591-023-02793-8. Erratum: Nature Medicine 30(6):1791. Discovery cohort n = 1,162; validation cohorts n = 2,331 (United States) and n = 832 (Europe).
  29. Wakabayashi J, Higashi S, Morifuji M (2026). Sublingual NMN administration increases early circulating terminal catabolites 2PY and 4PY compared with oral administration in healthy adult men. Scientific Reports 16(1):27464. PMID 42304075. DOI 10.1038/s41598-026-57552-9
  30. Maric T et al. (2023). A bioluminescent-based probe for in vivo non-invasive monitoring of nicotinamide riboside uptake reveals a link between metastasis and NAD+ metabolism. Biosensors and Bioelectronics 220:114826. PMID 36371959. DOI 10.1016/j.bios.2022.114826
  31. Sampath D, Zabka TS, Misner DL, O'Brien T, Dragovich PS (2015). Inhibition of nicotinamide phosphoribosyltransferase (NAMPT) as a therapeutic strategy in cancer. Pharmacology and Therapeutics 151:16-31. PMID 25709099. DOI 10.1016/j.pharmthera.2015.02.004
  32. ClinicalTrials.gov. The search key "nad" returned 263 studies; of the first 100 records read, 36 concern NAD+ or its precursors and the remainder use the same letters for unrelated substances. No randomised placebo-controlled efficacy trial of intravenous NAD+ was identified. Retrieved 7 September 2026. https://clinicaltrials.gov/
  33. Godic A, Townsend J (2026). Intravenous longevity therapy: a critical review of evidence, mechanisms, and clinical utility. Acta Dermatovenerologica Alpina, Pannonica et Adriatica 35(1):39-43. PMID 41915584. Concludes that intravenous longevity therapy should be regarded as experimental rather than evidence-based practice.
  34. Shoji M et al. (2025). Nicotinamide riboside supplementation benefits in patients with Werner syndrome: a double-blind randomized crossover placebo-controlled trial. Aging Cell 24(8):e70093. PMID 40459998. DOI 10.1111/acel.70093. Longest treatment period in the field: 26 weeks per arm.
  35. openFDA, adverse event endpoint (FAERS). Queried on 7 September 2026: 44 reports under the product name "NAD", 28 of them classed as serious; 30 under "Nadide"; 36 under "Nicotinamide Riboside", 21 of them serious; 5 each under "Nicotinamide Mononucleotide" and "Nicotinamide Adenine Dinucleotide". Most frequent reactions under "NAD", re-queried on 9 October 2026 with unchanged totals (44 reports, 28 serious): fatigue (8), headache (6), nausea (6), anxiety (5), erythema (5), insomnia (5); hot flush (2); the version of 7 September 2026 listed the erythema count as flushing. Across the 76 reports under "NAD", "Nadide" and "Nicotinamide Adenine Dinucleotide", NAD+ is coded as the suspect drug in 12; the three reports with injection-site terms name another injected medicine as suspect and NAD+ as concomitant. Reports concentrate in 2025 and 2026. https://api.fda.gov/drug/event.json
  36. EFSA Panel on Nutrition, Novel Foods and Food Allergens (2021). Safety of an extension of use of nicotinamide riboside chloride as a novel food. EFSA Journal 19(11):6843. PMID 34804232. States that experimental data suggest several routes by which nicotinamide or its precursors, at intakes well above physiological need, could have unwanted effects.
  37. EFSA Panel on Nutrition, Novel Foods and Food Allergens (2026). Safety of beta-nicotinamide mononucleotide as a novel food. EFSA Journal 24(5):e10007. PMID 42125559. Safe as a food supplement at the proposed intake for adults, excluding pregnant and breastfeeding women; the no-adverse-effect level comes from a 90-day rat study with effects on the reproductive organs, margin of safety 93.
  38. Trammell SA et al. (2016). Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nature Communications 7:12948. PMID 27721479. DOI 10.1038/ncomms12948. Three authors hold shares in the company supplying and sponsoring the product.
  39. Fukamizu Y et al. (2022). Safety evaluation of beta-nicotinamide mononucleotide oral administration in healthy adult men and women. Scientific Reports 12(1):14442. PMID 36002548. DOI 10.1038/s41598-022-18272-y. Registered as UMIN000043084. Five authors are employees of the funding company.
  40. openFDA, drug label endpoint. Queried on 7 September 2026: 44 American labels list "nadide" as a substance. Sample check: all are homeopathic over-the-counter preparations in which nadidum appears as one of several ingredients in homeopathic dilution, carrying the notice that the claims have not been evaluated by the FDA. https://api.fda.gov/drug/label.json
  41. Therapeutic Goods (Poisons Standard), Australia, June 2026 edition. Full text searched on 7 September 2026 for "nicotinamid", "dinucleotide", "riboside" and "mononucleotide" with no entry found. The neighbouring entry regulates nicotinic acid by dose in Schedules 2 and 4 and expressly excludes nicotinamide.
  42. Electronic Code of Federal Regulations, 21 CFR 216.23, list of bulk drug substances that may be used in compounding under section 503A. Full text retrieved on 7 September 2026: six substances are listed, and nicotinamide adenine dinucleotide is not among them. https://www.ecfr.gov/current/title-21/part-216/section-216.23
  43. US Food and Drug Administration. Certain bulk drug substances for use in compounding that may present significant safety risks. Page content current as of 22 April 2026, full text retrieved on 7 September 2026 and searched for "nicotinamid", "dinucleotide", "ribosid" and "mononucleotide" with no match; MOTS-c is recorded on the page. https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks
  44. PubChem. Compound CID 124886, glutathione. Formula C10H17N3O6S, 307.33 g/mol, CAS 70-18-8, UNII GAN16C9B8O. Retrieved 7 September 2026. https://pubchem.ncbi.nlm.nih.gov/compound/124886
  45. PubChem. Compound CID 950107, 5-amino-1-methylquinolin-1-ium. Formula C10H11N2+, 159.21 g/mol, CAS 685079-15-6. Retrieved 7 September 2026. https://pubchem.ncbi.nlm.nih.gov/compound/950107
  46. Neelakantan H, Wang HY, Vance V, Hommel JD et al. (2017). Structure-activity relationship for small molecule inhibitors of nicotinamide N-methyltransferase. Journal of Medicinal Chemistry 60(12):5015-5028. PMID 28548833. DOI 10.1021/acs.jmedchem.7b00389
  47. PubChem. Compound CID 146675088, MOTS-c. Sequence MRWQEMGYIFYPRKLR, 16 amino acids, C101H152N28O22S2, 2174.6 g/mol, CAS 1627580-64-6. Retrieved 7 September 2026. https://pubchem.ncbi.nlm.nih.gov/compound/146675088
  48. PubChem. Comparison compounds, all retrieved 7 September 2026: CID 439153 (NADH, C21H29N7O14P2, 665.4 g/mol), CID 14180 (nicotinamide mononucleotide, 334.22 g/mol), CID 439924 (nicotinamide riboside cation, 255.25 g/mol), CID 936 (nicotinamide, 122.12 g/mol), CID 938 (nicotinic acid). https://pubchem.ncbi.nlm.nih.gov/
  49. Yu X, Xu J, Cao J, Xu Q, Chen H, Yu D, Yao X, Chen K, Ma L (2026). Effect of nicotinamide adenine dinucleotide on heart failure caused by ischemic cardiomyopathy: a randomized, placebo-controlled trial. American Journal of Cardiovascular Drugs 26(1):97-106. PMID 40954388. PMC12779688. DOI 10.1007/s40256-025-00764-7. Registered as ChiCTR2200059169. Single centre, 180 adults, seven days; primary endpoint LVEF at one month 45.44 ± 8.55 % against 42.44 ± 9.09 % (p = 0.024); six-month MACCE 14.6 % against 24.7 % (p = 0.089). Product quoted as "SFDA Approved No. H41024721"; study drug and grant supplied by the manufacturer. Full text checked on 9 October 2026.
  50. Pei Z, Dong M, Meng X, Yao W, Guo Y, Wang F (2024). Effects of nicotinamide adenine dinucleotide on older patients with heart failure. Reviews in Cardiovascular Medicine 25(8):297. PMID 39228487. PMC11366984. DOI 10.31083/j.rcm2508297. Registered retrospectively as ChiCTR2300074326. 60 patients, seven days, NT-proBNP and LVEF changes not statistically significant; product quoted with "national drug approval number: H41024721"; cites the product instructions for occasional dry mouth, nausea, dizziness and palpitations; partly funded by the manufacturer. Full text checked on 9 October 2026.
  51. Hawkins J, Idoine R, Kwon J, Shao A, Dunne E, Hawkins E, Dawson K, Nkrumah-Elie Y (2024). Randomized, placebo-controlled, pilot clinical study evaluating acute Niagen+ IV and NAD+ IV in healthy adults. medRxiv preprint, not peer-reviewed. DOI 10.1101/2024.06.06.24308565. Registered as NCT06382688. Mean NAD+ infusion time 182.9 ± 55.93 min against 127.2 ± 40.82 min for NR (study 1) and 98.88 ± 46.70 min against 24.75 ± 8.33 min (study 2); white cell and neutrophil rise after NAD+ only. Four authors are employees of ChromaDex, which funded the study and sells the NR product. Full text checked on 9 October 2026.
  52. Kaifeng Knature Pharmaceutical Co., Ltd. Product index, "Coenzyme I for Injection" (注射用辅酶Ⅰ), freeze-dried powder for injection, approval numbers 国药准字H41025094 and 国药准字H41024721. http://www.kfkn.com.cn/cn/list/info_37.aspx?itemid=125. Retrieved through a search index on 9 October 2026; the National Medical Products Administration database could not be queried automatically (HTTP 412).
  53. DXY drug database. Label of Coenzyme I for Injection (注射用辅酶I), Kaifeng Knature Pharmaceutical. Label approved 8 December 2010, revised 9 July 2021; indications: supportive treatment of leukopenia, coronary heart disease and myocarditis; intramuscular use; adverse reactions "偶有口干、恶心、头晕、心悸等反应" (occasional dry mouth, nausea, dizziness, palpitations); "请仔细阅读说明书并在医生的指导下使用" (to be used under a doctor's direction). https://drugs.dxy.cn/drug/C0e3Iui9RyaWHKhCVVQQCw== Retrieved through a search index on 9 October 2026.
  54. ClinicalTrials.gov, API v2, queried 9 October 2026 for "nicotinamide adenine dinucleotide", "NAD+", "nadide" and "coenzyme I"; no Hudson Biotech record among the hits. NCT06919328 (Nutraceuticals Research Institute, collaborator ChromaDex): NAD+, NR or bacteriostatic water given subcutaneously, intramuscularly or as an intravenous push; primary outcomes McGill Pain Questionnaire and subjective discomfort one minute after injection; 70 planned; status recruiting, estimated completion 30 June 2025, no results posted. NCT05849519 (Sun Yat-Sen Memorial Hospital): Coenzyme I for Injection given intramuscularly in sudden hearing loss; status unknown, no results. NCT07839130, NCT07328100, NCT06776510, NCT06558253 and NCT06590844: Chinese hospital trials with intravenous Coenzyme I for Injection, none with results. NCT04604704: NAD+ by skin patch (iontophoresis), completed, no results posted. NCT07475546: NAD+ nasal spray within a combination, active, no results. https://clinicaltrials.gov/
  55. Gu J, Xu J, Yang S, Qiu Y, Yin L, Xu N (2026). Non-clinical safety evaluation of coenzyme I (NAD+): a GLP-compliant systematic study. Biomedicine and Pharmacotherapy 204:119934. PMID 42748828. DOI 10.1016/j.biopha.2026.119934. Abstract checked on 9 October 2026 (full text not accessible): intramuscular dosing in rats, rabbits and beagle dogs; "local injection-site and sciatic-nerve lesions were reversible"; in dogs the higher single doses "caused increased heart rate, shortened PR and QT intervals, and decreased blood pressure".
  56. Lowry OH, Passonneau JV, Rock MK (1961). The stability of pyridine nucleotides. Journal of Biological Chemistry 236(10):2756-2759. PMID 14466980. DOI 10.1016/S0021-9258(19)61730-8. Full text checked on 9 October 2026: DPN+ (NAD+) has "a low constant rate of destruction from pH 2 to 7" and becomes several thousand times more susceptible after losing one proton; temperature coefficient 11 % per degree between 60 and 100 °C; phosphate accelerates destruction; 0.5 mM in 0.02 N HCl showed no loss after a week at 4 °C or −85 °C and about 15 % loss at −20 °C.
  57. Sigma-Aldrich (Merck KGaA). Product information, β-nicotinamide adenine dinucleotide sodium salt, N0632, revision 09/22. Checked on 9 October 2026: "very hygroscopic", stored desiccated at −20 °C; aqueous solutions between pH 2 and 6 stored as single-use aliquots at −70 °C "are stable for at least 6 months"; "Neutral or slightly acidic solutions are stable at 0 °C for at least 2 weeks"; very labile in alkaline solution, especially with phosphate, maleate or carbonate; "Solutions are also sensitive to light"; for research use only, not for drug use. https://www.sigmaaldrich.com/deepweb/assets/sigmaaldrich/product/documents/310/970/n0632pis-ms.pdf
  58. Sigma-Aldrich (Merck KGaA). Product specifications, checked on 9 October 2026: N0632 (β-NAD sodium salt), aqueous solution "clear, colorless to faintly yellow"; N8285 (β-NAD), "clear, colorless solution"; N8129 (β-NADH), colour "white to light yellow". https://www.sigmaaldrich.com/US/en/product/sigma/n0632
  59. Wolfe KD, Alahuhta M, Himmel ME, Bomble YJ, Jennings GK, Cliffel DE (2024). Long-term stability of nicotinamide cofactors in common aqueous buffers: implications for cell-free biocatalysis. Molecules 29(22):5453. PMID 39598842. PMC11597533. DOI 10.3390/molecules29225453. 2 mM NAD+ at pH 8.5 and 19 °C over 43 days: in Tris the 260 nm peak fell by 4 %; in HEPES the solution "degraded nearly entirely"; NAD+ does not absorb at 340 nm, unlike NADH. Full text checked on 9 October 2026.
  60. Gasparrini M, Sorci L, Raffaelli N (2021). Enzymology of extracellular NAD metabolism. Cellular and Molecular Life Sciences 78(7):3317-3331. PMID 33755743. PMC8038981. DOI 10.1007/s00018-020-03742-1. Serum NAD "in the low micromolar range, between 0.1 and 0.5 µM"; degraded outside cells by CD38, CD157, CD73, NPP1 and ecto-ADP-ribosyltransferases.
  61. Kulikova V, Shabalin K, Nerinovski K et al. (2019). Degradation of extracellular NAD+ intermediates in cultures of human HEK293 cells. Metabolites 9(12):293. PMID 31795381. PMC6950141. DOI 10.3390/metabo9120293. With cells, less than 40 % of added NAD+ remained after 12 h and none was detectable after 48 h; in serum-free medium about 10 % was hydrolysed in 24 h; extracellular cleavage is "a prerequisite" for cells to use NAD+.

Cite this page

Every fact on this page was checked on 7 September 2026, and each register search behind the status table was run on that date. For a substance sold outside the approved medicines system, the date of the check matters as much as the text. Version 1.1 of 9 October 2026 added the Chinese approval, injection-site findings, the time course in the body, routes, colour and storage; the American approval search was repeated for it, the other register searches were not.

myPeptides Research & Editing. (2026). NAD+: what the studies show, status and safety. Version 1.1, 9 October 2026. myPeptides Peptide Register. Retrieved from https://mypep.app/peptides/nad

How pages in this register are compiled and graded is described under methodology; the full register is at peptides.

VersionDateNote
1.07 September 2026Initial publication
1.19 October 2026Chinese approval added, page now lists no doses; injection-site pain, time in the body, routes, colour and storage of the solution, five new questions; reading of the 2019 infusion study corrected

Identifiers

IdentifierValue
CAS number53-84-9
PubChem CID5892
UNII0U46U6E8UK
InChIKeyBAWFJGJZGIEFAR-NNYOXOHSSA-N
DrugBankDB14128
WikidataQ12499775
Molecular formulaC21H27N7O14P2
Molecular weight663.43

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Cite this page

Use this reference when you quote the page, and the JSON export when you process it automatically.

myPeptides Research & Editing (2026). NAD+: what the studies show, status and safety (Version 1.1). myPeptides. https://mypep.app/peptides/nad

Machine-readable version (JSON)

Last reviewed: September 2026

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