The Clinic Drip
NAD+ (injectable / IV)
Also known as Nicotinamide adenine dinucleotide · IV NAD
At a glance
- What it is
- The highest-volume wellness-clinic infusion, with no outcomes trial behind it.
- Evidence
- Practitioner experience onlyHow the tiers workA 2026 PRISMA systematic review of 113 studies, 33 human interventions and 28 of them randomised, states it plainly: no eligible outcomes trials evaluated intravenous or intramuscular NAD+ itself for anti-ageing or wellness indications. Why this tier
- Half-life
- Not established in available literature
- Routes
- Intravenous, Subcutaneous, Intramuscular
- Category
- Mitochondrial
- WADA
- We do not state a status
Putting NAD+ (injectable / IV) on a schedule, with the vial it comes from and a log of each dose, happens in the app: Claritide for iPhone.
Why this tier
A 2026 PRISMA systematic review of 113 studies, 33 human interventions and 28 of them randomised, states it plainly: no eligible outcomes trials evaluated intravenous or intramuscular NAD+ itself for anti-ageing or wellness indications. Oral precursors are a different story: nicotinamide riboside and NMN consistently show biochemical target engagement and good tolerability, while functional and metabolic outcomes remain heterogeneous and often null. We also decline to publish a widely cited 2023 randomised trial of subcutaneous NAD+ in adults over 45 reporting improved energy and physical performance. We could not locate that citation.
What it is
Injectable and intravenous NAD+ is probably the single highest-volume product in the wellness-clinic market. A 2026 systematic review of 113 studies found no eligible outcomes trial evaluating intravenous or intramuscular NAD+ itself for anti-ageing or wellness indications. The best-documented fact about the IV route is a tolerability finding: 500 mg infusions have to be run slowly because they are unpleasant.
How it works
NAD+ is a coenzyme every cell uses to move electrons around: it is the currency of redox reactions in the electron transport chain, and it is the substrate that sirtuins and PARP enzymes consume when they do repair and signalling work. Tissue NAD+ falls with age, which is the entire premise for supplementing it. The open question is not whether NAD+ matters but whether flooding the bloodstream with the intact molecule raises it inside cells: NAD+ is a large, charged molecule and the conventional understanding is that it is broken down extracellularly to smaller precursors before anything gets in. That is why oral precursors like nicotinamide riboside and NMN, which do measurably raise whole-blood NAD+, are studied more than the intravenous parent molecule, which is sold more.
Commonly researched ranges
- IV infusion · the dose with a published tolerability observation500 mg
A 2026 real-world retrospective ran four consecutive days of 500 mg IV. The infusion had to be extended to a mean of 97 minutes because of moderate-to-severe gastrointestinal symptoms, raised heart rate and chest pressure during administration, against 37 minutes for intravenous nicotinamide riboside in the same setting.
- Compounded intramuscular / subcutaneous25–100 mg
Re-verified on 17 August 2026 against a compounding pharmacy’s own injection monograph and a 2026 tolerability paper: 25–100 mg per injection, commonly kept under 300 mg across a week. The record previously carried 50–200 mg from a single vendor page. No trial establishes this route, and no FDA-approved NAD+ injectable exists by any route.
| Phase | Amount | Frequency | Timing | Note |
|---|---|---|---|---|
| IV infusion · the dose with a published tolerability observation | 500 mg | Daily, in a four-consecutive-day protocol | Not established in available literature | A 2026 real-world retrospective ran four consecutive days of 500 mg IV. The infusion had to be extended to a mean of 97 minutes because of moderate-to-severe gastrointestinal symptoms, raised heart rate and chest pressure during administration, against 37 minutes for intravenous nicotinamide riboside in the same setting. |
| Compounded intramuscular / subcutaneous | 25–100 mg | Per injection, one to three times per week | Not established in available literature | Re-verified on 17 August 2026 against a compounding pharmacy’s own injection monograph and a 2026 tolerability paper: 25–100 mg per injection, commonly kept under 300 mg across a week. The record previously carried 50–200 mg from a single vendor page. No trial establishes this route, and no FDA-approved NAD+ injectable exists by any route. |
- Cycle guidance
- The published IV protocol is four consecutive days. Our sources publish no cycling schedule for injectable use.
- Goals
- Energy, Longevity
Where this sits with the FDA
Not FDA-approved for any indication, and compounded NAD+ injections are not approved finished drug products. NAD+ does not appear on any FDA compounding category list, which means neither a permission nor a warning has been issued about it.
Primary sourceWADA status
Not named on the 2026 Prohibited List. NAD+ is an endogenous coenzyme rather than a drug in the S0 sense; we could not determine a classification and do not state one.
We looked and could not resolve it. This is not the same as "not prohibited". Treat it as unresolved and check with your federation before competing.
Mixing recipes our sources document
Not established in available literature. Use the calculator with the figures printed on your own vial.
Open the calculator
Week by week
Not established in available literature.
Side effects
Common
- Moderate-to-severe gastrointestinal symptoms during infusion
- Increased heart rate during infusion
- Chest pressure during infusion
Rare
- No laboratory abnormalities over 30 days
Contraindications and interactions
Do not use if
Not established in available literature.
Interactions
Not established in available literature.
Absence from this list does NOT mean safety. It means lack of research.
Storage and cost
- Storage
- Sources disagree on the water. Our sourcing list puts NAD+ on the sterile-water list, dosing guides mix NAD+ powder with bacteriostatic water, and we found no study of NAD+ in benzyl alcohol. Claritide takes the cautious side: sterile water, which means a 24-hour window, not 28 days. The compounded NAD+ injection we checked arrives already mixed, with a use-by date on its label. Clinic infusions are compounded and their handling is the clinic’s responsibility, which is the point of the endotoxin caution on this page.
- Cost
- Not established in available literature
Stacks with
NAD+ (injectable / IV) in full
The headline, verbatim
From a 2026 PRISMA systematic review of 113 studies, published in Ageing Research Reviews: "No eligible outcomes trials evaluated intravenous or intramuscular NAD+ itself for anti-aging or wellness indications."
That sentence is about the highest-volume product in the wellness-clinic industry. Not "the evidence is weak": no eligible outcomes trials at all.
What NAD+ is, and why the route matters so much
NAD+ is a coenzyme that every cell uses to shuttle electrons. It runs the electron transport chain, and it is consumed as a substrate by sirtuins and PARP enzymes doing repair and signalling work. Tissue levels fall with age. All of that is textbook and none of it is in dispute.
The dispute is about delivery. NAD+ is a large, charged molecule, and the conventional understanding is that it is broken down outside the cell into smaller precursors before anything crosses the membrane. Which means an intravenous bag of NAD+ may be an expensive way to deliver nicotinamide.
That is exactly why the evidence base splits by route, and why we ship a separate record for NMN. Oral precursors have data. The injectable parent molecule does not.
What the oral precursors show
A randomised trial in Nature Metabolism in January 2026, 65 participants over 14 days: nicotinamide riboside at 1,000 mg/day and NMN at 1,000 mg/day each roughly doubled whole-blood NAD+, increases of about 49.4 and 43.1 micromoles per litre. Plain nicotinamide at 500 mg/day did not.
So the biochemistry works, orally. The systematic review's summary of what that biochemistry translates into is more sober: consistent target engagement and good tolerability over weeks to months, with functional, metabolic and vascular outcomes that are heterogeneous and often null.
The concrete fact about the IV route
A February 2026 real-world retrospective ran four consecutive days of 500 mg intravenous NAD+ and reported something nobody selling the drip mentions: it produced moderate-to-severe gastrointestinal symptoms, increased heart rate and chest pressure during infusion, which forced a mean infusion time of 97 minutes against 37 minutes for intravenous nicotinamide riboside in the same setting. NR caused only minor tingling and cramping.
All symptoms resolved on completion. Over 30 days there were no significant changes in ALT, AST, hsCRP, BUN/creatinine or TSH.
That is a useful pair of findings. The infusion is genuinely unpleasant while it is running, and there is no organ-level signal afterwards in a small real-world sample. The "you have to run it slow" folklore turns out to be true and now has a number attached.
What we will not publish
A 2023 randomised trial of subcutaneous NAD+ in adults over 45 showing improvements in self-reported energy and physical performance is cited in several places. We could not locate the citation. It does not appear on this page.
Sourcing and sterility
NAD+ belongs with injectable glutathione and injectable GHK-Cu in the group where the sourcing question is not academic. In February 2019 FDA reported seven patients who received a compounded L-glutathione injectable and experienced adverse events within minutes, traced to bacterial endotoxin at five times the appropriate limit. Endotoxin is not removed by a sterile filter and is not visible in a clear solution.
For the water, sources disagree: our list says sterile water, dosing guides say bacteriostatic water, and we found no study that settles it. Claritide takes the cautious side, which means sterile water and a 24-hour window rather than bacteriostatic water and 28 days.
Sources
- 1Ageing Research Reviews, April 2026 · PRISMA systematic review of 113 studies on NAD+ and its precursors
- 2Frontiers in Aging, February 2026 · real-world retrospective of intravenous NAD+ versus nicotinamide riboside
- 3Nature Metabolism, January 2026 · NCT05517122, n=65, oral NR and NMN each roughly doubled whole-blood NAD+
- 4Empower Pharmacy · compounded NAD+ injection monograph. The 25–100 mg per-injection subcutaneous and intramuscular band (dose review, 2026-08-17)
- 5Grant et al., 2019 · pilot pharmacokinetics of a 750 mg intravenous NAD+ infusion over six hours, the documented infusion figure (dose review, 2026-08-17)
Every record in this library is free to read, and it stays free. Your own schedule, vials and log live in the app: Claritide for iPhone.