NAD+

They deliver nicotinamide adenine dinucleotide, a coenzyme every cell uses to make energy, as a shot under the skin (subcutaneous), into a muscle (intramuscular) or as an IV drip. Clinics and compounding pharmacies offer them. No NAD+ injection is an FDA-approved drug, and a 2026 systematic review found no outcome trials of IV or intramuscular NAD+ for aging or wellness.

No. NAD+ is a coenzyme, a small molecule (C21H27N7O14P2, molecular weight 663.4) rather than a chain of amino acids. It is often offered alongside peptides, which is why people search for it as one. It also behaves differently in a vial: it dissolves very easily in water, and vials hold hundreds of mg rather than a few.

No. The FDA lists NAD and a reduced form, NADH, in Category 1 of its 503A compounding policy. While it decides whether to add them to the official list, the FDA does not intend to take action against a state-licensed pharmacy that compounds them under the policy’s conditions. That is not an approval of any product. One salt form, beta-NAD disodium salt trihydrate, sits in Category 3, which does not get that policy.

There is no good evidence yet. A 2026 systematic review found no outcome trials of injected or IV NAD+ for aging or wellness, and a 2026 review of IV NAD+ found mostly small, uncontrolled studies. Raising NAD+ in the blood is also not simple: in one infusion study, plasma levels did not change for the first 2 hours.

Reports on IV NAD+ describe nausea, cramping, flushing and chest discomfort. Separately, the FDA has received reports of severe chills, shaking, vomiting and fatigue after NAD+ injections and says these reactions are consistent with excessive endotoxin levels, a sign of contamination; and NAD+ injections have been recalled for elevated endotoxin and for lack of sterility assurance. Long-term safety has not been studied.

There is no single correct amount. The water only sets the concentration: mg in the vial ÷ mL of water = mg per mL. For example (numbers for illustration only, not a dose), 500 mg of NAD+ in 5 mL makes 100 mg/mL, so each unit on a U-100 insulin syringe holds 1 mg. The same vial in 10 mL makes 50 mg/mL, or 0.5 mg (500 mcg) per unit. More water means each unit holds less; less water means each unit holds more. The reconstitution calculator does this arithmetic for your vial. Many NAD+ vials are already liquid (FDA recall listings show 50 to 200 mg/mL in 10 mL vials), so check the pharmacy label first and add nothing to a liquid. If it is a powder, the label or your pharmacist sets the volume.