Short answer: NAD+ (nicotinamide adenine dinucleotide) is a coenzyme your cells use to turn food into energy. NAD+ injections are marketed for energy and healthy aging, but the human evidence is early: most data come from oral precursors such as nicotinamide riboside, and we found no published trials of NAD+ injections for energy or aging outcomes. NAD+ is not an FDA-approved drug; the FDA lists it as a bulk substance under evaluation for pharmacy compounding. If you try it, use a licensed prescriber, a legitimate pharmacy and realistic expectations.
What Is NAD+?
NAD+ is an essential coenzyme with a central role in cellular energy metabolism. It is also a co-substrate for enzymes that researchers link to the benefits of calorie restriction, which is why it has drawn interest as a target for healthy aging. Researchers have proposed that keeping NAD+ at healthy levels may help in conditions where it is used up faster or made more slowly, including the aging process. That is a hypothesis being tested, not an established treatment.
What the Human Evidence Shows
Oral NAD+ precursors
The strongest human data are for precursors your body converts into NAD+. In a 2018 randomized, placebo-controlled crossover trial in healthy middle-aged and older adults, 6 weeks of nicotinamide riboside was well tolerated and raised NAD+ metabolism. Its authors said future trials should test possible benefits for blood pressure and arterial stiffness; the trial was not designed to prove those.
Intravenous NAD+
A 2019 pilot study gave 8 healthy men 750 mg of NAD+ by IV over 6 hours (3 received a saline placebo). NAD+ levels in the blood did not rise for the first 2 hours, because the body cleared it rapidly, and no adverse events were observed during the slow infusion. The study measured NAD+ and its breakdown products, not energy or other outcomes.
In a 2026 single-center randomized trial, 180 adults with heart failure from ischemic heart disease received IV NAD+ (10 mg a day for 7 days) or placebo alongside standard treatment. Heart pumping function (ejection fraction) improved more with NAD+ at 1 month (45.4% vs 42.4%). That was a hospital study in heart failure patients, so it doesn’t tell us what NAD+ does for energy or aging in healthy people.
NAD+ injections
As of October 2026, we found no published clinical trials in PubMed testing under-the-skin or intramuscular NAD+ injections for energy, focus or anti-aging outcomes. Claims about those benefits are not yet backed by trial data.
NAD+ Injections vs IV vs Oral
- IV infusions deliver NAD+ directly but take hours and a clinic chair; the pilot study above used a 6-hour drip.
- Injections are quick and, with a prescription and training, can be done at home. There are no head-to-head studies comparing them with IV.
- Oral precursors such as nicotinamide riboside have the most published human data showing they raise NAD+ levels.
Is NAD+ FDA-Approved?
No. In its list updated May 14, 2026, the FDA places nicotinamide adenine dinucleotide (NAD) in 503A Category 1: bulk drug substances nominated for compounding that are still under evaluation. Under its interim policy, the FDA does not intend to take action against licensed pharmacies compounding with Category 1 substances when certain conditions are met. The FDA also states that compounded drugs are not FDA-approved, which means it does not verify their safety, effectiveness or quality before they are marketed.
Are NAD+ Injections Safe?
Published safety data are thin. The pilot IV study saw no adverse events at a slow infusion rate, but it was small and short, and long-term safety of repeated injections hasn’t been studied. Practical steps:
- Use NAD+ only from a licensed pharmacy with a prescription, never unlabeled vials bought online.
- Have a provider review your health history and current medicines first, especially if you’re pregnant, breastfeeding or managing a chronic condition.
- Report any reaction at the injection site or any symptom that worries you to your provider.
NAD+ Injections at Home Through Telehealth
Because injections don’t need an infusion chair, NAD+ can be prescribed through a telehealth visit and used at home. Viking Alternative Medicine is a national telehealth clinic: you meet with a licensed provider by video or phone, they review your goals and health history, and if NAD+ makes sense it is shipped to you. You must be located in the state where your visit is booked and where your medication is shipped. Learn more on our NAD+ therapy page, see other options in the medication guide, or read our evidence review of glutathione injections. Start your online visit.
Frequently Asked Questions
What do NAD+ injections do?
They deliver NAD+, a coenzyme cells use for energy metabolism. They’re marketed for energy and healthy aging, but no published trials have tested NAD+ injections for those outcomes.
Do NAD+ injections work?
The evidence isn’t there yet. Oral NAD+ precursors raise NAD+ levels in trials, and IV NAD+ has been studied in small or disease-specific trials, but we found no published trials of NAD+ injections for energy, focus or aging.
Are NAD+ injections FDA-approved?
No. The FDA lists NAD in its 503A Category 1, bulk substances under evaluation for compounding. Compounded drugs are not FDA-approved.
Are NAD+ injections better than IV?
There are no head-to-head studies. Injections are faster and can be done at home; IV infusions take hours. Neither has proven benefits for energy or aging.
Are NAD+ injections safe?
Safety data are limited. A small IV study saw no adverse events at a slow infusion rate, but long-term safety of repeated injections hasn’t been studied. Use a licensed prescriber and pharmacy.
Can I do NAD+ injections at home?
Yes, with a prescription. A telehealth provider can review your history and, if appropriate, prescribe NAD+ and have it shipped to you.
Sources
- Martens CR et al. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nat Commun. 2018 (PubMed)
- Grant R et al. A Pilot Study Investigating Changes in the Human Plasma and Urine NAD+ Metabolome During a 6 Hour Intravenous Infusion of NAD+. Front Aging Neurosci. 2019 (PubMed)
- Yu X et al. Effect of Nicotinamide Adenine Dinucleotide on Heart Failure Caused by Ischemic Cardiomyopathy: A Randomized, Placebo-Controlled Trial. Am J Cardiovasc Drugs. 2026 (PubMed)
- FDA: Bulk Drug Substances Nominated for Use in Compounding Under Section 503A (updated May 14, 2026)
- FDA: Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act
- FDA: Compounding and the FDA: Questions and Answers
Medical disclaimer: This article is general education, not medical advice, and it does not create a patient relationship. Prescription medicines are only appropriate after evaluation by a licensed clinician who knows your history and lab results. If you have chest pain, trouble breathing, signs of a blood clot or stroke, or another emergency, call 911.