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LongevityLimited human evidence

NAD+ (Nicotinamide Adenine Dinucleotide)

Coenzyme essential for cellular energy production and DNA repair (NOT a peptide — it's a nucleotide). Available as IV infusion, intranasal, and oral precursors (NR, NMN). Heavily discussed in longevity communities. Direct NAD+ supplementation has weak human RCT support; precursors have somewhat better data.

Educational only — not medical advice. SmartPeptide does not prescribe, diagnose, or treat. Always consult a licensed healthcare provider before using any peptide, supplement, medication, or protocol.

What the research shows

NAD+ precursors (NR, NMN) raise blood and tissue NAD+ levels in humans. Effects on aging biomarkers, sleep, and cognitive measures are modest at best in published RCTs. Direct IV NAD+ has very limited rigorous human-trial support outside addiction medicine.

What's still experimental

Virtually every consumer-marketed claim about NAD+ extending healthspan, reversing aging, or treating long COVID is extrapolated from animal/in-vitro work, not from confirmatory human RCTs.

Anecdotal / community reports

Subjective energy, cognitive clarity, and 'recovery' reports are very common. These are heavily confounded by placebo (especially with high-cost IV infusions) and concurrent lifestyle changes.

Anecdotal reports are NOT scientific evidence. They reflect personal experience and may not generalize.

FDA approval status

Source: openFDA + DailyMed (NIH/NLM)
No FDA-approved drug label exists for “NAD+ (Nicotinamide Adenine Dinucleotide)”. This peptide is not currently approved by the FDA as a finished pharmaceutical product. Any commercial product claiming FDA approval should be treated with suspicion.

FDA enforcement & recalls

Live · openFDA Drug Enforcement API
Total actions
6
recalls + withdrawals
Ongoing
2
not yet completed
Class I (serious)
1
health hazard / death risk
  • Class IIOngoing· Voluntary: Firm initiated
    FDA record

    NAD+ (Nicotinamide adenine dinucleotide), a) 50 mg/mL, b) 100 mg/mL, 10 mL multi-dose vials, all strengths and presentations, GenoGenix, LLC, 2840 NW 2nd Ave Ste 204 Boca Raton, FL 33431-6692. Also la…

    Reason: Lack of Assurance of Sterility

    Jul 30, 2025·GenoGenix LLC
  • Class IOngoing· Voluntary: Firm initiated
    FDA record

    NAD+ (Nicotinamide adenine dinucleotide) for Injection, a) 100 mg/mL b) 200 mg/mL, 10 mL multi-dose amber vials, GenoGenix, LLC, 2840 NW 2nd Ave Ste 204 Boca Raton, FL 33431-6692.

    Reason: Microbial Contamination of Sterile Products: elevated endotoxin levels

    Jul 30, 2025·GenoGenix LLC
  • Class IICompleted· Voluntary: Firm initiated
    FDA record

    NAD+ Nicotinamide Adenine Dinucleotide, Lyophilized powder for reconstitution, Multi-Dose 500 mg per vial, Rx Only, Olympia Pharmaceuticals, 6700 Conroy Rd., Ste. 155 Orlando, FL 32835. NDC 73198-008…

    Reason: Lack of assurance of sterility.

    May 9, 2022·Olympia Compounding Pharmacy dba Olympia Pharmacy
  • Class IITerminated· Voluntary: Firm initiated
    FDA record

    NAD+ Nicotinamide Adenine Dinucleotide Lyophilized powder for reconstitution, Multi-Dose 500 mg Per Vial, Rx Only, Olympia Pharmaceuticals 6700 Conroy Rd., Ste. 155, Orlando, FL 32835. NDC 73198-0083…

    Reason: CGMP Deviations: prior to October 1, 2021, environmental and personnel monitoring Out of Action Limit (OOAL) excursions were not being properly investigated

    Apr 4, 2022·Olympia Compounding Pharmacy dba Olympia Pharmacy
  • Class IITerminated· Voluntary: Firm initiated
    FDA record

    NAD+ Nicotinamide Adenine Dinucleotide Lyophilized powder for reconstitution, Multi-Dose 500 mg Per Vial, Rx Only, Olympia Pharmaceuticals 6700 Conroy Rd., Ste. 155, Orlando, FL 32835. NDC 73198-0083…

    Reason: Failed Reconstitution time

    Apr 4, 2022·Olympia Compounding Pharmacy dba Olympia Pharmacy
FDA classifications: Class I = reasonable probability of serious adverse health consequences or death. Class II = temporary or medically reversible adverse consequences. Class III = unlikely to cause adverse health consequences.

Mechanism & targets

ChEMBL · UniProt · Open Targets

Molecule (ChEMBL)

View on ChEMBL
Formula
C21H27N7O14P2

Protein targets (UniProt)

  • Mitochondrial nicotinamide adenine dinucleotide transporter 1
    P40556gene: YIA6Saccharomyces cerevisiae (strain ATCC 204508 / S288c)· 373 aaReviewed

    Mitochondrial inner membrane carrier protein that mediates the import of NAD(+) into mitochondria (PubMed:16291748, PubMed:32906142, PubMed:33087354). Can transport NAD(+) by unidirectional transport or by exchange with intramitochondrially generated dAMP and dGMP (PubMed:16291748). Also able to transport NAD(+) by exchange with AMP, GMP or deamido-NAD (+) in vitro (PubMed:16291748)

  • Conidial surface nicotinamide adenine dinucleotide glycohydrolase
    Q7S936Neurospora crassa (strain ATCC 24698 / 74-OR23-1A / CBS 708.71 / DSM 1257 / FGSC 987)· 243 aaReviewed

    Conidial surface nicotinamide adenine dinucleotide glycohydrolase that cleave NAD(+) and NADP(+) but not their reduced counterparts, NADH and NADPH (PubMed:33712585, PubMed:6260480). Lacks both ADP-ribosyl cyclase and base exchange activity and does not mediate synthesis of calcium messengers cADPR or NAADP (PubMed:33712585). Its function is correlated with aerial hyphae formation and conidiogenesis, but its physiological role is still obscure (PubMed:131723, PubMed:165174). Is able to ADP-ribos…

  • NH(3)-dependent NAD(+) synthetase
    P18843gene: nadEEscherichia coli (strain K12)· 275 aaReviewed

    Catalyzes the ATP-dependent amidation of deamido-NAD to form NAD. Uses ammonia as a nitrogen source

Live research

PubMed · ClinicalTrials.gov · Europe PMC · OpenAlex
PubMed papers
3,850
total
Human studies
0
MeSH: humans
Clinical trials
0
published
Active trials
115
778 total registered

Clinical trials (ClinicalTrials.gov)

All trials for "NAD OR nicotinamide riboside OR NMN"

Europe PMC — 4,708 additional records

Includes EU/UK studies and PubMed Central full-text articles. Often surfaces research weeks before PubMed indexes it.

Research volume (OpenAlex topic graph)

Total works
6,049
all years
Last 5 years
3,883
recent activity
Open access
5,625
freely readable
OA share
93%
of all works

Human clinical evidence

Semantic Scholar · AI TLDRs · influence-ranked
Semantic Scholar API is currently rate-limited.

Human-study summaries for “NAD+ supplementation OR NMN OR nicotinamide riboside” are available on Semantic Scholar but the shared free-tier API quota is exhausted right now. Try refreshing in a few minutes, or check the PubMed and Europe PMC panels above for the same literature.

Research funding & verification

NIH RePORTER · CrossRef DOI registry

NIH-funded research

U.S. National Institutes of Health
Funded projects
8
all years
Top award sum
$3.4M
aggregate USD
Years covered
11
research span
Largest active / recent grants

Publication landscape

CrossRef · DOI registry
Indexed works (CrossRef)
131,812
all DOIs registered
Retracted papers
0
no retractions on record
Top funders of indexed research
  • National Natural Science Foundation of China2,837 works
  • National Institutes of Health985 works
  • National Key Research and Development Program of China712 works
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico508 works
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior474 works
  • National Research Foundation of Korea288 works

Funder diversity is a credibility signal. Research concentrated in a single drug company's funding warrants more scrutiny than research funded across NIH, charities, and academic grants.

Preprints — cutting edge

bioRxiv · medRxiv · via Europe PMC

Preprints have NOT been peer-reviewed. They are early research shared by authors before formal validation. Treat findings as preliminary.

Showing 6 of 95 preprints indexed by Europe PMC.

Known risks

IV NAD+ administration can cause significant flushing, chest pressure, nausea — particularly at fast infusion rates. Quality and dosing of compounded NAD+ vary widely. Long-term high-dose safety data is sparse. Theoretical concern about cancer cell metabolism support.

Reported side effects

IV: flushing, nausea, chest discomfort, fatigue post-infusion. Oral precursors (NR, NMN): generally well-tolerated; mild GI upset.

FDA adverse event reports (FAERS)

Updated quarterly by FDA
Reports filed
2
FAERS, all years
Serious reports
1
50% of reports
Top reporting countries
  • US2

Most-reported reactions

  • Blood Urine Present
    1
  • Diarrhoea Haemorrhagic
    1
  • Erectile Dysfunction
    1
  • Loss Of Libido
    1
  • Nausea
    1

Counts from FDA Adverse Event Reporting System (FAERS). Voluntary reports — they show what was reported, not whether the drug caused the event. Many reports lack confirmation. FAERS docs

What requires medical supervision

IV infusions require trained clinicians and proper monitoring. Oral precursors (NR, NMN) are sold OTC; quality varies. Discuss with a clinician if you have any cancer history or active malignancy.

Questions for your clinician

  • What's the evidence for my specific goal vs. just elevating NAD+ levels?
  • Are oral precursors a more rational starting point than IV?
  • What's the cancer-history discussion for me?

Editorially curated references

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