Peptifact

NAD+ Injection Dosage: The Trial Doses Differ From the Clinic Doses by Fifty Times

NAD+ is not a peptide and has no approved injectable product in the United States. Its human injection record runs from 5 mg to about 716 mg, and the gap between what trials gave and what the wellness market sells is the story.

Robert F · Edited by Caroline S · Published 2026-09-17

Illustration: Clear glass vials with varying amounts of white powder arranged on a slate surface.
Illustration

NAD+ is sold as an infusion, an injection, a nasal spray and a capsule; one research vendor's catalogue lists both its vial and its nasal spray at 500 mg. It is not a peptide: nicotinamide adenine dinucleotide is a coenzyme made of two nucleotides, with no amino acids in it. It sits in this catalogue because it is sold through the same vendors and clinics as research peptides, alongside 5-amino-1MQ, another non-peptide sold in the same channel.

This page reports what the published and registered record states. It does not recommend anything. Our guide to reading a dosing claim sets out how a label figure differs from a convention.

What does not exist

  • No FDA-approved NAD+ injection. DailyMed returned zero labels under "nicotinamide adenine dinucleotide" on 17 September 2026. The only NAD entries under the shorter name were homeopathic products listing "Nadidum".
  • No dose-finding study that compares the low trial doses with the high wellness doses.
  • No published result from either of the two US registrations that give NAD+ by injection.

Every human injection dose we could source

Dose Route and schedule Who Source Status
5 mg Intramuscular, once daily, 7 days Sudden hearing loss NCT05849519 (Coenzyme I for Injection) Registered, no posted results
10 mg Intravenous, once daily, 7 days 180 adults, heart failure Yu et al. 2026, Am J Cardiovasc Drugs Published RCT
10 mg and up Intravenous, daily, 21 days, three dose groups Cord-blood transplant NCT06558253 Recruiting
100 mg Intravenous, days 1–3 of each 21-day cycle Liver cancer, with immunotherapy NCT06590844 Registered
100 mg Intramuscular, subcutaneous or IV push, in 2 mL bacteriostatic water Healthy adults, US NCT06919328 No posted results
500 mg Intravenous, in 500 mL saline Healthy adults, US NCT06382688 No posted results
≈716 mg Intravenous, 3 µmol/min for 6 hours Healthy adults Grant et al. 2019, Front Aging Neurosci Published pharmacokinetic study

The 716 mg figure is our arithmetic, not the paper's: 3 µmol per minute for 360 minutes is 1,080 µmol, and at PubChem's molecular weight of 663.4 that comes to about 716 mg. The paper reports the rate, not the total.

Two other registered routes show how varied the delivery is: iontophoresis patches loaded with 400 mg of NAD+ solution (NCT04604704) and a nasal spray at 30 mg a day (NCT07475546), both sponsored by AgelessRx.

The fifty-fold gap

The only randomized placebo-controlled injection trial located gave 10 mg a day. The US infusion registration and a research vendor's vial both use 500 mg. That is a fifty-fold difference in a single administration, and it is not a difference of route: both the 10 mg trial and the 500 mg registration are intravenous.

Nothing in the published record bridges it. The Chinese trials use a product registered there as Coenzyme I for Injection at 5 to 100 mg. The US registration and vendor presentation are five to a hundred times larger. No study has tested both ranges against each other, so neither can be called the effective dose or the safe one. A page that quotes the heart-failure trial to support a 500 mg drip is quoting a result obtained at one fiftieth of that dose.

What the one pharmacokinetic study found

Grant and colleagues ran the first study of what happens to directly infused NAD+ in people. They infused 3 µmol per minute for six hours and sampled plasma and urine throughout.

The surprising result was an absence. Plasma NAD+ and its metabolites did not change for the first two hours. The authors conclude that at this rate NAD+ "is rapidly and completely removed from the plasma" over that period, with a metabolite profile consistent with enzymes that break NAD+ down outside cells. By six hours, urinary methylnicotinamide and NAD+ itself had risen; urinary nicotinamide had not.

Three limits matter. It was a pilot, it measured metabolites rather than any clinical outcome, and the author affiliations include NAD+ Research Inc. and the Springfield Wellness Center, both listed on the paper.

What the randomized trial found

Yu and colleagues randomized 180 adults with heart failure from ischaemic cardiomyopathy, ejection fraction 45% or below, to 10 mg of NAD+ or placebo intravenously for seven days, on top of standard treatment.

  • Primary outcome: ejection fraction at one month, 45.44% against 42.44% (p = 0.024).
  • Hospital admissions for heart failure at six months: 13.5% against 23.6% (p = 0.078), not significant.
  • Major cardiac and stroke events: 14.6% against 24.7% (p = 0.089), not significant.

It is a single-centre trial in a specific disease, at a dose far below the wellness range. It is evidence about 10 mg in heart failure and nothing wider.

What FDA found in a compounder's NAD+ vials

FDA's warning letter to GenoGenix LLC, an outsourcing facility in Boca Raton, dated 20 January 2026, is the most specific regulatory document on injectable NAD+ we located. It states three things:

  1. Eligibility. NAD+ "do[es] not appear on the 503B bulks list", so drug products compounded from it at an outsourcing facility do not qualify for the 503B exemptions.
  2. Patients. A healthcare provider reported that three patients developed low blood pressure, uncontrollable shaking, shivers and body aches during or shortly after receiving NAD+ from the same vial, and were directed to the emergency room.
  3. Contamination. The firm had done no finished-product testing before release. Product from that lot was then found to contain bacterial endotoxins at 3,360 EU/mL.

The same letter records other injectables from that facility testing at 43.1% and 65.3% of their labelled strength. The facility appears on our FDA warning-letter tracker. What sterility and endotoxin testing does and does not show is set out on our peptide testing page.

What is not established

  • No approved label, so no regulator has reviewed any NAD+ injection dose in the United States.
  • No dose-response study in people for any clinical outcome.
  • No comparison between the 5–100 mg trial range and the 500 mg wellness range.
  • No published result from the US injection registrations.
  • Whether injected NAD+ enters cells intact. The one pharmacokinetic study found it cleared from plasma with a breakdown-product pattern; what reaches tissue is not measured.

What a reader can check in five minutes

  1. Search DailyMed for "nicotinamide adenine dinucleotide" and count the labels.
  2. Open NCT06382688 and NCT06919328 on ClinicalTrials.gov and look for posted results.
  3. Read the Grant 2019 abstract and note the two-hour plasma finding.
  4. Read the Yu 2026 abstract and note the 10 mg dose.
  5. Open FDA's GenoGenix warning letter and search the page for "NAD+".

NAD+ is sold beside MOTS-c, a mitochondrial peptide with a thin human record of its own, and SS-31, the one compound in that marketing category with an FDA-approved label. The peptide dosage chart indexes every dose record on this site by the kind of source behind it.

Sources and dates

Opened 17 September 2026: PubChem CID 5892; the DailyMed SPL search API for "nicotinamide adenine dinucleotide" (zero labels) and "NAD"; the ClinicalTrials.gov v2 API, intervention records for NCT05849519, NCT06558253, NCT06590844, NCT06919328, NCT06382688, NCT04604704 and NCT07475546; PubMed through the NCBI E-utilities, abstracts for PMID 31572171 (Grant et al. 2019, doi:10.3389/fnagi.2019.00257) and PMID 40954388 (Yu et al. 2026, doi:10.1007/s40256-025-00764-7); FDA's warning letter to GenoGenix LLC, 20 January 2026; and a research vendor's catalogue listing a 500 mg NAD+ vial. Corrections go to the contact page.

Frequently asked questions

What is the standard NAD+ injection dose?

There is no standard a reader can check against a label, because no NAD+ injection has an FDA-approved label. The published human record spans two orders of magnitude: 5 mg intramuscularly and 10 mg intravenously in Chinese trials, 100 mg by injection and 500 mg by infusion in US registrations, and about 716 mg over six hours in the one published pharmacokinetic study. A research vendor's catalogue opened on 17 September 2026 lists NAD+ as a 500 mg vial and a 500 mg nasal spray, which sits at the high end of that range.

Is NAD+ a peptide?

No. NAD+ is nicotinamide adenine dinucleotide, a coenzyme built from two nucleotides joined by a phosphate bridge. It contains no amino acids. It is sold through peptide vendors and alongside peptide products, which is why buyers look for it here, but it belongs to a different chemical class.

What happens to NAD+ after it is infused?

In the one published human study of this question, Grant and colleagues infused 3 µmol per minute for six hours and measured plasma and urine. Plasma NAD+ and its metabolites did not change for the first two hours; the authors concluded the infused NAD+ was rapidly and completely removed from the plasma over that period. By six hours, urinary methylnicotinamide and NAD+ itself had risen. The study had no clinical outcome and did not test any benefit.

Is there a randomized trial of NAD+ injections?

Yes, one located on PubMed with a placebo arm and 180 participants: a single-centre Chinese trial in heart failure from ischaemic cardiomyopathy, published in 2026, which gave 10 mg intravenously for seven days alongside standard treatment. Ejection fraction improved more with NAD+ at one month (45.44% against 42.44%). The secondary outcomes, including hospital admissions, showed trends that were not statistically significant. It tested a 10 mg dose in heart failure, not a wellness infusion.

Why does the dose in trials differ so much from the dose in clinics?

No published source explains it. The Chinese trials use a registered product called Coenzyme I for Injection at 5 to 100 mg. On the US side, a registered infusion study and a research vendor's vial both use 500 mg. No dose-finding study compares the two ranges, so neither figure can be described as the effective or the safe one.

Can NAD+ be compounded in the United States?

FDA's warning letter to GenoGenix LLC, dated 20 January 2026, states that NAD+ does not appear on the 503B bulks list and is not used to compound a drug on the shortage list, so an outsourcing facility's NAD+ products do not qualify for the 503B exemptions. The same letter records three patients sent to the emergency room after receiving NAD+ from one vial, and endotoxin contamination of 3,360 EU/mL in that lot. Rules for 503A pharmacies are a separate question the letter does not address.