NAD+ Reconstitution Calculator

No. NAD+ is an endogenous coenzyme, not an FDA-approved drug for any indication; intravenous NAD+ is administered off-label in wellness clinics. Oral NAD+ precursors (NR, NMN) are marketed as dietary supplements, and European regulators have evaluated β-NMN as a novel food. Human efficacy for aging or wellness outcomes remains unproven [5, 6]. (RCT; systematic review)

Not clearly. Oral NR at 1,200 mg/day and oral NMN raise blood NAD+ within about 2 weeks in humans, and once-daily dosing sustains levels [7, 8, 9]. In a pilot RCT, 500 mg IV NR raised blood NAD+ by 20.7% at 3 hours and outperformed 500 mg IV NAD+ (p<0.01). Real-world records show IV NAD+ causes moderate-to-severe GI symptoms, chest pressure, and longer infusions (mean 97 vs 37 minutes) than IV NR. No outcomes trial supports parenteral NAD+ for wellness. Oral precursors are the better-supported route; IV NAD+ is not established. (RCT; observational)

Reported protocols: 250 mg in 500 mL saline over ~1 hour every 2 weeks; 500 mg daily for 4 consecutive days; 1,000 mg daily for 6 days in adults aged 70-80; single 500 mg doses in controlled studies. Community/practitioner protocols use 250-1,000 mg per session infused over 1-4 hours, 1-3 times weekly or stacked over 4-10 sessions. Slower infusion reduces nausea and chest discomfort [2, 6]. (case report; observational; community protocol)

Short-term use is tolerable in small studies [1, 4], with infusion-related nausea, cramping, flushing, chest discomfort, and transient tachycardia resolving when the infusion stops [2, 6]. One pilot RCT observed increased white blood cells and neutrophils after IV NAD+, consistent with a transient inflammatory response. Long-term safety data do not exist [5, 6]. Mechanistically, NAD+ supports metabolism of healthy and malignant cells, so indefinite high-dose use is unsupported. (RCT; mechanistic)

No human safety data exist for NAD+ in pregnancy. In an infertility setting, oral NMN in women under 35 with diminished ovarian reserve improved follicle growth, endometrial thickness, and pregnancy rate (48% vs 24%) in a retrospective analysis. This documents a fertility benefit of an oral precursor, not safety of IV NAD+ during established pregnancy. Practitioner consensus: avoid IV NAD+ during pregnancy and lactation. (observational)

Documented IV courses range from a single dose to 6 consecutive daily infusions [1, 2, 4]; oral precursor trials run weeks to months [8, 9]. No evidence supports indefinite parenteral use, and long-term safety is unknown. Blood NAD+ plateaus after ~2 weeks of daily oral dosing and declines slowly after stopping. Typical use (community protocol): a finite IV course of 4-10 sessions over 2-4 weeks, then optional maintenance with oral NR or NMN. (RCT; community protocol)

No indication is established. A small open study in 8 adults aged 70-80 found 6 daily 1,000 mg IV NAD+ infusions increased the blood NAD+ metabolome and SIRT1 expression while reducing oxidative and inflammatory markers. One rheumatoid arthritis case improved symptomatically and sonographically after 4 biweekly IV NAD+ infusions, but confounders preclude causal inference (case report). Systematic reviews find human efficacy for aging and wellness inconclusive, with heterogeneous or null functional results [5, 6]. (open-label; case report; systematic review)

Store reconstituted, compounded NAD+ injectable refrigerated (2-8°C), protected from light, and use within the pharmacy-assigned beyond-use date, commonly 28 days for compounded sterile preparations. Lyophilized powder can be kept at room temperature per label but should be reconstituted shortly before infusion. NAD+ is not a controlled substance; travel with labeled vials and carry the prescription or clinic label to avoid customs or security delays. (community protocol; practitioner consensus)