NAD+
aka NAD+ · Nicotinamide Adenine Dinucleotide
NAD+ in brief
NAD+ is a coenzyme critical for metabolism. NOT a peptide. Amino Axiom rates its evidence base strong, drawing on 45,822 PubMed results (14,492 human studies) and 20 registered trials listed below. It is filed under Metabolic & Mitochondrial in the Amino Axiom compound index. This summary reflects published research and is not medical advice.
Research data
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Long-form breakdowns
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Overview
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in all living cells. It is critical for metabolism, mitochondrial function, and cellular energy production. NOT a peptide. Precursors like NMN and NR are more commonly used for supplementation.
PubMed results: 45,822 · Human studies: 14,492 · Animal studies: 29,137
Dosing Ranges
Ranges reflect protocols studied in published research and animal-model extrapolation. Presented for research purposes only, not a recommendation or instruction for human use.
- Intravenous — standard range 250-1000 mg, Weekly
Half-Life
Unknown (low confidence)
Observed Benefits
- Cellular redox and metabolic coenzyme function (Strong clinical): NAD+ (nicotinamide adenine dinucleotide) is a universal redox coenzyme required for dehydrogenase reactions, mitochondrial electron transport, and cellular energy metabolism across all living cells
- Sirtuin and PARP pathway research (Strong preclinical): Research literature extensively studies NAD+ as a substrate for sirtuins and poly(ADP-ribose) polymerases, linking NAD+ availability to DNA repair, stress responses, and aging-related experimental models
- Mitochondrial bioenergetics research (Moderate clinical): Investigational and clinical research programs examine NAD+ status and precursors (e.g., NMN, NR) in relation to mitochondrial function, with human datasets growing but still heterogeneous by formulation and endpoint
- Cardiovascular and pulmonary research applications (Limited): Research interest includes contexts such as atrial fibrillation protocols, percutaneous coronary intervention–related stress, precapillary pulmonary hypertension, and interstitial lung disease models; evidence quality varies widely by indication
Side Effects
- Infusion-related flushing or discomfort — Mild, Common. When NAD+ has been studied via parenteral research or clinical infusion protocols, flushing, chest tightness, and nausea have been reported anecdotally and in protocol notes, with rates depending on infusion rate
- Gastrointestinal effects with precursor formulations — Mild, Uncommon. Oral NAD+ precursors used in supplementation research more often than NAD+ itself have been associated with mild GI discomfort in some human studies; direct oral NAD+ bioavailability is limited
Contraindications
- Active malignancy under NAD+-dependent pathway research caution (Theoretical / Preclinical): Cancer cells can have high NAD+ turnover for DNA repair and metabolism; research protocols sometimes caution against exogenous NAD+/precursor elevation in active malignancy settings pending better safety data
- Uncontrolled hypersensitivity to formulation components (Clinical): As with any injectable or compounded coenzyme preparation, known allergy to excipients or prior infusion reactions is a standard research exclusion criterion
Storage
Lyophilized (powder): Refrigerated (2-8°C), Up to 24 months (protect from moisture; follow supplier CoA). Light sensitive: yes, store dark
Reconstituted (solution): Refrigerated (2-8°C), Per manufacturer; often use promptly after reconstitution or as multi-dose under refrigeration. Solvent: Sterile water or as supplied (injectable solutions are often ready-to-use or reconstituted per label)
Clinical Trials
- NCT02425904 — Study of Clofarabine in Patients With Recurrent or Refractory Langerhans Cell Histiocytosis and LCH-related Disorders (PHASE2), status: ACTIVE_NOT_RECRUITING. Indications: Langerhans Cell Histiocytosis
- NCT04158934 — A Long-term Study of ADYNOVI/ADYNOVATE in Participants With Haemophilia A, status: ACTIVE_NOT_RECRUITING. Indications: Hemophilia A
- NCT06590844 — "cindilizumab + Bevacizumab + Coenzyme I for Injection" in Unresectable Hepatocellular Carcinoma (PHASE4), status: ACTIVE_NOT_RECRUITING. Indications: Unresectable Hepatocellular Carcinoma
- NCT04257409 — Musculoskeletal Changes After Physiotherapeutic Intervention in Podiatric Subjects (NA), status: UNKNOWN. Indications: Prevention of Diabetic Foot
- NCT02143687 — Patients With Pulmonary Hypertension or Interstitial Lung Disease at Altitude - Effect of Oxygen on Exercise Performance (PHASE4), status: COMPLETED. Indications: Precapillary Pulmonary Hypertension, Interstitial Lung Disease
- NCT02164864 — Evaluation of Dual Therapy With Dabigatran vs. Triple Therapy With Warfarin in Patients With AF That Undergo a PCI With Stenting (REDUAL-PCI) (PHASE3), status: COMPLETED. Indications: Atrial Fibrillation, Percutaneous Coronary Intervention
- NCT06882096 — Tracing the Metabolic Flux of Orally Administered NAD+ Precursors (PHASE1), status: RECRUITING. Indications: Healthy Adults
- NCT02477501 — Ephedrine vs. Nor Epinephrine Infusion in Preventing Hypotension After Spinal Anesthesia for Cesarean Section (PHASE4), status: COMPLETED. Indications: Anesthesia; Adverse Effect, Spinal and Epidural, Hypotension, Complications; Cesarean Section
- NCT07119190 — A Perioperative Comprehensive Diagnosis and Treatment System for Lung Cancer in the Era of Neoadjuvant Immunotherapy, status: NOT_YET_RECRUITING. Indications: Non-Small Cell Lung Cancer
- NCT00835978 — Axitinib (AG-013736) With Or Without Dose Titration (Increase) In Patients With Kidney Cancer (PHASE2), status: COMPLETED. Indications: Carcinoma, Renal Cell
- NCT06313203 — HAI-Floxuridine, or SIRT, Combined With Gemox For Patients With Intra-Hepatic Cholangiocarcinoma Not Amenable to Resection (TOMCAT) (PHASE2), status: RECRUITING. Indications: Intrahepatic Cholangiocarcinoma, Chemotherapy Effect
- NCT03371082 — Gan & Lee Insulin Glargine Target Type (1) Evaluating Research (PHASE3), status: COMPLETED. Indications: Diabetes Mellitus, Type 1
- NCT01768520 — Evaluation of the Efficacy and Safety of Entelon Tab. 150mg in Patients With Osteoarthritis of Knee (PHASE3), status: COMPLETED. Indications: Knee Osteoarthritis
- NCT04948996 — Treatment of Depression Using a Mobile Application in the Dominican Republic (NA), status: TERMINATED. Indications: Depression Mild, Depression Moderate
- NCT02495727 — Two Weeks of Reduced Activity and Skeletal Muscle Health in Older Men (NA), status: COMPLETED. Indications: Muscular Atrophy
- NCT01813370 — A Registry for Patients Treated on the Clinical Trial TAX 3503, status: COMPLETED. Indications: Prostate Cancer
- NCT04880642 — A Trial to Investigate Recovery From COVID-19 With C21 in Adult Subjects (PHASE3), status: COMPLETED. Indications: COVID-19
- NCT02523040 — Lenalidomide for Adult Histiocyte Disorders (PHASE2), status: ACTIVE_NOT_RECRUITING. Indications: Langerhans Cell Histiocytosis (LCH), Histiocytoses Erdheim-chester Disease, Histiocytic Sarcoma (HS)
- NCT06776510 — A Clinical Study of NAD in the Treatment of Immune Thrombocytopenia (PHASE1 / PHASE2), status: RECRUITING. Indications: Immune Thrombocytopenia, Treatment
- NCT02114788 — Interactive Sections Of An Internet-Based Intervention Increase Patient Empowerment: A Study With Chronic Back Pain Patients, status: COMPLETED. Indications: Group 1 (Control): Access to a Static Version of the Website Containing Only Static Features (i.e. Library, First Aid, and FAQ), Group2 (Intervention) Access to an Interactive Version of the Website Containing Both Static and Interactive Features