NAD+ injections and intravenous drips are currently widely offered by wellness clinics, med-spas, IV therapy centres and some telehealth providers. They are most commonly promoted in the context of energy, recovery and anti-aging.
Commercial popularity is not, however, the same as clinical validation.
Intravenous NAD+ has been studied for specific medical applications, and some providers also offer intramuscular and subcutaneous forms. At the same time, standard wellness protocols currently used in clinics have significantly less controlled human trial data than oral NAD+ precursors such as NR and NMN.
In this guide, we explain what NAD+ injections and infusions involve, how the different routes of administration differ, what you can expect before, during and after the session, what reactions have been reported, and how the available evidence compares to oral supplementation.
What does an NAD+ infusion or injection involve?
NAD+ can be administered intravenously, intramuscularly or subcutaneously. All of these routes bypass the digestive tract, but they differ in their method of administration, infusion rate, volume, required monitoring and the amount of research available.
Under the term „NAD+ injections”, two main approaches are usually hidden.
The first is intravenous infusion.
During IV administration, NAD+ is slowly delivered directly into the vein over a specified period.
The second approach is intramuscular or subcutaneous injections.
Intramuscular administration involves introducing a solution into muscle tissue, whereas with subcutaneous administration the solution goes into the fatty tissue located beneath the skin.
These routes typically use a smaller volume and require significantly less time than an intravenous infusion.
In clinical trials, intravenous NAD+ was administered according to precisely defined protocols.
For example, in one randomised, placebo-controlled trial in patients with heart failure, 10 mg of NAD+ was administered intravenously daily for seven days, alongside standard heart failure treatment. [1]
Such a research protocol differs significantly from the higher-dose NAD+ infusions offered during single sessions in wellness clinics.
Commercial infusions are often described as lasting from around an hour to several hours and may be offered as a single session or a series of repeat visits.
However, it is important that such commercial regimens have not been standardised on the basis of the same type of peer-reviewed clinical trials.
The amount of NAD+ administered during a single session, the infusion rate, the frequency of treatments, and the total duration of therapy can therefore vary significantly between providers.
IV infusion and intramuscular or subcutaneous NAD+ injection: what is the difference?
Intravenous, intramuscular and subcutaneous NAD+ bypass digestion in the gastrointestinal tract.
However, they do not provide an identical way of delivering the compound into the body.
NAD+ intravenous infusion
An intravenous infusion delivers NAD+ directly into the bloodstream via a vein.
A small catheter is usually inserted into a vein in the hand or arm and connected to an infusion bag containing the prepared solution.
From the point of view of the route of administration, one of the main advantages is the ability to control the infusion rate.
The solution can be administered gradually, enabling clinical staff to alter the rate should unpleasant symptoms appear.
Intravenous administration also makes it possible to use a larger volume of fluid than would typically be practical for a single intramuscular or subcutaneous injection.
This route of administration appeared in some clinical trials, including the previously described controlled trial concerning heart failure. [1]
It is also the dominant method used by commercial clinics offering NAD+ infusions.
Intramuscular NAD+ injection
Intramuscular administration involves injecting NAD+ directly into muscle tissue using a needle and syringe.
The material is subsequently absorbed from the muscle into the circulation.
The whole procedure is usually much shorter than an IV session, as it does not require a prolonged infusion.
At the same time, the volume of solution that can practically be administered in a single injection is more limited.
Subcutaneous NAD+ injection
When administered subcutaneously, the solution goes into the layer of fat tissue located under the skin.
This route is also used for many other injectable preparations, as it allows the use of relatively small needles and generally requires a less complex procedure than an intravenous infusion.
Some telemedicine services now offer subcutaneous NAD+ preparations designed for home use.
However, published clinical data regarding such contemporary at-home NAD+ protocols remain limited.
The simplest distinction is therefore as follows:
An IV infusion provides direct and gradual delivery of NAD+ into the bloodstream.
An intramuscular injection requires the absorption of the compound from the muscle.
A subcutaneous injection requires absorption from the tissue located beneath the skin.
All three methods bypass digestion, but merely bypassing the gastrointestinal tract does not prove greater clinical efficacy.
What can one expect before, during and after the administration of NAD+?
The course of an NAD+ session depends on the route of administration, the amount of preparation, the infusion rate, the provider's procedures, and individual response.
Before the session
NAD+ administration in a clinic typically begins with some form of health assessment.
It may include questions about current medications, allergies, cardiovascular history, chronic illnesses, and previous reactions to injections or intravenous therapies.
Adequate hydration may also be discussed prior to the IV infusion.
The scope of such an assessment varies between suppliers, which is another reason why one should not assume that commercial NAD+ administration follows a single standardised protocol.
During the IV infusion
A catheter is usually placed in a vein in the hand or arm.
Then the NAD+ solution is administered gradually.
Some people report unpleasant systemic symptoms during the infusion.
They may include hot flushes, nausea, abdominal discomfort, a feeling of tightness in the chest or other sensations that may become more noticeable with faster administration.
Because of this, staff may reduce the infusion rate if symptoms appear.
The relationship between tolerance and the rate of administration is one of the reasons why IV NAD+ sessions can take significantly longer than other types of intravenous therapy.
During an intramuscular or subcutaneous injection
Intramuscular and subcutaneous injections are usually much shorter procedures.
Instead of remaining connected to an IV line, the person receives a measured dose of the preparation in a single injection.
You may experience localised pain, a burning sensation or slight discomfort at the injection site.
Because administration is faster and involves a smaller volume, the visit itself can be significantly shorter than an IV session.
After administration
Feelings after administration can vary significantly.
An IV infusion naturally requires more time, as the infusion itself can take anywhere from less than an hour to several hours, depending on the protocol used.
Visits for a single injection are usually much shorter.
In retrospective real-world data, gastrointestinal and cardiac symptoms were reported more frequently with IV NAD+ than with intravenous nicotinamide riboside. [2]
These results do not allow the reaction of each person to be predicted, but are important when assessing what may occur during or after the infusion.
Injection site reactions and other reported symptoms
Local reactions may occur with virtually any preparation administered by injection or intravenously.
NAD+ is no exception.
Mild redness, swelling, tenderness, bruising, pain or temporary burning may occur at the needle or catheter insertion site.
They must be distinguished from systemic reactions.
Systemic symptoms refer to reactions extending beyond the injection site itself.
In a retrospective study comparing IV NAD+ with intravenous nicotinamide riboside, gastrointestinal and cardiac-related symptoms were more frequently reported in the NAD+-receiving group. [2]
Reported gastrointestinal symptoms included nausea and abdominal cramps, among others.
Among the ailments related to the circulatory system, palpitations and chest discomfort were described.
Such symptoms are of greater clinical significance than mild bruising or tenderness at the injection site.
Their occurrence may also be influenced by the rate of infusion and the volume of the preparation administered.
Therefore, significant chest discomfort, persistent nausea, pronounced dizziness, palpitations or other notable symptoms during the infusion should not simply be treated as a normal part of a NAD+ session.
They should be reported immediately to the medical personnel supervising the procedure.
In-clinic NAD+ vs at-home injections
NAD+ is currently offered both in traditional clinical settings and through telemedicine services delivering injectable preparations for home use.
Both approaches create very different practical conditions.
NAD+ administered in the clinic
Administration in the clinic enables medical staff to directly supervise the procedure.
This is of particular importance with IV infusions, as a session can last several hours and the infusion rate may need to be adjusted if symptoms occur.
Staff are also available to evaluate unexpected reactions.
The drawbacks are mainly of a practical nature.
Treatment at a clinic usually requires booking an appointment, travelling to the clinic, setting aside more time, and paying a higher cost per session due to the involvement of the clinic’s staff and facilities.
NAD+ home injections
Some telemedicine providers offer subcutaneous NAD+ for self-administration at home.
This solution is more convenient and can reduce the costs associated with regular visits to the clinic.
Self-administration, however, shifts a number of responsibilities onto the user.
They include correct measurement of the preparation, proper injection technique, rotation of injection sites, hygienic handling of the preparation, safe disposal of needles and recognition of symptoms requiring medical attention.
There are still very few published clinical studies on modern NAD+ home injection programmes.
Therefore, the mere availability of commercial products for self-injection should not be equated with a confirmed clinical evidence base regarding their long-term efficacy or safety.
The quality of the preparation is also an important issue.
Products intended for injection require higher standards of sterility and contamination control than standard oral supplements, as they bypass many of the body's external protective barriers.
Whether the preparation is administered in a clinic or delivered to the home, its identity, purity, sterility, storage conditions and manufacturing quality matter.
Are NAD+ injections better than oral supplements?
NAD+ injections and infusions are often advertised as more effective because they bypass digestion in the gastrointestinal tract.
Such reasoning seems simple, but controlled human study data presents a more complex picture.
Oral NAD+ precursors, such as nicotinamide riboside and nicotinamide mononucleotide, have been evaluated in numerous randomised placebo-controlled trials. [3–6]
These studies consistently show that oral NR and NMN can increase circulating NAD+ or levels of related metabolites.
These compounds also generally showed good tolerability in the short and medium term covered by the studies.
The functional results were, however, less consistent.
Increasing NAD+ does not automatically lead to an improvement in every metabolic, cardiovascular, physical performance or cognitive function parameter studied.
Even so, oral precursors have a significantly larger base of controlled clinical trials than direct NAD+ injections.
Evidence regarding IV and injectable NAD+
A 2026 systematic review on NAD+ interventions found no eligible controlled human studies directly evaluating intravenous or intramuscular NAD+ for general anti-aging or wellness applications. [7]
This is particularly important because it is precisely in these areas that these methods are widely promoted.
Clinical trials are being conducted on intravenous NAD+ in specific medical contexts.
One example is the controlled trial on heart failure described earlier. [1]
However, the protocol used involved a specific group of patients, a relatively small daily dose of 10 mg of NAD+, a seven-day intervention period and concurrent standard treatment.
This study should not be regarded as confirmation of the much broader commercial NAD+ IV protocols used in wellness clinics.
Direct evidence does not automatically mean better evidence
Bypassing the gastrointestinal tract changes the route of administration.
It does not automatically prove that it is more effective.
To demonstrate the superiority of IV or injectable NAD+ over oral NR or NMN, direct studies would be required to compare, under equivalent conditions, the pharmacokinetics, cellular uptake, relevant biomarkers, clinical outcomes, adverse effects and long-term safety.
Such data remains limited.
The current evidence therefore supports a more cautious conclusion.
NAD+ injections and infusions allow for direct systemic administration, but oral NR and NMN currently have a stronger body of evidence from randomised human trials confirming their ability to increase NAD+-related biomarkers.
IV NAD+ vs NAD+ injections vs oral precursors
| Feature | IV NAD+ | Intramuscular/subcutaneous NAD+ | Oral NR/NMN |
|---|---|---|---|
| Application route | Directly into a vein | Muscle or subcutaneous tissue | Absorption via the gastrointestinal tract |
| It bypasses the digestive system | Yes | Yes | Not |
| A typical way of serving | Slow infusion | A single injection | Capsule, tablet or powder |
| Session time | Usually longer | Short | No clinical consultation required |
| Clinical supervision | Usually continuous | A clinic or a home, depending on the provider | Not usually required |
| Randomised human trials | Limited in scope and relating to specific diseases | Very limited | The strongest evidence base |
| Controlled anti-ageing/wellness trials | No eligible studies were identified in the 2026 review [7] | No eligible studies were identified in the 2026 review [7] | Numerous controlled studies on precursors [3–6] |
| Demonstrated increase in NAD+ biomarkers | Biologically plausible, but limited evidence regarding wellness | Limited direct data | Yes, demonstrated multiple times |
| Reported tolerance issues | Gastrointestinal and cardiac symptoms in a retrospective study [2] | Local and systemic effects are not well characterised | Generally well tolerated in clinical trials |
| Home use | Not | Increasingly offered | Universal |
| Proof of superiority over oral precursors | Not demonstrated | Not demonstrated | — |
The main difference, therefore, does not simply come down to whether a particular compound bypasses the digestive tract.
Much more important is the depth and quality of the evidence concerning each route of administration.
Frequently asked questions about NAD+ injections and IV drips
What happens during an IV NAD+ infusion?
The catheter is inserted into a vein, and the NAD+ solution is administered gradually.
Commercial sessions can last from less than an hour to several hours, depending on the volume of the solution and the infusion rate.
Some individuals report nausea, flushing, chest tightness, abdominal discomfort or similar sensations during the infusion, particularly with faster administration. [2]
Are NAD+ injections and NAD+ IV drips the same thing?
No.
Administration IV delivers NAD+ directly into the bloodstream via a vein.
When administered by intramuscular or subcutaneous injection, NAD+ first enters the tissue, from where it must then be absorbed into the bloodstream.
These methods therefore differ both in terms of their route of administration and their pharmacokinetic profile.
Do IV NAD+ infusions have clinically proven anti-aging effects?
There is currently no robust, controlled evidence confirming IV NAD+ as an anti-ageing method.
A systematic review from 2026 found no eligible controlled trials on intravenous or intramuscular NAD+ for anti-ageing or wellness purposes. [7]
Has intravenous NAD+ been clinically trialled?
Yes, but in certain contexts.
For example, in a randomised trial on heart failure, 10 mg of NAD+ was administered intravenously every day for seven days alongside standard treatment. [1]
Such a protocol does not confirm the effectiveness of larger commercial wellness infusions offered by private clinics.
Are NAD+ injections better than NMN or NR?
This has not been demonstrated.
Oral NR and NMN have a larger body of evidence from randomised, placebo-controlled trials in which increases in NAD+-related biomarkers have been observed. [3–6]
There is a lack of direct comparative studies confirming greater clinical effects of injectable NAD+.
Can IV NAD+ cause side effects?
Systemic symptoms have been reported.
In a retrospective comparison, gastrointestinal and cardiac-related complaints were observed more frequently with IV NAD+ than with intravenous nicotinamide riboside. [2]
As this was a retrospective study, it does not allow the exact incidence of such reactions to be determined for all NAD+ infusion protocols.
Can NAD+ be injected at home?
Some telemedicine services offer subcutaneous NAD+ preparations for use at home.
However, published research regarding such contemporary home-based protocols remains limited.
Self-injection also involves issues relating to technique, hygiene and sterility, the correct measurement of the dose, storage, the disposal of needles, and recognising reactions that require medical attention.
Are reactions at the injection site normal?
Following an injection or the insertion of an IV catheter, you may experience mild redness, tenderness, bruising, swelling or temporary discomfort.
Such local reactions should be distinguished from systemic symptoms, such as chest discomfort, severe nausea, dizziness or palpitations.
Limitations of current evidence
One of the main limitations is the difference between commercial NAD+ protocols and those used in research.
Wellness clinics may use different doses of the preparation, infusion rates, treatment frequencies and session lengths, whilst published studies usually concern precisely defined interventions in specific populations.
In the controlled trial on heart failure described here, 10 mg of NAD+ was administered intravenously daily for seven days. [1]
It should not be assumed that the results of this study represent or corroborate the significantly different IV protocols commonly promoted in the context of energy, regeneration, longevity or general wellbeing.
Another limitation is the data on tolerances.
The comparison between IV NAD+ and intravenous nicotinamide riboside was drawn from a retrospective pilot study conducted in a real-world setting, rather than from a randomised clinical trial. [2]
This means that the observed differences in gastrointestinal and cardiac symptoms may serve as an early signal, but do not allow for the establishment of a definitive comparative safety profile.
The evidence base for intramuscular and subcutaneous NAD+ is even smaller.
Published clinical research concerning contemporary injectable forms used in wellness clinics or home telemedicine programmes remains limited.
According to a 2026 systematic review, there were no eligible controlled human trials specifically evaluating IV or intramuscular NAD+ for anti-ageing or general wellness applications. [7]
Finally, bypassing gastrointestinal absorption should not be equated with a proven clinical advantage.
Direct comparative studies are still needed to show whether IV or injectable NAD+ leads to more significant biological or clinical effects than better-studied oral precursors such as NR or NMN.
Disclaimer
This article is for educational and scientific-information purposes only. It does not constitute medical advice, instructions for dosing or performing injections, administration guidelines, therapeutic recommendations, or a recommendation to use NAD+ intravenously, intramuscularly, subcutaneously, or by any other route.
NAD+ injections and infusions have significantly fewer controlled human study data regarding general wellness, anti-aging, energy, or recovery than their widespread commercial availability might suggest. Results obtained in specific clinical protocols should not be automatically extrapolated to commercial infusion programmes utilising larger quantities, different administration rates, or varying dosing schedules.
NAD+ injections and infusions are not approved by the FDA or EMA as treatments, preventatives, or cures for diseases. Injectable products also raise additional concerns regarding sterility, contamination, dosage accuracy, vascular or injection site complications, and systemic reactions. Any intervention involving injectable or intravenous NAD+ should only be considered under the supervision of an appropriately qualified healthcare professional. Pregnant or breastfeeding individuals, those with cardiovascular conditions or other significant medical issues, and those taking prescription medications should obtain personalised medical advice before considering such interventions. Pain or significant chest pressure, severe or persistent nausea, marked dizziness, palpitations, breathing difficulties, fainting, or other serious symptoms occurring during or after an injection or infusion require urgent medical evaluation.
References
[1] American Journal of Cardiovascular Drugs. (2026). Effect of nicotinamide adenine dinucleotide on heart failure caused by ischaemic cardiomyopathy: A randomised, placebo-controlled trial. American Journal of Cardiovascular Drugs. https://pmc.ncbi.nlm.nih.gov/articles/PMC12779688/
[2] Reyna, K., Heinzen, G., Patel, N., Ritter, M., Siojo, A., Legere, H., & Pojednic, R. (2026). Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): A retrospective tolerability pilot study in a real-world setting. Frontiers in Aging, 7, 1652582. https://doi.org/10.3389/fragi.2026.1652582
[3] Yi, L., Maier, A. B., Tao, R., Lin, Z., Vaidya, A., Pendse, S., Thasma, S., Andhalkar, N., Avhad, G., & Kumbhar, V. (2022). The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: A randomised, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial. GeroScience, 45, 29–43. https://doi.org/10.1007/s11357-022-00705-1
[4] Martens, C. R., Denman, B. A., Mazzo, M. R., Armstrong, M. L., Reisdorph, N., McQueen, M. B., Chonchol, M., & Seals, D. R. (2018). Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults. Nature Communications, 9, 1286. https://doi.org/10.1038/s41467-018-03421-7
[5] Conze, D., Brenner, C., & Kruger, C. L. (2019). Safety and metabolism of long-term administration of NIAGEN (nicotinamide riboside chloride) in a randomised, double-blind, placebo-controlled clinical trial of healthy overweight adults. Scientific Reports, 9, 9772. https://doi.org/10.1038/s41598-019-46120-z
[6] Dellinger, R. W., Santos, S. R., Morris, M., Evans, M., Alminana, D., Guarente, L., & Marcotulli, E. (2017). Repeat dose NRPT (nicotinamide riboside and pterostilbene) increases NAD+ levels in humans safely and sustainably: A randomised, double-blind, placebo-controlled study. npj Aging and Mechanisms of Disease, 3, 17. https://doi.org/10.1038/s41514-017-0016-9
[7] Gallagher, C., & Emmanuel, O. O. (2026). NAD+ supplementation for anti-aging and wellness: A PRISMA-guided systematic review of preclinical and clinical evidence. Ageing Research Reviews, 116, 103057. https://doi.org/10.1016/j.arr.2026.103057