Your cells' master energy currency and anti-aging powerhouse—NAD+ keeps your mitochondria humming, activates longevity genes called sirtuins, and helps repair DNA damage that accumulates as you get older.
Written by Michael Carroll — Owner, Director of Research · Reviewed by the Peptide Initiative Research Team · Editorial standards
Oral (NR or NMN precursors)
Route
3 recommended
Sites
Once daily
Frequency
Preparation
NAD+ powder vial (for injectable forms)
Sterile saline or bacteriostatic water
Sterile syringes and needles
Alcohol swabs
Sterile vial for mixing
Pro tip
Prepare all supplies on a clean surface before you begin. Having everything ready makes the process smoother and more sterile.
Mixing
Wash your hands thoroughly with soap and water. Gather all supplies on a clean, flat surface.
Remove the plastic cap from the peptide vial and wipe the rubber stopper with an alcohol swab. Let it air dry.
Draw the appropriate amount of bacteriostatic water into a sterile syringe.
Insert the needle into the vial at an angle, aiming at the inside wall of the vial. Slowly push the plunger to let the water trickle down the glass wall -- do NOT squirt directly onto the powder.
Once all water is added, gently swirl the vial in a slow circular motion. Never shake the vial, as this can damage the peptide bonds.
Continue swirling until the powder is completely dissolved and the solution is clear. If particles remain, let the vial sit for a few minutes and swirl again.
Label the vial with the date of reconstitution, the peptide name, and the concentration (e.g. 250mcg per 0.1mL).
Example calculation
For IV infusion: A typical 250mg vial mixed with 250mL saline creates a 1mg/mL solution. The entire bag is then infused slowly over 2-4 hours to minimize flushing.
Dose calculation
IV infusions are typically prepared by medical professionals. For oral supplements, simply take the capsule or powder as directed—no mixing required.
Pro tip
Always add the bacteriostatic water slowly, letting it run down the side of the vial. Never shake the vial -- swirl gently to avoid damaging the peptide.
Location
Site 01
Upper Arm
Back or outer area of the upper arm. This site may require assistance from another person for proper technique.
Site 02
Upper Arm
Back or outer area of the upper arm. This site may require assistance from another person for proper technique.
Site 03
SubQ: Abdominal area (if applicable)
Follow your provider's instructions for this injection site. Rotate sites regularly to prevent tissue damage.
Rotate between 3 sites to prevent tissue buildup and ensure consistent absorption.
Pro tip
Rotate your injection sites with each dose to prevent lipohypertrophy (buildup of fatty tissue). Keep a simple log of where you last injected.
Step by step
IV NAD+ should only be administered by qualified healthcare professionals
The infusion rate is crucial—too fast causes intense flushing and discomfort
Typical infusions run over 2-4 hours for 250-500mg doses
Slower rates (4+ hours) are better tolerated but require more time
Monitor for flushing, nausea, or chest tightness during infusion
Pro tip
This peptide uses intravenous (iv) infusion is most common for direct nad+; subcutaneous or intramuscular injections are less common but sometimes used. Inject at a 45-90 degree angle into pinched skin. Aspirate before injecting to ensure you haven't hit a blood vessel.
Timing
Optimal timing
Best time
Morning is generally recommended for oral NAD+ precursors since they can boost energy and alertness. Some people find afternoon doses interfere with sleep. IV infusions can be done anytime but plan for 2-4 hours.
With food?
NAD+ precursors can be taken with or without food. Some people find taking with food reduces any digestive upset. Fat-soluble companions like resveratrol absorb better with a meal containing healthy fats.
Stacking notes
NAD+ precursors pair beautifully with sirtuin activators like resveratrol and quercetin—they work synergistically. CoQ10 and PQQ support the same mitochondrial health pathways. Space supplements 30 minutes apart if taking multiple.
Sample daily schedule
Morning (with breakfast)
250-500 mg oral precursor (NR or NMN) injection
Site: Oral administration
Taking in the morning supports daytime energy and avoids potential sleep interference. Can be taken with food to reduce any digestive upset. This is the most common daily protocol.
Scheduled appointment (for IV)
250-500 mg NAD+ IV infusion injection
Site: IV in arm vein
IV sessions are typically done weekly to monthly depending on goals. Plan for 2-4 hours. Eat a light meal beforehand and stay well-hydrated.
Dosing tiers
Dose
250 mg NR or NMN
Frequency
Once daily
Duration
4-8 weeks
Lower end of trial-validated oral precursor dosing; NMN 250-900 mg/day and NR from 250 mg/day raise blood NAD+ [1][6].
Dose
500 mg NR or NMN
Frequency
Once or twice daily
Duration
Ongoing
500 mg twice daily NR raised PBMC NAD+ ~60% in a randomized placebo-controlled trial in older adults [1][4].
Dose
500 mg NAD+ in 500 mL saline
Frequency
Per infusion — run time is the critical setting, not the milligrams
Duration
Studied as 4 consecutive days; no established schedule
Source class: clinical practice. The milligrams alone do not describe this dose; the published studies also state how fast it went in. In the tolerability study, all 6 people (6 of 6, 100%) receiving 500 mg reported moderate to severe abdominal cramping, diarrhoea, nausea, vomiting, increased heart rate, throat pain, congestion and chest pressure during infusion, against 5 of 8 reporting minor tingling and mild cramping on nicotinamide riboside. Participants set their own rate by tolerance; average total infusion time was 97 minutes for NAD+ and 37 minutes for NR [6]. A separate study infused NAD+ at 3 micromoles per minute over 6 hours [7]. Three hours after infusion, blood NAD+ was significantly higher in the NR group than the NAD+ group [6].
Preservation
Before mixing
Store NAD+ powder in the refrigerator at 36-46°F (2-8°C). For oral supplements (NR, NMN), a cool, dry place works, but refrigeration extends shelf life. Keep away from light and moisture.
After mixing
Reconstituted NAD+ solutions should be refrigerated and used within 14-21 days. Never freeze. Discard if solution becomes cloudy, discolored, or contains particles.
Shelf life after mixing
14-21 days
Signs of degradation
Discard the vial immediately if you notice any of these:
Yellow or brown discoloration (should be clear to slightly yellow)
Cloudy appearance or floating particles
Unusual smell
Powder that won't fully dissolve
Important
When to stop
Any signs of allergic reaction—difficulty breathing, severe rash, swelling
Persistent digestive problems that don't improve after 2 weeks
Severe or persistent headaches
Heart palpitations or significant changes in heart rhythm
If you develop any condition where NAD+ is contraindicated (like cancer diagnosis)
Side effects that concern you or affect quality of life
NAD+ supplements and infusions are not FDA-approved for treating any medical condition. The information provided is for educational purposes only. Always consult with a qualified healthcare provider before starting, stopping, or changing any supplement regimen.
Clean technique checklist
Wash hands thoroughly with soap and water before handling supplies
Swab vial tops and injection site with alcohol and let dry
Never touch the needle tip or allow it to contact non-sterile surfaces
Use a new syringe and needle for each injection
Dispose of used sharps in a proper sharps container
Store reconstituted peptides according to the storage instructions above
Published research
Vinten KT, Trætowicz MM, Coskun E · 2025
This comprehensive review evaluated human clinical trials of NAD+ precursors, finding that while NAD+ levels clearly decline with age, the clinical benefits of supplementation in humans are still being established. The review highlights the need for larger, longer trials.
Yu X, Xu J, Cao J · 2026
In 180 heart failure patients, IV NAD+ significantly improved heart function (ejection fraction) compared to placebo. Patients also showed trends toward fewer hospitalizations and better functional capacity, suggesting NAD+ may help struggling hearts.
Berven H, Kverneng S, Sheard E · 2023
A phase I randomised, double-blind trial in 20 people with Parkinson's disease, split 10 on nicotinamide riboside 1,500 mg twice daily (3,000 mg/day) and 10 on placebo, for four weeks. All 20 completed. The primary outcome was the frequency of moderate and severe adverse events: there were none, and mild adverse events did not differ significantly between the two groups. Blood NAD+ rose up to 5-fold. NR recipients showed a slight initial rise in serum homocysteine. Total MDS-UPDRS scores improved, but that change was also associated with a shorter interval since the last levodopa dose. The authors support extending the dose range to 3,000 mg/day in phase II with safety monitoring.
Wang DD, Airhart SE, Zhou B · 2022
A 30-participant trial in patients with clinically stable heart failure with reduced ejection fraction, given nicotinamide riboside 1,000 mg twice daily (2,000 mg/day). NR appeared safe and well tolerated and approximately doubled whole blood NAD+. Within individuals, the rise in NAD+ correlated with increased basal (R2 = 0.413, P = 0.003) and maximal (R2 = 0.434, P = 0.002) respiration in peripheral blood mononuclear cells, and with decreased NLRP3 expression (R2 = 0.330, P = 0.020). The trial reports safety and tolerability; it was not designed to measure whether heart failure outcomes improved.
Szarvas Z, Reyff ZA, Peterfi A · 2025
In older adults with blood vessel disease, 4 weeks of NAD+ precursor supplementation improved brain blood vessel function and cognitive performance across multiple domains. The supplement also reduced oxidative stress in blood vessel cells.
Reyna K, et al. · 2026
Clients received 500 mg lyophilized NAD+ (or NR) in 500 mL saline IV on four consecutive days; NAD+ infusions averaged ~97 minutes with GI symptoms prompting slower rates.
Grant R, Berg J, Mestayer R, Braidy N, Bennett J, Broom S, Watson J · 2019
NAD+ was infused intravenously at 3 micromoles per minute for 6 hours. Plasma NAD+ and its metabolites (nicotinamide, methylnicotinamide, ADP-ribose, nicotinamide mononucleotide) did not change until after 2 hours. Increased urinary excretion of methylnicotinamide and NAD+ was detected at 6 hours, with no significant rise in urinary nicotinamide.
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