NAD+ (nicotinamide adenine dinucleotide) studies and research data

NAD+ (nadide is the INN, USAN and JAN name; also coenzyme I, DPN and codehydrogenase I) is a dinucleotide: a nicotinamide nucleotide joined by a pyrophosphate bridge to an adenosine nucleotide. The formula is C21H27N7O14P2 (663.4). It is also a substrate that enzymes use up: UniProt lists NAD(+) in the catalytic reactions of PARP1 (poly-ADP-ribosylation), SIRT1 (protein deacetylation), CD38 (cyclic ADP-ribose and ADP-ribose formation) and SARM1 (NAD(+) hydrolysis). No approved NAD+ drug product was found in the US. Drugs@FDA (openFDA) has no match for nadide, and the DailyMed search for 'nadide' returns homeopathic combination products and one oral dietary supplement label (Viatrexx-NAD Plus, 500 mg powder, last revised 2019). FDA lists NAD in 503A category 1 (under evaluation) and beta-NAD in 503B category 1, and the disodium salt trihydrate in category 3 of both lists. FDA warned compounders on 2024-10-30 that food-grade NAD+ is not suitable for sterile IV products and said it had adverse event reports after NAD+ injectable drugs (severe chills, shaking, vomiting, fatigue) that fit high endotoxin levels. An NAD+ for injection product from GenoGenix LLC was recalled in a Class I recall (elevated endotoxin, recall initiated 2025-07-30, reported 2025-10-15, status ongoing). In China, coenzyme I for injection (Enaidi, now sold by Knature Biopharmaceutical, Hefei, a company founded in 2017) was first approved in 2002 according to Chinese news reports about the company's Hong Kong listing filing; the reported label uses are adjuvant treatment of coronary heart disease, myocarditis and leukopenia, by intramuscular injection. The NMPA record itself was not read. Chinese regulator registrations (CDE) list phase 1 and phase 2 trials of coenzyme I for injection in heart failure and ovarian function decline. WADA does not name NAD+ on the 2026 or 2027 Prohibited List. Rule M2.2 limits IV infusions and injections to 100 mL per 12 hours outside hospital treatment, surgery and diagnostic work. Direct NAD+ studies in people are few and small. Examples: a 2019 pilot of a 6 hour IV infusion in people (PMID 31572171, title read only), a 2026 real-world comparison of 500 mg NAD+ IV with NR IV for 4 days that reported moderate to severe gastrointestinal symptoms, faster heart rate and chest pressure with NAD+ (Frontiers in Aging), and a 2026 randomized trial of IV NAD+ 10 mg per day for 7 days in heart failure (PMID 40954388, not read beyond the abstract). Science-Based Medicine reports a February 2026 systematic review that found no eligible controlled outcome trials of IV, IM or SC NAD itself for anti-aging or wellness. The same commentary reports the review authors' argument that NAD+ is a large polar molecule not expected to cross cell membranes intact. Oral NMN and NR (precursors) are different compounds and are not described here.

Kind

Small molecule

Formula

C₂₁H₂₇N₇O₁₄P₂

Identifiers

ChEMBLCHEMBL1234613 (opens in a new tab)CHEMBL3039307 (opens in a new tab)PubChem CID5892 (opens in a new tab)5893 (opens in a new tab)UNII0U46U6E8UK (opens in a new tab)DrugBankDB14128 (opens in a new tab)CAS53-84-9151411-04-0KEGGD00002 (opens in a new tab)C00003 (opens in a new tab)

Development

Approved in China onlyKnature Biopharmaceutical (Hefei, China) markets coenzyme I for injection in China. In the US, the sponsors of the registered NAD+ studies include Nutraceuticals Research Institute (injection comparison with nicotinamide riboside), AgelessRx (a telehealth company; NAD+ nasal spray and patch studies) and BioNADrx (oral NAD+). No drug maker holds a US or EU NAD+ product.Meaning of highest_phase 'approved': one NAD+ injection is reported as approved in China since 2002 (news reports, not a label page). Nothing is approved in the US or EU. ChEMBL max_phase for CHEMBL1234613 is 2.0 and ChEMBL lists no mechanism and no indication for it. ClinicalTrials.gov API v2 (2026-10-13): 22 studies when the term is the intervention name 'NAD+' (query.term=AREA[InterventionName]"NAD+"; the synonym search 'NAD+' in the intervention field gives 267 because the site expands it to NMN, NR and other terms). Hand screening of the records found studies that give NAD+ itself: NCT06919328 (injectable NAD+ 100 mg by IM, SC or IV push vs Niagen vs placebo, n=70, recruiting), NCT06382688 (IV NAD+ vs IV and oral Niagen, n=53, status unknown), NCT05849519, NCT06558253, NCT06590844 (phase 4), NCT07328100 and NCT06776510 (coenzyme I for injection, China, various uses), NCT07839130 (pediatric cardiac dysfunction, IV NAD 2 or 4 mg/kg/day for 7 days, phase 2, not yet recruiting, estimated start 2026-10-01, n=180), NCT07475546 (phase 3, AgelessRx, a drug combination in which NAD+ is a nasal spray 30 mg/day), NCT04604704 (phase 2, naltrexone plus NAD+ by iontophoresis patch, 400 mg solution, post-COVID, completed), NCT07336836 (oral NAD+ 500 mg, early phase 1, completed) and NCT06579209 (oral NAD+ supplement pilot). Studies named 'Qualia NAD+' give a precursor blend, not NAD+ itself. Phase labels are the sponsors' own. Published human work: 6 hour IV infusion pilot (2019, PMID 31572171), retrospective NAD+ IV vs NR IV (Frontiers in Aging 2026), RCT in ischemic heart failure (PMID 40954388), and older trials in alcohol withdrawal and schizophrenia (1967 to 1971) and Alzheimer disease (PMID 15134388, 'stabilized oral nicotinamide adenine dinucleotide'; whether the product is NAD+ or NADH was not checked). Study protocol authors and results were not read. Source (opens in a new tab)

• NMN vs NAD+

• MOTS-c evidence
• Epitalon evidence
• Glutathione evidence
• Methylene blue evidence