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Pyridine dinucleotide coenzyme (compounded injectable) · safety

NAD+ side effects

Also written NAD plus.

The nad+ side effects reported most often are moderate to severe stomach and gut symptoms during the infusion, raised heart rate during the infusion and chest pressure during the infusion. The full list is below, with the cited trial report cited at the bottom of the page.

The sources describe these effects in relation to the dose and to the early weeks.

NAD+ is a substance every cell uses to turn food into energy and carry out repair work. It is a coenzyme, not a peptide. Clinics promote NAD+ IV drips and injections for energy, focus, recovery, hangovers, addiction recovery and healthy aging.

The human studies on NAD+ itself are small and used IV infusions. They have not shown that NAD+ injections improve those goals. The clearest finding so far is discomfort during the drip, including stomach symptoms, a faster heartbeat and chest pressure.

Further down: the full list with frequencies · when to get medical help · questions

Medically reviewed by Jennifer Montecillo, MD · non-practicing medical reviewerReviewed 2026-08-12open the primary sources

At a glance

Common reactions listed

4

Serious reactions listed

0

Boxed warning

No label exists

Strongest source

limited human data

The counts show how many distinct reactions the cited trial report names. The percentages show how often a reaction appeared in a study group, not the chance that it will happen to you.

Common reactions

The full list, as reported across the available trial evidence. There is no approved label to read frequency bands off, so these are the trials’ own figures.

Common reactionstrial-reported
ReactionFrequency
Moderate to severe stomach and gut symptoms during the infusionReported in the NAD+ arm at 500 mg daily; resolved when the infusion finished
Raised heart rate during the infusionReported in the NAD+ arm at 500 mg daily; resolved when the infusion finished
Chest pressure during the infusionReported in the NAD+ arm at 500 mg daily; resolved when the infusion finished
Infusion having to be slowed because people could not handle the original speedNAD+ infusions averaged 97 minutes against 37 minutes for the same dose of nicotinamide riboside

limited human dataEvery reaction above comes from a cited trial. These are study findings, not instructions on what to take.

When to seek medical care

The trial report does not give a separate list of serious reactions. There is also no approved label. That gap does not mean serious reactions cannot happen. This compound has been studied in fewer people and for less time than an approved drug.

EmergencySome symptoms should not wait for an appointment. Call emergency services (911 in the US) if they are severe, getting worse fast, or involve trouble breathing, chest pain, fainting or confusion.

1Read deeperTiming, evidence limits, and product context

When these effects tend to occur

The cited evidence describes these effects in relation to the dose and to the early period of taking it, rather than as a constant background throughout.

When a study reports how side effects changed over time, it describes the group as a whole. It cannot predict one person’s experience.

Common questions

How long do nad+ side effects last, and do they go away?

The sources do not commit to a set number of days. What they describe is a pattern — reactions cluster after you start and after each increase, then ease while the dose is held steady. Any page quoting an exact number of days is quoting something the sources do not say.

What are the most common nad+ side effects?

Moderate to severe stomach and gut symptoms during the infusion, raised heart rate during the infusion, chest pressure during the infusion and infusion having to be slowed because people could not handle the original speed — the table above has the rest, each with its frequency band and source.

Does nad+ have a boxed warning?

No, because a boxed warning is part of an FDA-approved label and nad+ has no approved label. That reflects what regulatory review has and has not covered, not a finding that serious risks were looked for and ruled out.

Can the nad+ dose be lowered if side effects are hard to tolerate?

That decision belongs to the prescribing clinician. No approved schedule exists for this compound, so there is no labeled framework for adjusting a dose. That leaves the prescriber as the only place the decision can sit.

Does nad+ cause hair loss?

Hair loss is not among the reactions listed on this page for nad+, because the cited trial report cited here does not carry it. Anything missing from the tables is outside what can be sourced here rather than ruled out, and a symptom that worries you belongs with a clinician.

Is fatigue a listed nad+ side effect?

No — the cited trial report cited here does not list it. That describes what was reported, not proof that the symptom cannot happen.

Is constipation a listed nad+ side effect?

Not separately. If a source groups stomach and gut events together, this page keeps that group intact. It does not invent named reactions the source never listed.

What should someone do about a serious nad+ reaction?

Contact a clinician promptly, and emergency services if symptoms are severe or getting worse quickly. The available sources do not list any reactions as separately serious. That means there is no early-warning list here—not that serious reactions are impossible.

Do the frequencies on this page mean the chance it happens to one person?

No. These figures describe groups in a study. A band shows how often a reaction appeared under that trial’s conditions. It cannot predict what will happen to one person.

Related

The schedule these reactions were recorded against, the comparisons, and the sourcing rules behind every grade on this page.

Questions readers ask

What are the risks of taking NAD+?

Everything published concerns the infusion itself. A clinic reviewed its own pages against nicotinamide riboside on the same protocol. At 500 mg daily, people reported gut symptoms, a faster heartbeat and chest pressure.

A chart review run by the company selling the infusions is honest evidence and weak evidence at once. The larger risk is what nobody has looked at: no study has injected this coenzyme under the skin.

Why do I feel weird after a NAD shot?

The one published account puts this during the drip rather than after it. Gut symptoms, a raised heart rate and chest pressure all showed up in the NAD+ arm. All settled when the infusion finished.

Staff had to slow the drip to get through it. NAD+ infusions averaged 97 minutes against 37 for the same dose of nicotinamide riboside.

What happens if you take NAD every day?

On safety, nobody has watched a daily course for long. The longest on record is 21 days at 10 to 50 mg, in twelve people. The only other daily course registered is one week at 100 mg.

Both were phase 1 studies, into a vein, with staff watching. No published work follows daily use past three weeks.

What to avoid when taking NAD?

No interaction list exists because studies have not tested this coenzyme alongside other drugs. It would be unsafe to invent one from theory alone.

One distinction does matter: most human NAD+ research studies the swallowed precursors NR and NMN. Their milligram amounts do not describe NAD+ injections.

1primary source, each with the day we read it — open the documents used on this page