Not a peptide, not approvedNAD+ is a coenzyme, not a peptide,[1] and there is no FDA-approved NAD+ drug.[2] It appears on this site because "NAD" is often sold and searched alongside peptides.
Why NAD+ is not a peptide
A peptide is a chain of amino acids; NAD+ contains none. PubChem describes it as "a dinucleotide of adenine and nicotinamide" with coenzyme activity.[1]
| Peptide (e.g. BPC-157) | NAD+ | |
|---|---|---|
| Building blocks | Amino acids | Two nucleotides (adenine and nicotinamide, each with a ribose sugar and a phosphate) |
| Linked by | Peptide bonds | A pyrophosphate (phosphate–phosphate) bridge |
| Elements | C, H, N, O, sometimes S | C, H, N, O and phosphorus: C21H27N7O14P2[1] |
| Role in the body | Varies by peptide | Coenzyme in redox reactions and ADP-ribose donor |
U.S. drug law draws its peptide and protein lines around amino-acid chains,[14] so NAD+ falls outside both. That is also why the sequence molecular weight calculator on this site cannot handle it, and why the what are peptides page does not count it.
FDA status of NAD+
No NAD+ drug is FDA-approved; for compounding, the FDA lists it as under evaluation, not on the approved bulks list.
| List | NAD+ status |
|---|---|
| 503A categories (May 14, 2026)[3] | Category 1 (under evaluation): NAD and NADH; Category 3: one salt form |
| 503B categories (Mar 21, 2025)[4] | Category 1: beta-NAD |
| 503A bulks list, 21 CFR 216.23[5] | Not listed (the list has six substances) |
Category 1 means the FDA is evaluating the substance and generally does not intend to take action against pharmacies compounding with it meanwhile; it is not an approval.[6]
NAD injection side effects and FDA warnings
Reported side effects of NAD+ injections include chills, shaking, vomiting and fatigue, which the FDA links to endotoxin from unsuitable ingredients, and stomach symptoms, faster heart rate and chest pressure during infusions.[7][11]
- Food-grade ingredients. FDA: "The agency is aware of compounders using food-grade nicotinamide adenine dinucleotide (NAD+) sold by repackagers to make intravenous products", with reports of "severe chills, shaking, vomiting and fatigue" consistent with excessive endotoxin.[7]
- A warning letter. In January 2026 the FDA wrote that three patients had "low blood pressure, uncontrollable shaking, shivers, and body aches" after one lot of an outsourcing facility's NAD+ and "were directed to the emergency room"; an unopened vial held endotoxin at 3,360 EU/mL. The letter also said NAD+ products were not eligible for that facility's 503B exemptions.[8]
What the human studies show
Studies of IV NAD+ are few and small, and no trial of NAD+ injected under the skin or into muscle was found.[12]
| Study | People | Amount and route studied | Reported |
|---|---|---|---|
| Grant 2019[9] | 11 healthy men (8 NAD+, 3 saline) | 750 mg IV over 6 hours | Blood NAD+ unchanged for 2 hours, then up about 400% by 6 hours; no adverse events |
| Yu 2026[10] | 180 adults with ischemic cardiomyopathy, randomized | 10 mg IV daily for 7 days, plus usual care | Heart pumping fraction 45.4% vs 42.4% at 1 month; major events not significantly different |
| Reyna 2026[11] | Wellness-clinic patients, retrospective | 500 mg IV daily for 4 days | Stomach symptoms, faster heart rate and chest pressure during NAD+ infusions |
A 2026 systematic review found no eligible outcome trial of IV or injected NAD+ for anti-aging or wellness.[12]
NAD+ and sport
NAD+ is not named on the WADA 2026 list, but large IV drips are banned as a method whatever they contain: WADA prohibits "intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period" outside legitimate hospital care.[13] See are peptides banned in sports?
Other peptide pages
The peptides most often looked up alongside this one. Each page gives that peptide's FDA status, compounding status and published human evidence, with sources; the status table has all 23 in one place.
- MOTS-cNot approved 16-amino-acid mitochondrial peptide. No human trials of MOTS-c itself.
- SS-31 (elamipretide)FDA-approved Forzinity, approved 2025 for Barth syndrome. Ready-to-use; no mixing.
- CagrilintideNot approved Amylin analogue; CagriSema under FDA review.
- BPC-157Not approved 15-amino-acid peptide. Human data: a few tiny, uncontrolled studies.
- TB-500Not approved A 7-amino-acid fragment of thymosin beta-4. No human trials of TB-500 itself.
- BPC-157 + TB-500 blendNot approved Two peptides in one vial: the arithmetic of a fixed ratio.
Frequently asked questions
Is NAD a peptide?
No. NAD+ is a dinucleotide coenzyme built from two nucleotides; it contains no amino acids.[1]
Is NAD+ FDA-approved?
Are NAD+ injections safe?
There are no large trials. The FDA has received reports of severe chills, shaking, vomiting and fatigue after IV NAD+, consistent with endotoxin contamination from unsuitable ingredients.[7]
Is NAD+ banned in sport?
NAD+ itself is not named, but IV infusions over 100 mL per 12 hours are a prohibited method under WADA rules.[13]
Sources
- PubChem CID 5892: nadide (NAD+)
- openFDA Drugs@FDA searches for AOD-9604, KPV, epitalon, semax, selank, cagrilintide, melanotan and NAD (no application found)
- Bulk drug substances nominated for use in compounding under section 503A (category lists)
- Bulk drug substances nominated for use in compounding under section 503B (category lists)
- 21 CFR 216.23: bulk drug substances that can be used under section 503A
- Bulk drug substances used in compounding under section 503A of the FD&C Act
- FDA reminds compounders to use ingredients suitable for sterile compounding (NAD+)
- Warning letter: GenoGenix LLC (503B outsourcing facility)
- Grant R et al. Pharmacokinetics of intravenous NAD+ in healthy men (Front Aging Neurosci 2019;11:257)
- Yu X et al. Intravenous NAD+ in ischemic cardiomyopathy: randomized trial (Am J Cardiovasc Drugs 2026;26:97–106)
- Reyna K et al. IV NAD+ vs nicotinamide riboside infusions: retrospective review (Front Aging 2026;7:1652582)
- Gallagher C, Emmanuel OO. Systematic review of NAD+ precursor and NAD+ interventions in humans (Ageing Res Rev 2026;116:103057)
- World Anti-Doping Code: Prohibited List 2026
- Final rule: Definition of the term "biological product" (85 FR 10057)