Are NAD+ Injections Safe? The Real Risks and Benefits Shared

What side effects are common

People commonly report:

• Redness, soreness or a small bump where you injected
• Flushing or a warm feeling
• A tight or heavy feeling in the chest or stomach during the dose
• Nausea, headache or tiredness afterward

What the studies found

In a 2019 pilot, healthy men received 750 mg of NAD+ by IV over six hours with no adverse events during the infusion. A 2026 real-world review of faster IV doses (500 mg daily) found that all six people on NAD+ had moderate to severe cramping, nausea, vomiting, a raised heart rate and chest pressure, which stopped when the infusion stopped.

For under-the-skin NAD+, the evidence is a single small preprint that hasn't been peer reviewed. That isn't enough to call it proven safe long term.

What the FDA has warned about

In 2024 the FDA warned compounders that food-grade NAD+ isn't suitable for sterile injections, after reports of severe chills, shaking, vomiting and fatigue following NAD+ injections; the reactions were consistent with bacterial endotoxins. In January 2026 the FDA issued a warning letter after three patients became ill and an unopened NAD+ vial tested high for endotoxins.

That's why where your NAD+ comes from matters as much as the dose.

How to lower your risk

• Use a licensed provider who reviews your health and medicines first
• Get NAD+ only from a licensed U.S. pharmacy with a prescription
• Inject slowly, rotate sites and use a new sterile needle every time
• Report side effects to your provider and to FDA MedWatch