Contraindications of NAD+ IV Administration
NAD+ intravenous administration is contraindicated in patients with a history of cardiovascular disease, hypotension, and those taking medications with potential drug interactions such as monoamine oxidase inhibitors.
Primary Contraindications
- Cardiovascular conditions: Patients with unstable angina, non-ST-elevation myocardial infarction, or other cardiovascular conditions should avoid NAD+ IV due to potential hemodynamic effects 1
- Hypotension: NAD+ IV should not be administered to patients with systolic blood pressure less than 100 mm Hg or less than 30 mm Hg below baseline 1
- Medication interactions: NAD+ IV is contraindicated for use in combination with monoamine oxidase inhibitors due to potential adverse interactions 1
Secondary Contraindications and Precautions
- Hepatic or renal dysfunction: Patients with impaired liver or kidney function should avoid NAD+ IV due to altered metabolism and clearance 1
- Inflammatory conditions: High-dose NAD+ supplementation may increase inflammatory markers and should be avoided in patients with pre-existing inflammatory conditions 2
- Atherosclerosis: Recent research indicates NAD+ boosting may increase atherosclerotic plaques and inflammation in susceptible individuals 2
- Drug-drug interactions: NAD+ may interact with medications that affect SA and/or AV nodal function 1
Common Adverse Effects
- Cardiovascular effects: NAD+ IV can cause changes in heart rate and blood pressure 3
- Neurological symptoms: Headaches, sleep disturbances, and nervous system disorders have been reported 3
- Musculoskeletal effects: Muscle pain and fatigue are commonly reported side effects 3
- Gastrointestinal effects: Nausea and gastrointestinal discomfort may occur during administration 3
Special Populations
- Pregnancy and lactation: NAD+ IV should be avoided in pregnant or lactating women due to insufficient safety data 1
- Elderly patients: Older adults may have increased sensitivity to hemodynamic effects and should be monitored closely if NAD+ IV is administered 4
- Patients with diabetes: Those with diabetes require careful monitoring due to potential effects on insulin sensitivity 3
Monitoring Recommendations
- Vital signs: Regular monitoring of blood pressure, heart rate, and respiratory status during infusion 1
- Infusion rate: The infusion rate should be carefully controlled and may need to be reduced if adverse effects occur 5
- Duration: NAD+ is rapidly cleared from plasma within the first 2 hours of infusion, requiring careful monitoring of metabolic effects 5
Safety Considerations
- While oral NAD+ precursors have demonstrated safety in clinical trials, IV administration presents different pharmacokinetics and potential risks 6, 5
- The safety profile of NAD+ IV has not been as extensively studied as oral supplementation, warranting caution 3
- Patients should be monitored for at least 2 hours after NAD+ IV administration to ensure no delayed adverse effects occur 5