NAD Injection Protocol
There is no established, evidence-based protocol for NAD injections in clinical practice, as current research is limited to oral supplementation studies and one small pilot study using IV infusions for substance use disorder—not standardized injections. 1, 2, 3
Current Evidence Limitations
The available literature does not support injectable NAD as a standard medical intervention:
Oral supplementation is the only well-studied route: Research has focused exclusively on oral NAD+ precursors (nicotinamide riboside, nicotinamide mononucleotide) with dosing ranging from 250-2000 mg daily for 4-12 weeks. 1, 2
The single IV study used prolonged infusions, not injections: One pilot study administered NAD via IV infusion (not injection) in 50 patients with substance use disorder, but provided no standardized dosing protocol, infusion duration, or concentration details. 3
No safety data exists for injectable NAD: Unlike established injectable medications with FDA-approved protocols (such as naloxone 2 mg IM/IN for opioid overdose 4 or ferumoxytol 1020 mg IV over 15 minutes for iron deficiency 5), NAD injections lack pharmacokinetic studies, safety profiles, or dosing guidelines. 1, 2
Critical Clinical Considerations
If NAD injections are being considered for substance use disorder specifically, the evidence is insufficient to recommend this approach:
The pilot study showing reduced cravings, anxiety, and depression used IV infusions (not injections) with unspecified dosing, and lacked placebo controls, randomization, or long-term follow-up. 3
Standard addiction treatment should take priority: Patients with substance use disorder require evidence-based interventions including naltrexone (50 mg daily oral or 380 mg monthly injection), buprenorphine maintenance, behavioral therapy, and psychosocial support. 6, 7
For patients with active addiction history, any injectable therapy carries risks of misuse, diversion, and triggering relapse behaviors. 6, 8
Recommended Alternative Approach
Oral NAD+ precursor supplementation is the only route with established safety data:
- Nicotinamide riboside: 250-1000 mg daily 2
- Nicotinamide mononucleotide: 250-500 mg daily 2
- Duration: 4-12 weeks with monitoring 1, 2
- Common side effects: muscle pain, headache, fatigue, sleep disturbance (all mild and self-limited) 1
Injectable NAD protocols promoted in wellness clinics or alternative medicine settings lack scientific validation and should not be used in medical practice without rigorous clinical trial data establishing safety, efficacy, pharmacokinetics, and appropriate dosing. 1, 2