# NAD IV therapy: Infusion Pharmacokinetics and Tolerability Research (NAD+) > NAD IV therapy delivers NAD+ intravenously. Research digest of the pharmacokinetics — near-complete plasma clearance within ~2 hours — infusion-rate tolerability, and the thin controlled evidence for NAD+. What the literature measures when NAD+ is run into a vein: rapid plasma clearance, infusion-rate tolerability, and a controlled-evidence base that is the weakest of any route. ## In plain English NAD IV therapy means dripping NAD+ (the cell's energy-handling helper molecule) straight into a vein so it skips the gut. Clinics market it; the research behind it is surprisingly thin. The clearest finding is about timing: when NAD+ is infused, the body removes almost all of it from the blood within about two hours [5]. These infusions are compounded — mixed to order, not FDA-approved — and one compounded injectable was recalled for contamination [5]. This page reports what studies measured. It is not a how-to and recommends no dose. ## NAD+ Infusion: Plasma Clearance and Infusion-Rate Tolerability Intravenous NAD+ infusion is the wellness route with the loudest marketing and the quietest data. The single best-characterized property is pharmacokinetic. A pilot study of an intravenous NAD+ infusion found near-complete removal of NAD+ from plasma within roughly the first two hours of the infusion — the molecule does not linger in the bloodstream [5]. A continuous-infusion protocol used in pharmacokinetic work ran at about 3 µmol/min over six hours [5]. That rapid clearance is mechanistically unsurprising for a charged dinucleotide and is one reason intravenous protocols are run slowly and over long sessions. Tolerability is dominated by infusion rate. The discomfort described in connection with IV NAD+ — flushing, chest or abdominal pressure, nausea — is tied to how fast the solution is run and eases when the rate is slowed [5]. These are sensations linked to the infusion itself, not evidence of a therapeutic mechanism. Reported clinical infusion protocols span roughly 250 to 1000 mg of NAD+ per session over several hours [5], but those are session parameters drawn from practice and small reports, not validated doses, and this digest presents them as study and protocol parameters only. ## Does NAD IV actually work in controlled studies? NAD IV — intravenous NAD+ — has the weakest controlled evidence of any route in this literature. The bulk of intravenous human data come not from NAD+ itself but from its reduced form, NADH, in Parkinson's disease research, and even there the controlled results are unimpressive. In a small double-blind study, five Parkinson's patients given 25 mg NADH intravenously once daily for four days (then intramuscularly at weeks 2 and 4) showed only a non-significant tendency to improve that did not differ from the saline control group, with no change in cerebrospinal-fluid markers [7]. Open-label reports look more favorable but lack controls. An open prospective study of 15 idiopathic Parkinson's patients receiving intravenous NADH (10 mg over 30 minutes) for 7 days alongside conventional therapy reported a significant improvement on the Unified Parkinson's Disease Rating Scale and a rise in plasma levodopa availability [8]. A larger open-label series of 885 patients — about half intravenous, half oral — reported roughly 80% showing some clinical benefit, with the oral and parenteral routes comparable [9]. Open-label, uncontrolled designs cannot separate drug effect from expectation, so the honest reading is that robust efficacy for IV NAD+ is unestablished. For animal mechanism data, intravenous NAD+ at 10-20 mg/kg dose-dependently reduced myocardial infarct size in a rat ischemia/reperfusion model (about 85% reduction at 20 mg/kg) [11] — a striking preclinical result that has not been replicated as a human clinical outcome. ## The quality and safety picture for infused NAD+ Intravenous NAD+ is a compounded preparation, which means it is mixed by a pharmacy rather than manufactured and approved as a finished drug, and compounding carries documented quality risk. The FDA issued a Class I recall — its most serious category — of a compounded injectable NAD+ product for elevated bacterial endotoxin [5]. Endotoxin contamination in an intravenous product is a real hazard, independent of whatever NAD+ does once infused. A further, theoretical concern applies to any NAD+-raising intervention: because NAD+ supports the metabolism of proliferating cells, boosting it could in principle support existing cancers, and NAD+'s role in oncology is dual and context-dependent [5]. None of this is a claim that IV NAD+ is dangerous in a specific case; it is the documented risk profile of an unapproved compounded route with thin efficacy data. Does NAD IV actually work — read the [does NAD IV actually work](/nad-infusion) evidence above and weigh it against this safety picture. ## Does NAD IV actually work? IV NAD+ has the weakest controlled evidence of any route. Infused NAD+ is cleared from plasma within about two hours [5], and most clinical reports are pilot or retrospective rather than randomized; controlled NADH studies in Parkinson's showed no significant difference from saline [7]. The research base does not support strong efficacy claims for intravenous NAD+. ## When should you inject NAD+? There is no validated timing protocol in the peer-reviewed literature. Published parenteral studies used fixed research schedules — for example 25 mg NADH daily for four days [7], or 10 mg NADH over 30 minutes for 7 days [8] — which are study designs, not dosing instructions. Timing questions are for a qualified clinician, not this digest. --- A terrazzo-bright reading of the NAD+ literature — the coenzyme scattered apart from the NMN and NR precursors that rebuild it, the oral trials that moved blood NAD+ set in their own panels from the rapidly-cleared IV drip and the recalled compounded injectable, each claim stamped to its study and each gap left in plain view; no clinic behind the confetti and nothing here infused, injected, dosed, or sold.