PeptideTrace
Research CompoundCoenzyme (Non-Peptide, Adjacent Market)Metabolic

NAD+ (Peptide-Adjacent) (Nicotinamide Adenine Dinucleotide)

B

Evidence Grade B — Strong clinical evidence. 46281 published studies, 14651 human. 231 registered clinical trials.

231 trials46,281 studiesUSEUCA

Medically reviewed by a licensed medical professional

Overview

NAD+ is a molecule essential for cellular energy production — it is not a peptide. It is included in this database because NAD+ precursors (NMN, NR) and intravenous NAD+ infusions are commonly encountered alongside peptide compounds in longevity and wellness markets. While NAD+ biology is well-established in basic science, no pharmaceutical has been approved for any therapeutic use of NAD+.

Also Known As

NAD+ (Peptide-Adjacent) is also known by these brand and alternate names:

Research Activity

46,281studies
Human 14651
Animal 14708
In-vitro 5393
Reviews 4245

46,281 published studies: 14651 human, 14708 animal, 5393 in-vitro, 4245 reviews

Regulatory Status

US
Not approved by FDA(FDA)
EU
EMA-authorised(EMA)
CA
Not approved by Health Canada(Health Canada)

Legal Status

USNot applicable (not approved)
EUPrescription medicine (EU centralised authorisation)
CANot applicable (not approved)

Summary

NAD+ has no pharmaceutical marketing authorisation for any therapeutic indication. Meta-analyses of NMN (an NAD+ precursor) randomised controlled trials have found that while supplementation elevates blood NAD+ levels, clinically relevant outcomes were not significantly different from placebo across metabolic endpoints.

NAD+ biology is well-established in basic science. The gap between established biochemistry and clinical therapeutic benefit remains unresolved. NAD+ is not a peptide. Intravenous NAD+ infusions marketed through wellness clinics have not been evaluated in rigorous clinical trials.

Mechanism of Action

NAD+ is a well-characterised coenzyme that participates in hundreds of cellular reactions. Its role in energy metabolism is established biochemistry. The therapeutic hypothesis is that restoring declining NAD+ levels with age may improve cellular function, but this hypothesis has not been validated through clinical outcomes in human trials.

Research Summary

Research suggests that NMN and NR supplements consistently raise blood NAD+ levels across multiple randomised trials. However, the translation from striking animal results to human clinical benefit has been disappointing — two 2024 meta-analyses explicitly cautioned against exaggerated benefit claims, finding that clinically relevant outcomes were not significantly different from placebo across metabolic endpoints. Most human trials are small (20-80 participants), short (2-16 weeks), and show high individual variability. No large-scale trial (over 500 participants) exists, and no data extend beyond 6 months. Safety appears favourable for oral supplementation. A theoretical cancer concern exists because rapidly dividing cells (including cancer cells) also require NAD+. Intravenous NAD+ infusions marketed through wellness clinics have not been evaluated in rigorous trials.

Clinical Trials

PeptideTrace tracks 231 registered clinical trials for NAD+ (Peptide-Adjacent) sourced from ClinicalTrials.gov.

NCT05416658N/ANot Yet Recruiting

Shared Decision Making for Antipsychotic Medications

New York State Psychiatric InstituteEndpoint: The 9-item Shared Decision Making Questionnaire for Psychiatry (SDM-Q-9-Psy) (Primary)Completion: 2027-06-30
NCT07394946Phase IINot Yet Recruiting

Neoadjuvant Letrozole in Postmenopausal Women With Hormone Receptor-Positive, HER2-Negative, Node Positive, Early-Stage Breast Cancer.

Cancer Care Hospital & Research Centre Foundation, LahoreEndpoint: Extent of Axillary Nodal Pathologic Complete Response (pCR)Completion: 2029-07-01
NCT07604350Phase IIINot Yet Recruiting

Edaravone Dexborneol for Post-Stroke Epilepsy

First Affiliated Hospital of Wenzhou Medical UniversityEndpoint: Proportion of participants with composite seizure-related eventsCompletion: 2030-12-01
NCT07579429Phase IIRecruiting

Research On Nicotinamide Riboside Supplement Support in MDS (ROSS Trial)

University of Colorado, DenverEndpoint: Preliminary Efficacy: Cytopenia ImprovementCompletion: 2030-12-18
NCT07579741Phase IINot Yet Recruiting

A Study to Evaluate JL18008 in Subject With HIV Immunological Non-Responders

Jecho Biopharmaceuticals Co., Ltd.Endpoint: Number of Participants with Treatment-Emergent Adverse Events (TEAEs) as Assessed by DAIDS v2.1Completion: 2027-09-28
View all 231 trials on ClinicalTrials.gov →

Regulatory Timeline

2018
Regulatory

EMA Marketing Authorisation

Scientific Detail

Overview (Scientific)

NAD+ (nicotinamide adenine dinucleotide) is a dinucleotide coenzyme, not a peptide, included in peptide databases due to overlapping markets. Its molecular weight is 663.43 Da with molecular formula C21H27N7O14P2 (CAS 53-84-9). NAD+ exists in oxidized (NAD+) and reduced (NADH) forms. Circulating NAD+ has a very short plasma half-life (approximately 30 minutes). Key precursors include NMN (nicotinamide mononucleotide, MW 334.22 Da) and NR (nicotinamide riboside, MW 255.25 Da). NAD+ levels decline with age, and this decline is implicated in aging-related metabolic dysfunction.

Mechanism of Action (Scientific)

NAD+ is an essential substrate for sirtuins (SIRT1-7), NAD+-dependent protein deacetylases that regulate mitochondrial biogenesis, DNA repair, inflammation, and stress resistance. SIRT1 deacetylates PGC-1alpha, p53, NF-kB, and FOXO transcription factors. NAD+ is consumed by poly(ADP-ribose) polymerases (PARP1/PARP2) during DNA repair and by CD38, a major NADase whose expression increases with age. In the electron transport chain, the NAD+/NADH couple shuttles electrons through Complex I. Biosynthesis occurs through salvage (nicotinamide via NAMPT to NMN to NAD+), Preiss-Handler (nicotinic acid), and NR kinase (NRK1/NRK2) pathways.

Summary (Scientific)

A meta-analysis of 12 NMN RCTs (Zhang et al. 2024, N=513) found NMN elevated blood NAD+ but concluded most clinically relevant outcomes were not significantly different from control. A second meta-analysis (Chen et al. 2024, 8 NMN RCTs, N=342) found no significant benefit on fasting glucose, insulin, HbA1c, HOMA-IR, or lipids. Yoshino et al. (2021, Science, N=25) showed 25.5% increased muscle insulin sensitivity with 250 mg NMN/day (p=0.04). Martens et al. (2018, Nature Communications, N=24) showed NR at 1000 mg/day increased whole blood NAD+ by approximately 60%. A direct IV NAD+ pilot (2024) found that NAD+ IV failed to alter whole blood NAD+ levels, while NR IV successfully raised them.

The information on this page is provided for educational and research reference purposes only. This is not medical advice. Always consult a qualified healthcare professional before making any health-related decisions.

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Related Compounds

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Elamipretide

Approved
Mitochondria-Targeted Tetrapeptide (Approved)

Elamipretide (Forzinity) was approved by the FDA for Barth syndrome based on the TAZPOWER trial. The randomised crossover phase (12 patients) did not meet its primary endpoints, but the open-label extension (168 weeks) demonstrated durable improvements in walking distance and muscle strength that formed the basis for approval. Barth syndrome affects approximately 1 in 300,000–400,000 births. A larger Phase III trial in primary mitochondrial myopathy (218 patients, MMPOWER-3) did not meet its primary endpoint, and the drug was not approved for that broader indication. Elamipretide remains approved exclusively for Barth syndrome. See also SS-31 (#158) for the research compound context.

Glucagon

Approved
Counter-Regulatory Peptide Hormone

Glucagon has been available as an emergency injection since the 1960s and remains the standard rescue treatment for severe hypoglycaemia. Recent innovation has focused on making it easier to administer in emergencies. Baqsimi, approved in 2019, was the first needle-free option as a nasal powder. Gvoke, also approved in 2019, eliminated the need to mix and reconstitute the medication before injection — a significant advance since severe hypoglycaemia often impairs the ability to follow complex preparation steps. Dasiglucagon (Zegalogue), a next-generation stable liquid glucagon approved in 2021, further improved on the convenience of rescue administration. Beyond emergency rescue, glucagon's receptor is now a major research target — dual and triple agonists combining glucagon receptor activity with GLP-1 (such as survodutide and retatrutide) are in advanced clinical trials for obesity and metabolic disease.

Related Research

This content is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making decisions about your health.