Niagen IV Therapy
An intravenous nicotinamide riboside (NR) infusion that raises NAD+ in about an hour. The same NAD+ precursor you may know as Tru Niagen, delivered directly into the bloodstream and converted to NAD+ inside your cells, without the long drip and the chest tightness that make NAD+ IV a half-day commitment.
From $450 · about 45 to 75 minutes · St. Marys, Georgia
What Nicotinamide Riboside Does
Nicotinamide riboside is a form of vitamin B3 and one of the raw materials a cell uses to make NAD+. NAD+ is the coenzyme that carries electrons through the mitochondrial chain that produces ATP, and it is consumed by the sirtuin and PARP enzymes that regulate cellular stress responses and repair DNA. The brain, which uses about a fifth of the body’s energy, is unusually dependent on an adequate NAD+ supply, and tissue NAD+ falls steadily with age.
The reason NR matters as a precursor rather than simply giving NAD+ itself comes down to how cells take it up. NAD+ is a large, charged molecule. When it is infused it is largely broken down in the bloodstream by enzymes such as CD38, and the pieces are taken up and reassembled inside the cell. NR, by contrast, is transported into cells intact and then converted in two steps: the nicotinamide riboside kinases (NRK1 and NRK2) turn it into NMN, and NMNAT enzymes turn NMN into NAD+. Oral NR has been shown in more than a hundred human studies to raise blood NAD+ reliably, with a good safety record at doses up to 2,000 mg a day.
The intravenous form, marketed as Niagen+ or Niagen IV, became available to clinics in 2024 and is prepared by an FDA-registered 503B outsourcing facility. It is worth being clear about the state of the evidence: oral NR is well studied, the IV route is not yet. The human data on IV NR so far consist of small clinic series, and no controlled trial has compared IV NR with IV NAD+ on a clinical outcome. What is well established is the biochemistry, the oral safety record, and the practical fact that NR can be infused far faster than NAD+ without the symptoms that force the NAD+ drip to run slowly.
Niagen IV vs. NAD+ IV
We offer both. Which one Dr. Orr recommends depends on your goals, your prior experience with NAD+, and how much time you have.
| Niagen IV (NR) | NAD+ IV | |
|---|---|---|
| What is infused | Nicotinamide riboside, an NAD+ precursor | The finished NAD+ coenzyme |
| How it reaches the cell | Transported intact, converted to NAD+ inside the cell by NRK enzymes | Broken down in the blood, pieces re-enter the cell and are reassembled |
| Chair time | about 45 to 75 minutes | 2 to 4 hours |
| Typical infusion experience | Generally comfortable at a steady rate | Chest pressure, flushing or nausea if the drip runs too fast; rate is titrated |
| Molecules per milligram | About 2.3× the molar content of NAD+ (MW ~291) | Reference (MW ~663) |
| Human evidence | Oral NR: 100+ trials. IV NR: small clinic series only | Decades of clinical use; small trials, no large outcome study |
| Price | $450–$1,450 by dose | $1 per mg; discounts over 500 mg |
Read more about our NAD+ IV therapy or see the full IV infusion menu.
Who Chooses Niagen IV
Patients who found NAD+ IV hard to tolerate
The most common reason a patient stops NAD+ therapy is not lack of benefit but the infusion itself. Chest pressure, flushing and nausea limit how fast NAD+ can be given. For patients who want to keep raising NAD+ but cannot sit through another four-hour drip, NR is the alternative we reach for first.
Executives and professionals on a schedule
An hour in the chair fits into a workday in a way that a half-day infusion does not. Patients in our Executive Brain Health Program often use NR for maintenance between visits.
Combination visits
Because NR runs quickly, it can share a visit with a Myers’ cocktail, a migraine infusion or a glutathione push. Our booking form lets you select more than one infusion for the same appointment.
Patients in a brain-health protocol
Within the Intensive Brain Health Program, Dr. Orr may use NR on days when the schedule is full of other therapies and a long NAD+ drip would crowd them out. The choice is made per patient, based on labs, tolerance and the rest of the plan.
Niagen IV Pricing
Priced by dose. Dr. Orr sets the dose at your first visit; most patients start at 500 mg.
Direct-care pricing, paid at the time of service. We provide a superbill for HSA or FSA reimbursement. IV infusions are available Mondays, Thursdays and Fridays at our St. Marys office.
Safety, Sourcing and What We Check
The serious adverse events reported with NAD-related infusions in the United States have not been caused by the molecule. They have been caused by contaminated product. In October 2024 the FDA warned that some compounders were using food-grade NAD+ in IV preparations, with patients reporting severe chills, shaking and vomiting consistent with endotoxin exposure. That is the risk we take most seriously, and it is why our nicotinamide riboside comes only from an FDA-registered 503B outsourcing facility, with a certificate of analysis for every lot that includes a bacterial endotoxin result.
Before your first infusion we review your medications, kidney function and any history of hearing change or tinnitus. The last item is specific to NR: repeated high-dose intravenous NR has been associated with changes in the inner ear in rat studies, with no human counterpart reported. We do not consider that a reason to avoid the therapy, but it is a reason to ask the question and to keep doses within the range Dr. Orr sets. During the infusion a nurse monitors you throughout, and any chills, fever or rigors are treated as a possible product problem and the infusion is stopped.
Injectable nicotinamide riboside is not an FDA-approved drug. The oral supplement’s safety notifications do not carry over to the injectable form, and Dr. Orr discusses that distinction, along with the thin state of the IV evidence, with every patient before treatment.
What to Expect
Brief screening
Estimated time: 10 minutes
On your first visit a clinician reviews your medications, prior NAD+ or NR experience, kidney history and any hearing symptoms. Dr. Orr confirms the dose. Returning patients skip straight to the chair.
IV placement
Estimated time: 5 to 10 minutes
A nurse places a small peripheral IV, usually in the forearm or hand, and records baseline vital signs.
Infusion
Estimated time: about 45 to 75 minutes
Nicotinamide riboside runs at a steady rate while you read, work or rest. Most patients notice nothing more than the cool sensation of the fluid. If you have booked a second infusion for the same visit, it runs before or after the NR as Dr. Orr directs.
Check-out
Estimated time: 5 minutes
Vital signs are rechecked, the IV is removed and you leave. There is no recovery period and you can drive yourself home.
Frequently Asked Questions
What is a Niagen IV?+
How is Niagen IV different from NAD+ IV?+
How much does a Niagen IV cost?+
How long does a Niagen infusion take?+
Why is 500 mg of Niagen not the same as 500 mg of NAD+?+
Is Niagen IV safe, and what are the side effects?+
Is Niagen IV FDA approved?+
Can I combine a Niagen IV with another infusion on the same visit?+
Related Treatments
Raise Your NAD+ in About an Hour
Niagen IV is available Mondays, Thursdays and Fridays at our St. Marys, Georgia office. Book online, or call if you would like to talk through NR versus NAD+ first.