Dietary supplements, NAD+ precursors (local classification)
ATC code: A11JA-NR (Nicotinamide riboside (NR) – local code)
Brand names – supplements
Tru Niagen, Elysium Basis, Thorne Niacel
Supplements are not tested in clinical trials and are not registered as medications.
Nicotinamide riboside (NR) is a natural pyridine nucleoside and a form of vitamin B3. In cells it converts to nicotinamide mononucleotide (NMN), then to NAD+. NAD+ levels decline with age, linked to mitochondrial and sirtuin ageing. Mouse models show that oral NR raises tissue NAD+ and improves surrogate markers. Bioavailability in humans is better than NMN. NR is the only NAD precursor that retained dietary supplement status in the US after 2022, when the removed NMN from supplement classification.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Nicotinamide riboside (NR) is a form of vitamin B3 marketed as an anti-aging and longevity supplement, on the idea that it raises cellular NAD+ levels. In people, a meaningful benefit for this use has not been shown – the supplement does raise blood NAD+, but there is no solid evidence that this slows aging or extends lifespan. For healthy aging, the approaches with real backing are steady sleep, regular physical activity, a balanced diet, and not smoking. NR is well tolerated in this context; the issue is simply the lack of a proven effect.
Not recommended
Nicotinamide riboside (NR) is a form of vitamin B3 sold as an energy supplement and marketed for chronic fatigue. NR has not shown convincing benefit for this condition – there is no evidence base for this use. With ongoing fatigue, the more useful step is to find the cause with a doctor: checking sleep, deficiencies (iron, B12, vitamin D), thyroid function, mood, and chronic illness, then treating what turns up. NR is harmless in this role, but do not take it instead of proper evaluation and treatments with proven benefit, or you risk missing the real cause.
Not recommended
Nicotinamide riboside (NR) is a form of vitamin B3 and a precursor to the coenzyme NAD+. It is marketed as a supplement for memory, focus, energy, and "anti-aging." For memory and concentration, no convincing benefit has been shown, and there is no good-quality evidence behind this use. If memory or focus is slipping, the cause is worth tracking down with a doctor: sleep loss, stress, thyroid problems, or low B12 or iron are common culprits, and treating the actual cause is what helps. Do not take this supplement in place of evaluation and proven treatment, since that can delay care for a condition that does respond to therapy.
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Use in pregnancy has not been studied; supplement is not recommended.
Use during breastfeeding has not been studied; supplement is not recommended.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Nicotinamide riboside (NR) is evaluated for the following indications with varying evidence strength: Chronic fatigue (evidence tier D), Anti-aging and longevity (evidence tier D), Memory and concentration enhancement (evidence tier D). See the full indication matrix with dosing and citations above on this page.
Common side effects of Nicotinamide riboside (NR) (≥ 1 in 100): Nausea, GI discomfort, Facial flushing – less than with niacin, Headache. See the Safety section for uncommon and serious reactions.
FDA category N. Use in pregnancy has not been studied; supplement is not recommended.
Use during breastfeeding has not been studied; supplement is not recommended.
Nicotinamide riboside (NR) is contraindicated in: Pregnancy and breastfeeding; Age under 18; Hypersensitivity; Active malignancy (theoretical risk of tumour NAD metabolism stimulation). Full list in the Safety section.