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The FDA considers it a non-toxic substance under the Generally Recognized as Safe (GRAS) classification for specific applications

Where the Record Stands The core AOD9604 literature was produced between 1993 and 2015 and has not been followed by additional human clinical trials since the 2007 conclusion of the Metabolic Pharmaceuticals program

Cell culture and measurement of cellular NAD + CHO cells stably transfected with a mouse CD38 plasmid (CHO-mCD38) were cultured in DMEM medium supplemented with 10% FBS (Thermo Fisher Scientific), 2 mM L-glutamine, 120 U ml 1 penicillin and streptomycin (Lonza, Alpharetta, GA), and 400 nM nicotinamide mononucleotide (NMN))

5-amino-1-methylquinolinium injection also upregulates GLUT4 (glucose transporter 4) expression, promoting glucose transport into adipose and muscle cells and reducing blood glucose accumulation

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It is worth noting that a 2025 meta-analysis in Frontiers in Pharmacology found oral, sublingual, and injected B12 comparably effective at raising serum levels, so for non-severe cases liquid is usually a reasonable place to start