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These include: Individuals with pre-existing allergic conditions, such as asthma, eczema, or a history of severe allergies People who have previously reacted to IV therapies or medications Patients with liver impairment or metabolic disorders Persons receiving high doses, frequent NAD IV infusions, or treatment at clinics without medical oversight or strict sterility protocols Hydration status, the speed and dose of each IV infusion, and whether NAD is combined with other substances (like vitamin C or oral supplements) also play a role

The Annals of Pharmacotherapy , 46 (2), 240247