Compounded · Not FDA-approved

NAD+: uses, dosing, side effects and where to get it

A coenzyme every cell uses for energy metabolism and DNA repair. Clinics sell compounded NAD+ injections and nasal sprays for energy and healthy aging, but no human trial has shown that they slow aging.

By the RxLineup editorial team · Fact-checked against provider sites and FDA labels · Updated Oct 17, 2026

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Active ingredient: Nicotinamide adenine dinucleotide (NAD+)
Made by: State-licensed compounding pharmacies
Form: Subcutaneous injection or nasal spray
Price online: Prices vary by clinic.

Safety

There is no FDA label, and compounded NAD+ isn’t FDA-reviewed for safety, effectiveness or quality. Clinics list injection-site redness or soreness, nausea, headache, flushing and cramping. In a 2026 review of 6 people given 500 mg IV infusions, all reported moderate to severe stomach cramping, nausea or vomiting, a faster heart rate or chest pressure during the drip, which stretched infusions to about 97 minutes on average. No long-term human safety data exist.

Talk to a licensed clinician about your health history and every medication you take before you start.

Legal status

Prescription only; compounded and not FDA-approved. NAD+ is prepared by a compounding pharmacy for an individual prescription. Compounded products are not FDA-approved, and the FDA does not review them for safety, effectiveness or quality. NAD+ is not FDA-approved. FDA lists it in Category 1 of its 503A bulk substances list (updated May 14, 2026), an interim policy under which it does not intend to act against licensed pharmacies that compound it for individual prescriptions from an FDA-registered source. That is enforcement discretion, not approval, and it ends if FDA does not add NAD to the final list.

What NAD+ is

NAD+ is short for nicotinamide adenine dinucleotide. No NAD+ drug has ever been approved; every injection and nasal spray sold online is compounded.

Dosing

Set by your prescriber; clinics describe injections daily or every other day and nasal sprays daily. Products we checked include 500 mg and 1,000 mg vials at 100 or 200 mg/mL, and nasal sprays of 50 to 200 mg/mL.

How well it works

No randomized trial has tested NAD+ injections or nasal spray for aging, energy or lifespan. In a 2019 pilot, 750 mg infused over 6 hours in 8 men was cleared from the blood for the first 2 hours. Oral precursors do raise NAD+ levels: nicotinamide riboside in a 6-week crossover trial of healthy middle-aged and older adults (2018), and NMN, which improved muscle insulin sensitivity over 10 weeks in women with prediabetes (2021). Individual results vary.

NAD+ cost

Prices vary by clinic.

Guides about NAD+

Questions, answered

How much does NAD+ cost online?

Prices vary by clinic.

Is NAD+ FDA-approved?

No. NAD+ is compounded: a compounding pharmacy prepares it for an individual prescription, and it isn’t FDA-approved. NAD+ is not FDA-approved. FDA lists it in Category 1 of its 503A bulk substances list (updated May 14, 2026), an interim policy under which it does not intend to act against licensed pharmacies that compound it for individual prescriptions from an FDA-registered source. That is enforcement discretion, not approval, and it ends if FDA does not add NAD to the final list.