NAD+ Injection

Product Overview

NAD+ (Nicotinamide Adenine Dinucleotide) is an essential coenzyme present in all living cells and is fundamental to cellular energy production, mitochondrial function, DNA repair, and metabolic regulation. NAD+ levels may decline with age, chronic illness, metabolic stress, or increased physiologic demand.

NAD+ Injection 200 mg/mL (5 mL vial) is a compounded sterile injectable formulation intended for parenteral administration under medical supervision. Injectable delivery bypasses gastrointestinal metabolism and provides direct systemic availability, making it an option in clinical settings where oral or transmucosal formulations are not appropriate or sufficient.

NAD+ injection may be considered by healthcare providers for patients with documented NAD+ depletion, mitochondrial dysfunction, chronic fatigue states, or certain neurologic or metabolic conditions, based on individualized medical assessment. Use for generalized wellness, athletic enhancement, or anti-aging purposes is not FDA-approved.

This medication is available only by prescription and must be prepared by a licensed compounding pharmacy. All administration should be performed by, or under the direction of, a qualified healthcare professional.

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Dosage & Administration

General Dosing Information

NAD+ injection dosing is highly individualized and determined by the prescribing healthcare provider based on diagnosis, treatment goals, patient tolerance, and route of administration.

Typical Adult Dosing (Examples)

• 200–500 mg per dose, administered:

  • Intramuscularly (IM),

  • Subcutaneously (SC), or

  • Intravenously (IV, typically via slow infusion)

The 200 mg/mL concentration allows flexibility in dosing volume. Frequency may range from once weekly to multiple times per week, depending on clinical indication and provider judgment.

Note: IV administration should always be performed in a monitored clinical setting due to potential infusion-related reactions.

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Administration Details

• Supplied as a sterile multidose vial

• Inspect solution before use; do not use if discolored or particulate matter is present

• Use aseptic technique for all preparation and administration

• Injection sites should be rotated when administered IM or SC

• IV infusion should be administered slowly to minimize adverse effects

• Dispose of all needles and syringes in approved sharps containers

Patients should not self-administer injectable NAD+ unless specifically trained and authorized by their healthcare provider.

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Treatment Duration & Monitoring

The duration of NAD+ injection therapy varies based on patient response and clinical objectives. Some individuals may receive short treatment courses, while others may continue therapy with periodic reassessment.

Monitoring may include:

• Clinical response (energy, cognitive function, neurologic symptoms)

• Vital signs during IV infusion

• Metabolic markers as clinically indicated

• Tolerance and adverse effects

Therapy may be adjusted or discontinued if benefits are not observed or if side effects occur.

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Mechanism of Action

NAD+ functions as a central coenzyme in cellular oxidation-reduction reactions, supporting:

• ATP generation within mitochondria

• Activation of sirtuins and PARPs, enzymes involved in DNA repair and cellular regulation

• Maintenance of normal metabolic and neurologic function

Parenteral NAD+ delivery provides immediate systemic availability, potentially supporting cellular energy pathways more directly than oral formulations. The physiologic response depends on individual cellular uptake and metabolic needs.

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Contraindications & Precautions

NAD+ injection should be used with caution or avoided in patients with:

• Known hypersensitivity to NAD+ or formulation components

• Active malignancy, unless cleared by an oncologist

• Severe hepatic or renal impairment without close monitoring

NAD+ injection is not intended for cosmetic, performance-enhancing, or anti-aging use, and should be prescribed only when medically appropriate.

Patients should undergo medical evaluation before initiating therapy.

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Drug Interactions

NAD+ may interact with therapies affecting:

• Cellular metabolism

• Mitochondrial function

• Redox balance

Patients should disclose all medications, supplements, and IV therapies prior to treatment. Caution is advised when combined with high-dose niacin or other NAD+ precursors.

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Adverse Reactions & Side Effects

Common

• Flushing or warmth sensation

• Nausea

• Headache

• Fatigue

Injection / Infusion-Related

• Local injection-site discomfort

• Chest tightness or pressure (more common with rapid IV infusion)

• Lightheadedness

Slowing the infusion rate often reduces infusion-related effects. Most adverse reactions are transient and resolve without intervention.

Patients should seek medical attention if severe or persistent symptoms occur.

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Pregnancy & Breastfeeding

There are no adequate clinical studies evaluating injectable NAD+ use during pregnancy or breastfeeding. Use is not recommended unless clearly necessary and determined appropriate by a healthcare provider.

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Storage & Handling

• Store vials under refrigerated conditions (2–8°C) unless otherwise directed by the compounding pharmacy

• Protect from light

• Do not freeze

• Follow pharmacy-assigned beyond-use dates

• Keep out of reach of children and pets

Unused or expired medication should be disposed of according to pharmacy or medical facility guidelines.

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Important Notice

This information is provided for educational purposes only and does not replace medical advice. All dosing, administration, and treatment decisions must follow the prescribing healthcare provider’s instructions.