NAD+ dosage is the detail prescribers come here for. Search the term and the first results are supplement retailers and clinics selling infusion packages. Neither one publishes the strength, the vial size or the storage range a prescriber needs before writing.
This page runs on a single editorial rule. Published values are reproduced as published, without rounding or restatement. Anything a source does not publish is named as missing, never replaced with a figure that only looks right.
There are no approved dosages or regimens for NAD+. The values below are common dose ranges. The common range is 20 to 100mg injected subcutaneously, one to three times per week.
Patients typically start at a low dose and titrate up by 20mg every one to two weeks, depending on effectiveness and side effects.
NAD+ dosage ranges and titration
There are no approved dosages or regimens for NAD+. The values below are common dose ranges.
- 20 to 100mg injected subcutaneously
- One to three times per week
- A typical start at a low dose in that range
- Titration up by 20mg every one to two weeks
- Titration guided by effectiveness and side effects
The range above is written for the subcutaneous route. The published route of administration is subcutaneous or intramuscular, so the route written on the prescription is the prescriber’s decision. Subcutaneous and subq describe the same route, and the published range is the same either way it is written.
Frequency moves inside the same range. Two prescriptions at the same NAD+ dosage can differ in weekly total, because the range runs from one to three injections per week. The published values give a dose range and a frequency range rather than a fixed schedule.
Dose, frequency and what a protocol includes
The published values cover the dose and the frequency. A course length is not among them.
The upper published figure is 100mg. We do not publish a NAD+ dosage above that. A higher dose is a question for a pharmacist through the provider inquiry form before the prescription is written.
The solution is supplied at 100mg/ml, so the volume drawn follows from the concentration and the NAD+ dosage chosen. Formulation, directions and storage for the exact preparation sit on the NAD+ injection product page, which is also where a prescription starts.
Product specification, strength and vial sizes
The rows below are the published specification for the preparation. The dose rows repeat the common ranges from the section above, and the rest cover strength, vial size, route, storage and insurance.
| Item | Published value |
|---|---|
| Common dose range | 20 to 100mg injected subcutaneously |
| Common frequency | One to three times per week |
| Common titration step | 20mg every one to two weeks |
| Strength and form | NAD+ 100mg/ml injection solution |
| Vial sizes | 5ml or 10ml |
| Route of administration | Subcutaneous or intramuscular |
| Storage | Refrigerated at 36 to 46 degrees Fahrenheit |
| Beyond-use date | Approximately one month after the patient receives it |
| After the first vial puncture | Use within 28 days |
| Insurance | Unlikely to be covered |
The strength is 100mg/ml and the dose range runs from 20 to 100mg. The two numbers are read together, because the strength describes the solution in the vial and the dose describes what is injected.
Both vial sizes hold the same 100mg/ml solution. The difference between them is the total volume in the vial, 5ml or 10ml.
The route row allows subcutaneous or intramuscular administration. The published dose range was written for the subcutaneous route, so an intramuscular range is not part of what we publish.
NAD+ is unlikely to be covered by insurance. It is compounded from a bulk drug powder, which most prescription drug plans exclude.
The bulk drug powder is the starting active ingredient the pharmacy compounds from. The 100mg/ml solution in a 5ml or 10ml vial is the finished form the patient receives. The insurance exclusion attaches to the starting ingredient rather than to the finished solution.
NAD+ is compounded based on a prescription for an individual patient, written by a licensed prescriber. MediVera Compounding Pharmacy™ lists its longevity preparations on the longevity compounding service page.
Storage, beyond-use date and the 28 day window
NAD+ is stored refrigerated at 36 to 46 degrees Fahrenheit. That is the storage condition published for the preparation. The beyond-use date is approximately one month after the patient receives it.
After the first vial puncture, the product should be used within 28 days. The beyond-use date is set from the day the patient receives the vial, so a later handover moves it. The 28 day limit runs from the first puncture, so a patient who waits before the first injection starts that clock later.
The same figures carry over to the patient’s instructions. Storage stays refrigerated at 36 to 46 degrees Fahrenheit. The vial’s beyond-use date is approximately one month after the patient receives it, and use ends 28 days after the first puncture.
How long NAD+ lasts in the fridge
Two dates answer that question rather than one shelf life figure. Stored at 36 to 46 degrees Fahrenheit, the vial carries a beyond-use date of approximately one month after the patient receives it. After the first vial puncture, the product should be used within 28 days.
Reconstitution
We do not publish a reconstitution volume, a diluent or a stability figure for a reconstituted vial. Send those questions to a pharmacist through the provider inquiry form, naming the preparation your patient receives.
What is published is the strength of 100mg/ml and the refrigerated range of 36 to 46 degrees Fahrenheit. The vial also carries a beyond-use date of approximately one month after the patient receives it. Use ends 28 days after the first puncture.
Anything that depends on reconstitution, including a post-reconstitution stability window, comes from a pharmacist rather than from a general reference.
Regulatory status of NAD+ in the United States
No FDA-approved drug product containing NAD+ as an active ingredient exists in the United States. That statement applies to approved drug products. It does not apply to compounded preparations, which are not FDA-approved and are not reviewed by FDA for safety or effectiveness.
NAD does not appear on the list of bulk drug substances that may be used to compound under section 503A. That list sits at 21 CFR 216.23 and contains six substances.
- Brilliant Blue G
- cantharidin
- diphenylcyclopropenone
- N-acetyl-D-glucosamine
- squaric acid dibutyl ester
- thymol iodide
Because no approved NAD+ product exists, no approved dosage exists either. That is why every dose figure on this page is described as a common range rather than a regimen.
A compounded medication reaches a patient on a prescription written for that individual by a licensed prescriber. That prescription is where the preparation described on this page starts.
MediVera Compounding Pharmacy is a 503A compounding pharmacy. It is PCAB-accredited for sterile and non-sterile compounding, sources ingredients from FDA-registered suppliers, and compounds in alignment with USP 795, 797 and 800.
What the published research reports about NAD+
NAD+ is the oxidized form of nicotinamide adenine dinucleotide. Accepting a hydride ion reduces it to NADH (2). The body produces NAD+ through the metabolism of niacin (1).
NAD+ acts as a coenzyme for redox reactions in the mitochondrial electron transport chain, which produces ATP (1). It is involved in several other cellular processes, including acting as a cofactor for enzymes that regulate cellular functions (1).
NAD+ levels decline with age (3). In the brain, NADH levels increase while NAD+ levels decrease, which indicates an imbalance in the redox state (3). NAD+ is under investigation for its role in the aging process and in Alzheimer’s (1).
Why the injectable route is used
Diet alone can be insufficient to maintain the needed levels of NAD+ (2). NAD+ is a highly polar molecule. That limits its passage through the intestinal tract and therefore its systemic absorption when taken orally (2).
NADH supplements do not effectively raise blood levels, because the body has difficulty oxidizing NADH (3). Parenteral administration raises NAD+ levels more than oral routes (3).
NAD+ and NADH are available in over-the-counter supplements and compounded oral forms. NAD+ is also available as subcutaneous and intramuscular injections and as intravenous infusions from a compounding pharmacy.
Those findings describe the molecule and the route of administration. They do not describe any single preparation. The guide to NAD injections covers how the injectable route works and what a patient experiences during a protocol.
Reported side effects of NAD+ injections
There are no large randomized controlled studies. The effects below are the ones commonly reported.
- nausea
- brain fog
- cramping
- tenderness, swelling or bruising at the injection site
- headaches
- fatigue
- abdominal pain
- diarrhea
Uncommon reported effects are infection at the injection site and phlebitis. Tenderness, swelling or bruising at the injection site is on the common list. A reaction at the injection site can therefore belong to either list.
Reported effects feed the titration step. The common step is 20mg every one to two weeks, moved up or held depending on effectiveness and side effects.
Reaching the pharmacy before the prescription is written
MediVera Compounding Pharmacy has a staff of trained pharmacists available to discuss NAD+ or other medications with a prescriber or their staff. The provider page carries the inquiry form and the prescribing routes. That form is the destination for every unpublished detail named on this page.
Pharmacists address questions on dosing, storage and shipping. The details this page does not publish sit in that same set.
- A course length or duration
- An intramuscular dose range
- A reconstitution volume or diluent
- A post-reconstitution stability window
- An exact beyond-use day count
NAD+ is one of several prescription formulations available through the pharmacy’s longevity compounding services, alongside peptide and antioxidant options. Those preparations are listed on the longevity compounding service page.
When the pharmacy receives a prescription, the pharmacy team contacts the patient to arrange pick-up or delivery. A pharmacist discusses the use of each medication with the patient. The pharmacy can also help transition patients from other pharmacies.
Formulation, directions and storage for this preparation sit on the NAD+ injection product page, which is where a prescription starts. Anything outside those published values goes to a pharmacist through the provider inquiry form.
Send the prescription or ask a question first
Send the prescription through the provider portal with the strength, route and quantity you intend for your patient. Call instead if you would rather settle a detail before you write it.
A valid patient-specific prescription from a licensed provider is required before any compounded medication is dispensed.
Frequently asked questions about NAD+ dosage
What is the common NAD+ dosage per week?
There are no approved dosages or regimens for NAD+. The values below are common dose ranges. The common range is 20 to 100mg injected subcutaneously, one to three times per week.
The weekly total depends on the dose and on how many injections are given in that week. Both parts come from the same published set of values.
What NAD+ dosage should a patient start at?
There are no approved dosages or regimens for NAD+. The values below are common dose ranges. Patients typically start at a low dose and titrate up by 20mg every one to two weeks.
The step depends on effectiveness and side effects. The starting point sits inside a common range rather than an approved schedule.
Is NAD+ FDA approved?
No FDA-approved drug product containing NAD+ as an active ingredient exists in the United States. Compounded medications are not FDA-approved and are not reviewed by FDA for safety or effectiveness. They are compounded based on a prescription for an individual patient, written by a licensed prescriber.
NAD also does not appear on the 21 CFR 216.23 list of bulk drug substances that may be used to compound under section 503A.
Does NAD+ need to be refrigerated?
Yes. NAD+ is stored refrigerated at 36 to 46 degrees Fahrenheit. That range is the storage condition published for the preparation.
The vial also carries a beyond-use date of approximately one month after the patient receives it.
How long does NAD+ last in the fridge?
Two dates apply rather than one shelf life figure. The beyond-use date is approximately one month after the patient receives it. After the first vial puncture, the product should be used within 28 days.
Storage stays refrigerated at 36 to 46 degrees Fahrenheit.
How is NAD+ reconstituted?
We do not publish a reconstitution volume, a diluent or a stability figure for a reconstituted vial. A pharmacist can confirm those through the provider inquiry form.
What is published is the strength of 100mg/ml and the vial sizes of 5ml or 10ml. The beyond-use date is approximately one month after the patient receives it. Use ends 28 days after the first puncture.
Can NAD+ be given intramuscularly?
The route of administration is subcutaneous or intramuscular. There are no approved dosages or regimens for NAD+. The values below are common dose ranges.
The common range of 20 to 100mg, one to three times per week, was written for the subcutaneous route. We do not publish a separate intramuscular range. A pharmacist can confirm the route through the provider inquiry form before it is written.
Why is NAD+ injected instead of taken by mouth?
NAD+ is a highly polar molecule, which limits its passage through the intestinal tract and therefore its systemic absorption when taken orally (2). NADH supplements do not effectively raise blood levels, because the body has difficulty oxidizing NADH (3). Parenteral administration raises NAD+ levels more than oral routes (3).
NAD+ and NADH are available in over-the-counter supplements and compounded oral forms. NAD+ is also available as subcutaneous and intramuscular injections and as intravenous infusions from a compounding pharmacy.
Is NAD+ covered by insurance?
NAD+ is unlikely to be covered by insurance. It is compounded from a bulk drug powder, which most prescription drug plans exclude. The bulk drug powder is the starting active ingredient, and that is why most plans exclude the preparation.
Who can a prescriber talk to about NAD+ dosing?
MediVera Compounding Pharmacy has a staff of trained pharmacists available to discuss NAD+ or other medications with a prescriber or their staff. Questions on dosing, storage and shipping go to a pharmacist.
The provider page carries the inquiry form and the prescribing routes.
How does a prescriber order NAD+?
NAD+ is compounded based on a prescription for an individual patient, written by a licensed prescriber. The NAD+ injection product page carries the formulation, directions and storage, and is where a prescription starts.
The provider page carries the inquiry form and the prescribing routes. MediVera Compounding Pharmacy is a 503A compounding pharmacy, PCAB-accredited for sterile and non-sterile compounding.
This document is provided as a response to solicited questions about the use of NAD+.
Compounded medications referenced are not reviewed by the FDA for safety or effectiveness and are prepared by prescription for individual patients. Providers are solely responsible for determining their appropriateness.
References
MV
Chris Kinaya, PharmD
Chris Kinaya is a licensed pharmacist with six years of experience and a strong commitment to patient care. Since joining MediVera Compounding Pharmacy in 2024, he has contributed to the pharmacy’s daily operations with a focus on precision, service, and quality. Chris earned his PharmD from Ferris State University and is licensed in five states. He is passionate about supporting providers and patients through customized medication solutions tailored to individual needs.
