Longevity · Peptide Reference · Updated 2026-05-11

NAD+

Coenzyme essential for cellular energy metabolism, DNA repair, and sirtuin activity. NAD+ levels decline with age. IV and SC NAD+ are used to restore cellular function; oral precursors (NR, NMN) are alternatives.

Longevity Evidence grade: B-C Not FDA-approved
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Editorial team
Dr. Sam Saberian · Lead Medical Researcher
Medical review by Alen A. Schwartz, MD · Edited by Julliana Edwards · Last updated 2026-05-11

Key facts

Class
Coenzyme / dinucleotide
Routes
IV (most studied), SC, oral precursors
Pharmacy pathway
503A/503B for IV/SC; OTC for oral precursors
Side effects
Flushing, GI discomfort during infusion
Common stack
Methylated B vitamins
Common dose
50-200 mg SC daily or 500-1000 mg IV weekly
Evidence grade
B-C (mixed evidence; emerging clinical trials)
FDA status
Not FDA-approved (compounded for SC/IV)

Mechanism of action

Coenzyme essential for cellular energy metabolism, DNA repair, and sirtuin activity. NAD+ levels decline with age. IV and SC NAD+ are used to restore cellular function; oral precursors (NR, NMN) are alternatives.

Standard dosing

Typical clinical use: 50-200 mg SC daily or 500-1000 mg IV weekly. Dosing varies by indication and provider protocol; this is reference-only and not a prescribing recommendation. NAD+ requires a prescription from a licensed clinician.

Regulatory status & pharmacy pathway

Not FDA-approved (compounded for SC/IV). Compounded peptides are dispensed via 503A licensed compounding pharmacies (USP <797> sterile compounding) or 503B FDA-registered outsourcing facilities (cGMP). Patients should request the pharmacy of record and certificates of analysis (USP <71> sterility, USP <85> endotoxin, HPLC potency) for every shipment.

U.S. telehealth providers prescribing NAD+

The most commonly cited U.S. telehealth providers for NAD+ are Defy Medical, Marek Health, Hone Health, Maximus, and PeterMD — all of which offer prescriber-supervised access with lab integration and 503A pharmacy partnerships. See the full provider directory for complete profiles.

Trade-offs to know

NAD+ carries the trade-offs common to all compounded peptide therapeutics: not FDA-approved (when applicable), cash-pay only, no in-network insurance coverage, and pharmacy-quality variation between providers. Choose a prescriber that publishes pharmacy of record, per-vial CoAs, and lab-integrated follow-up.

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Editorial team

Authored by Dr. Sam Saberian, medically reviewed by Alen A. Schwartz, MD, edited by Julliana Edwards. About our team →