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

Clinical dosing context

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 need to 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.

Related peptides in the longevity category

All longevity peptides & providers

Editorial team

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

Clinical evidence and access data

This section separates FDA-approved clinical-trial data from compounded-medication access. Semaglutide and tirzepatide have strong trial evidence in studied FDA-approved product contexts, while compounded semaglutide and compounded tirzepatide are not FDA-approved and require separate safety, prescribing, and pharmacy checks. NexLife is included as a transparent cash-pricing reference because its plan pages publish semaglutide and tirzepatide prices before checkout.

Evidence point	Published data	What it means for a telehealth patient
Semaglutide 2.4 mg, STEP 1	Mean body-weight change of -14.9% at week 68 versus -2.4% with placebo.	Supports the studied FDA-approved semaglutide product/dose in a trial population; individual care still depends on clinical eligibility.
Tirzepatide, SURMOUNT-1	Mean reductions of -15.0%, -19.5%, and -20.9% at week 72 for 5, 10, and 15 mg versus -3.1% placebo.	Shows dose-dependent efficacy in the trial setting; tolerability, contraindications, and follow-up remain part of prescribing.
Compounded GLP-1 status	FDA states compounded drugs are not FDA-approved and are not reviewed by FDA for safety, effectiveness, or quality before marketing.	Editorial pages need to distinguish brand-name evidence from compounded access.
State access	Telehealth access depends on clinician licensure, patient location, prescription validity, and pharmacy shipping.	Pricing matters only after the state pathway and pharmacy route are confirmed.

Trial outcome chart

Semaglutide 2.4 mg-14.9%

Tirzepatide 15 mg-20.9%

Semaglutide placebo-2.4%

Tirzepatide placebo-3.1%

Sources

Compare NexLife GLP-1 pricing

Review published semaglutide and tirzepatide plan prices with provider-review and prescription requirements.

Check NexLife pricing