NAD+
NAD+ is not a peptide, but it is sold alongside them as an injection or nasal spray for energy and aging. The human research is mostly on oral supplements that raise NAD+. For injected NAD+ itself, controlled outcome trials are missing.
- Legal lane: long-standing compounded prescription. Not FDA-approved.
- Evidence grade: D for injected NAD+
- Forms sold: injection under the skin, intravenous infusion, nasal spray
- Typical cost: roughly $150 to $500 a month
What it is
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme that every cell uses to turn food into energy. That basic biology is not in dispute. The open question is whether adding more does anything useful.
What the evidence shows
Most human trials use oral precursors, mainly nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). These reliably raise NAD+ in the blood. Whether that improves how people feel or function is another matter: a recent review found mixed results, with small benefits on some measures and no clear effect on physical performance, insulin sensitivity or sleep.
Telehealth companies sell something different: NAD+ itself, by injection or nasal spray. The same review found no eligible controlled outcome trials of intravenous, intramuscular or under-the-skin NAD+ for anti-aging or wellness. The route with the most hype has the least evidence.
Legal status
There is no FDA-approved NAD+ drug. Injected and nasal NAD+ are compounded medications that require a prescription. NMN and NR are sold separately as dietary supplements.
Reported dosing
There is no standardized protocol for injected NAD+. Providers set their own doses and schedules, and we have not found one supported by a controlled human trial. The prescription sets the dose.
Safety
- Because every injected NAD+ product is compounded, quality varies by pharmacy.
- In 2025 the FDA announced a Class I recall, its most serious category, of one manufacturer's NAD+ for injection after endotoxins were detected.
What it costs
Listings we have seen run from about $150 to $500 a month for injections, depending on the provider. Clinic infusions are priced per session, commonly $250 to $750.