NAD+ Injectable

Common questions about NAD+ Injectable

What is an NAD+ injection?

An NAD+ injection is a sterile compounded injectable that delivers nicotinamide adenine dinucleotide (NAD+) directly into circulation, bypassing the digestive system. NAD+ is a coenzyme present in every cell that drives mitochondrial energy production, DNA repair, and sirtuin signaling. Levels decline with age (roughly 50 percent between 40 and 60). The NAD+ injectable Optimal Balance Pharmacy compounds for PeptideRx prescriptions is a 100 mg/mL solution dispensed in 10 mL vials (1,000 mg total) at $100 with a $39 medical visit fee.

What does an NAD+ injection do for energy and longevity?

NAD+ replenishment supports mitochondrial ATP production, activates sirtuin-1 (a longevity-associated enzyme), and provides substrate for PARP-1 DNA repair. Patients commonly report improved daytime energy, sharper cognitive focus, better stress tolerance, and improved exercise recovery within the first 2 to 4 weeks of consistent dosing. Long-term mechanistic data on extending healthspan in humans is still emerging; the strongest evidence supports NAD+ as a metabolic and cognitive support intervention rather than a guaranteed longevity drug.

How much NAD+ should I inject?

The PeptideRx starting dose is 20 units (20 mg) on a U-100 insulin syringe drawn from the 100 mg/mL vial. Many patients titrate up to 50 to 100 mg per dose 2 to 3 times per week as tolerated. NAD+ injections can cause flushing or chest tightness if pushed too fast, so start low and increase slowly. Your provider will set a titration schedule.

Where to give an NAD+ injection?

Subcutaneously into the abdomen, upper outer thigh, or back of the upper arm using a 31-gauge, 5/16-inch (8 mm) needle on a U-100 insulin syringe. Push slowly over 30 to 60 seconds to minimize flushing or chest pressure, which are common with NAD+ administration. Some providers prescribe intramuscular delivery into the deltoid or gluteal site for faster onset; ask your provider which delivery is right for your protocol.

How long does NAD+ stay in your system?

NAD+ has a short plasma half-life (under 1 hour) because it is rapidly taken up by cells and incorporated into the cellular NAD+ pool. The metabolic effects from a single dose last roughly 24 to 48 hours as cellular NAD+ levels rebuild and the activated sirtuin and PARP pathways continue working. Most protocols dose 2 to 3 times per week to maintain elevated cellular NAD+ over time.

How fast does an NAD+ injection work?

Acute energy and focus effects are typically reported within 1 to 2 hours of injection. Cognitive and mood effects build over the first 2 weeks of consistent dosing as cellular NAD+ stores rebuild. Long-term metabolic and cellular health effects continue building through the first 8 to 12 weeks of a protocol. Onset varies with starting NAD+ status; patients with lower baseline levels often feel a faster initial response.

Why is the compounded NAD+ injection 100 mg/mL?

100 mg/mL is the most common compounded NAD+ concentration because it allows convenient dosing across the typical therapeutic range (20 to 200 mg per injection) with low injection volumes. The 1,000 mg total per 10 mL vial supports a 4 to 8 week supply at moderate dosing without frequent refills. Optimal Balance Pharmacy compounds and tests every batch for sterility (ScanRDI or Celsis) and bacterial endotoxin (USP <85>); the Certificate of Analysis is published on this product page. The vial ships pre-reconstituted and ready to inject.