NAD+ Injection & IV Pricing: April 2026

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme that cells need to make energy, repair DNA, and switch on sirtuins. Levels fall about 50% between ages 40 and 60, which drives interest in NAD+ for longevity, cellular energy, cognition, and addiction recovery. NAD+ is not a peptide, but it gets grouped with peptide therapy because it is usually delivered by injection or IV through the same compounding channels.

Why oral NAD+ fails: Oral NAD+ is functionally useless because it breaks down in the gut. Clinical effects require an IV, a shot under the skin (subcutaneous) or into muscle (intramuscular), or a nasal spray. The oral options that work are NMN (nicotinamide mononucleotide) and NR (nicotinamide riboside), NAD+ precursors that the body converts into NAD+ and that absorb well by mouth. For example, 1,000 mg of NR raised NAD+ levels 142%.

Forms: IV infusion delivers 250–1,000 mg per session over 90 minutes to 5+ hours and puts the most NAD+ into the bloodstream. Subcutaneous injection is 20–100 mg per dose, 1–3 times a week, self-given at home, while intramuscular injection is less common and uses a similar dose range. Compounded nasal spray is convenient, with moderate absorption. AgelessRx sells transdermal patches (iontophoresis) that deliver about 400 mg. Oral NMN and NR are the legal supplement route: different molecules, same goal.

Typical protocols: A loading phase is 4–10 daily IV sessions of 500–1,000 mg each, and addiction detox runs 10–14 days at up to 8 hours a day. Maintenance is a monthly IV, or a subcutaneous shot every week or two. Self-injection starts at 0.1 mL (20 mg) and works up to 0.5 mL (100 mg), 1–3 times a week.

Regulatory status: NAD+ is not FDA-approved as a finished drug. Injectable, IV, and nasal spray forms are compounded by 503A and 503B pharmacies (Empower, Olympia, and others) from FDA-registered active ingredients, with a prescription. A 503A pharmacy compounds patient-specific prescriptions, while a 503B facility compounds in bulk for clinics. In 2022, FDA said oral NMN is a drug, not a supplement, which left it in a legal gray area, while NR remains a legal supplement sold over the counter without a prescription. Insurance does not cover NAD+ therapy.