NAD+ Nasal Spray — Cellular Energy, Compounded for the Individual

NAD+ is central to cellular energy metabolism. It serves as a coenzyme in all processes of cellular respiration including glycolysis, the Krebs cycle, and the electron transport chain to produce ATP. Key mechanisms include:

• Sirtuin Activation (Sirt 1–7): NAD+-dependent histone deacetylases that regulate cellular metabolism, stress responses, circadian rhythms, and endocrine functions — linked to longevity and cardio/neuroprotection in model organisms.
• PARP DNA Repair (PARP 1–17): Poly-ADP ribose polymerases use NAD+ to regulate DNA repair and nuclear stability.
• Mitophagy Support: NAD+ repletion restores mitophagy (selective removal of defective mitochondria), improves fat metabolism, and reduces mitochondrial oxidative stress.
• cADP-Ribose Signaling: Acts as a precursor for cyclic ADP-ribose, a secondary messenger critical for calcium transmission and intercellular communication.

Age-related NAD+ decline is driven largely by increased activity of CD38 (a membrane-bound NADase), as well as oxidative stress and inflammation. Replenishment targets these downstream pathways to support healthy cellular aging.

NAD+ replacement therapy is being explored for support across multiple clinical areas:

• Healthy Aging & Longevity: Countering age-related NAD+ depletion associated with mitochondrial dysfunction, DNA damage, and metabolic decline.
• Metabolic Health: Low NAD+ levels have been linked to diabetes, cardiovascular disease, and vascular dysfunction.
• Neuroprotection: Research associates NAD+ decline with Alzheimer's disease, ischemic brain injury, and vision loss.
• Mitochondrial Disease Support: Preclinical and early clinical work suggests benefit in progeroid syndromes and metabolic disorders driven by mitochondrial dysfunction.
• Addiction Recovery (Historical Use): IV NAD+ infusions have been used historically for addiction support; intranasal delivery provides a more accessible route.

Note: Clinical trials evaluating NAD+ injection in humans are ongoing. These benefits are based on preclinical and early-phase research. This medication is not FDA-approved for any of these indications.

Contraindications:

• Known hypersensitivity or allergy to NAD+ or any component of the formulation
• Pregnancy — safety has not been assessed; avoid use
• Nursing mothers and pediatric patients — safety not established; avoid use

Reported Side Effects (generally well tolerated at therapeutic doses):

• Headache
• Shortness of breath (reported with rapid IV infusion at rates above 35 drops/min; not expected with intranasal use)
• Constipation (rare)
• Transient changes in liver enzymes (not considered clinically significant in pilot studies)

IV NAD+ administered at a moderate drip rate was described as causing "no distress" in early case studies. Nasal delivery is expected to offer favorable tolerability.

• Store refrigerated at 2°C to 8°C (36°F to 46°F)
• Do not freeze. Discard if product has been frozen.
• Protect from light. Store in original packaging until use.
• Keep all medication out of reach of children.
• Discard after the beyond-use date listed on the label.
• Do not flush unused medications or pour down a sink or drain.
• The medicine should be fine for 5 days from the shipping date at temperatures up to 105 degrees Fahrenheit.

What is NAD+ and why does it matter?

NAD+ (Nicotinamide Adenine Dinucleotide) is a coenzyme found in every cell of the body. It is essential for energy production, DNA repair, and mitochondrial health. Levels naturally decline with age, which is associated with fatigue, metabolic slowing, and increased susceptibility to age-related disease.

Why a nasal spray instead of IV or injection?

Intranasal delivery offers a convenient, non-injectable route with rapid mucosal absorption. It avoids the logistical requirements of IV infusion while providing an accessible daily supplementation option for patients.

Will I experience the skin flushing associated with niacin (vitamin B3)?

No. Unlike oral niacin, which commonly causes skin flushing, NAD+ administered via injection or intranasal spray has not been associated with this side effect.

How quickly will I notice effects?

Individual response varies. Some patients report improved energy and mental clarity within days to weeks. Longer-term metabolic and longevity-related benefits would be expected over months of consistent use.

Is this FDA-approved?

No. Compounded NAD+ Nasal Spray is prepared in a 503A-licensed compounding pharmacy pursuant to a valid patient-specific prescription. It is not an FDA-approved product.