An NAD+ injection is a prescription form of nicotinamide adenine dinucleotide, a coenzyme every cell uses for energy metabolism, delivered by needle rather than swallowed. It is most often given subcutaneously or intramuscularly, while IV infusions are a separate clinic-based option. Human research on injected NAD+ is still limited, so a licensed provider decides whether it fits you.
If you have typed "what is NAD injection" into a search bar, you have probably seen the same three letters attached to IV lounges, wellness clinics, peptide shops and supplement brands. This guide explains what NAD+ is, what an NAD+ injection actually involves, how the routes compare, what the research does and does not show, and how prescription NAD+ works at telos rx.
What NAD+ is, in one paragraph
NAD+ stands for nicotinamide adenine dinucleotide. It is a coenzyme, a helper molecule that enzymes need in order to work, and it is present in every cell in your body. It shuttles back and forth between NAD+ and NADH in the redox reactions that turn food into usable energy.
NAD+ is also used up by other enzyme families, including sirtuins, PARPs, which are involved in DNA repair, and CD38. A 2021 review in Nature Reviews Molecular Cell Biology describes these roles and notes that tissue NAD+ levels decline with age in several model organisms, including rodents and humans. The same review is clear that much remains unknown about whether restoring NAD+ is safe and beneficial in ageing humans.
NAD+ is not a peptide. It contains no amino acids. It is also not a hormone or a vitamin. The longer explainer is in What is NAD+? and Is NAD+ a peptide?
What is NAD injection therapy, in plain terms?
An NAD+ injection, sometimes called an NAD shot or an NAD plus injection, is a sterile preparation of NAD+ that is put into the body through a needle. When it is prescribed, a licensed pharmacy prepares it for an individual patient, and the prescribing provider sets the route, dose and schedule.
"NAD injections" is a broad label, though. It can describe a small subcutaneous dose you give yourself at home, an intramuscular shot given in a clinic, or a multi-hour IV drip.
The three routes: subcutaneous, intramuscular and IV
| Subcutaneous (subQ) | Intramuscular (IM) | Intravenous (IV) | |
|---|---|---|---|
| Where it goes | Fat layer just under the skin | Into a muscle | Directly into a vein |
| Typical sites | Abdomen or thigh | Deltoid, thigh or glute | Arm vein, through a cannula |
| Setting | Often at home, after instruction | Usually a clinic | Clinic, often over several hours |
| Human evidence for NAD+ | Limited | Limited | Small pharmacokinetic studies |
Subcutaneous injection is the route most telehealth programs use, because it is practical at home. The detail is in NAD+ subcutaneous injection explained, and the two needle routes are compared side by side in NAD+ IM vs subcutaneous injection.
IV infusion is a different commitment: a chair, a line and a block of time. How it stacks up against a home injection is covered in NAD+ injection vs IV therapy.
Why people choose injections over oral supplements
Intact NAD+ taken by mouth is largely broken down in the gut before it reaches circulation. That is why most supplements on the shelf sell precursors instead, such as nicotinamide riboside (NR), nicotinamide mononucleotide (NMN), nicotinamide or niacin, which the body can convert into NAD+.
An injection skips the gut entirely. That is the appeal, though it is a rationale, not a proven outcome. The trade-offs are laid out in oral NAD+ vs injectable and NAD+ vs NMN.
Curious whether prescription NAD+ suits you? A short online visit is reviewed by a licensed provider, and you pay nothing if you are not approved.
See if NAD+ is right for youWhat the evidence does and does not show
- The biology is well established. NAD+ is central to energy metabolism and is used by enzymes involved in DNA repair and cell signalling.
- Age-related decline is reported. Animal studies and some human tissue studies show lower NAD+ with age, though the size of the drop varies by tissue and method.
- IV pharmacokinetics are early-stage. A 2019 pilot study in Frontiers in Aging Neuroscience infused 750 mg of NAD+ over 6 hours in eight healthy men. NAD+ was rapidly cleared from plasma for at least the first 2 hours, and the authors observed no adverse events at that slow rate.
- SubQ and IM human data are limited. Most published human research involves IV NAD+ or oral precursors, not injected NAD+ under the skin or into muscle. Human evidence for intranasal NAD+ is limited too.
So NAD+ is studied for its role in cellular energy and healthy ageing, but no specific result can be promised and individual experiences vary. What the research says about potential benefits is collected in NAD+ injection benefits.
Safety basics
Commonly reported reactions to NAD+ injections include:
- Redness, soreness or swelling at the injection site
- Flushing or a warm sensation
- Nausea
- Headache
- Fatigue or lightheadedness
These are reported effects, not a predictable list, and anything severe or persistent should go to your provider. More in NAD+ injection side effects and the step-by-step subcutaneous injection guide.
How dose and schedule are decided
There is no single standard NAD+ injection dose to copy from the internet. The prescribing provider sets the starting dose, schedule and any adjustments based on your health history, goals and how you respond, and the pharmacy label tells you exactly what was prescribed. How providers approach that decision is explained in the NAD+ injection dosage guide.
How prescription NAD+ works at telos rx
telos rx offers prescription NAD+ in two forms: a needle-free nasal spray or a subcutaneous injection. Your provider helps you choose. You can see both on the NAD+ product page, and the comparison is in NAD+ nasal spray vs injections.
- Complete a 5-minute online visit. Health history, medications and goals.
- A licensed provider reviews it asynchronously. No scheduled appointment. Every prescription is subject to medical approval by a licensed provider, and you pay nothing if you are not approved.
- A licensed US partner pharmacy fills it. Free 2-day shipping in discreet packaging.
- Ongoing care. Unlimited care-team messaging, dose adjustments and quarterly labs.
Plans start as low as $116 per month, are FSA/HSA eligible and can be cancelled anytime. telos rx is LegitScript-certified. Compounded NAD+ is not FDA-approved, and the FDA notes that it does not verify the safety, effectiveness or quality of compounded drugs before they are marketed. The full walkthrough is in how to get NAD+ injections online.
Who should talk to a provider first
Everyone needs a provider review before prescription NAD+, but some situations deserve extra discussion:
- Pregnancy, trying to conceive or breastfeeding (see NAD+ and pregnancy)
- A current or past cancer diagnosis
- Kidney, liver or heart conditions
- Several prescription medications or supplements already in use
- A history of fainting or strong reactions to needles
More in this NAD+ injection guide
- "NAD+ peptide" injections explained
- NMN injection vs NAD+ injection
- Is NAD+ FDA-approved? Compounding explained
Frequently asked questions
What is an NAD+ injection?
An NAD+ injection is a prescription preparation of nicotinamide adenine dinucleotide, a coenzyme found in every cell, given by needle instead of by mouth. It is usually injected subcutaneously, into the fat just under the skin, or intramuscularly, into a muscle.
Is NAD+ a peptide?
No. NAD+ is a coenzyme made of two nucleotides joined together. It contains no amino acids, so it is not a peptide, and it is not a hormone or a vitamin either.
Are NAD+ injections better than oral NAD+ supplements?
Injection avoids the gut, where intact NAD+ taken by mouth is largely broken down, which is why most oral supplements contain precursors such as NR or NMN instead. That is not proof of better outcomes, because human research on subcutaneous and intramuscular NAD+ is still limited.
Is NAD+ injection FDA-approved?
No. Compounded NAD+ is not FDA-approved, which means the FDA has not evaluated it for safety, effectiveness or quality. A licensed provider decides whether it is appropriate for you.
What side effects are reported with NAD+ injections?
Commonly reported reactions include redness, soreness or swelling at the injection site, flushing, nausea, headache, fatigue and lightheadedness. Anything persistent or severe should go straight to your provider.
Can I get NAD+ injections online?
Yes. At telos rx you complete a short online visit, a licensed provider reviews it asynchronously, and if NAD+ is appropriate a licensed US partner pharmacy ships it to you. Every prescription is subject to medical approval by a licensed provider.
Ready to take the next step? Start a 5-minute online visit. A licensed provider reviews it and helps you choose between the nasal spray and the subcutaneous injection.
Start your online visitThis article is for general education and is not medical advice. Compounded NAD+ is not FDA-approved and has not been evaluated by the FDA for safety, effectiveness or quality. All prescriptions are subject to medical approval by a licensed provider; approval is not guaranteed. Individual experiences vary. telos rx is an online-first, asynchronous telehealth service and is LegitScript-certified. Medications are filled by licensed US partner pharmacies.