NAD+ injection vs IV, nasal spray and pills: what each one is
NAD+ (nicotinamide adenine dinucleotide) is sold in several forms; this page covers four common ones: compounded injections given under the skin or into a muscle, compounded IV infusions given at a clinic, compounded nasal sprays, and oral supplements, including products that contain NAD+ precursors such as nicotinamide riboside (NR) or nicotinamide mononucleotide (NMN) rather than NAD+ itself. None of the compounded forms is FDA-approved.
A 2026 systematic review found no outcome trials of intravenous or intramuscular NAD+ itself for the wellness uses it reviewed, and human data on subcutaneous NAD+ are limited to a three-day pilot in which six people received it, reported in a 2026 preprint that has not been peer reviewed.
Through Cora Health, NAD+ is available only as a compounded injectable solution, injected under the skin (subcutaneously), if a licensed provider prescribes it; VialsRx, a US-licensed 503A compounding pharmacy, prepares it. Cora Health does not offer NAD+ IV infusions, nasal sprays or pills.
Facts and prices checked October 10, 2026.
Four common forms at a glance
| Form | How it is given | Who prepares or sells it | FDA status |
|---|---|---|---|
| Injection | Injected under the skin or into a muscle, at home or at a clinic, on a prescription | A compounding pharmacy, for an individual patient | Compounded; not FDA-approved |
| IV infusion | Infused into a vein at a clinic or infusion center | A compounding pharmacy, ordered by the clinic | Compounded; not FDA-approved |
| Nasal spray | Sprayed into the nose, on a prescription | A compounding pharmacy, for an individual patient | Compounded; not FDA-approved |
| Oral NR or NMN | Swallowed as a capsule or powder | Supplement companies, as dietary supplements | FDA does not approve dietary supplements before they are marketed |
What the human studies cover
- Injected NAD+ (IV or into a muscle): a 2026 systematic review of 113 studies, 33 of them in humans, found no outcome trials of intravenous or intramuscular NAD+ itself for the wellness uses it reviewed.
- IV NAD+: a 2019 pilot gave 750 mg of NAD+ intravenously over six hours to eight healthy men (three more received saline). It measured how the body handled the infusion and did not measure a clinical outcome.
- Subcutaneous NAD+ (under the skin): a 2026 industry-funded preprint, not peer reviewed, reported a randomized three-day pilot in which six people received subcutaneous NAD+. It assessed safety only.
- Oral NR and NMN: randomized trials of these precursors test different compounds from injected NAD+ and do not show what injected NAD+ does. The 2026 review described their outcomes as heterogeneous and often null.
- Nasal sprays: none of the studies above tested a nasal spray.
Where each form stands with the FDA
Compounded NAD+ is not FDA-approved in any form. A search of FDA’s Drugs@FDA database on October 10, 2026 found no FDA-approved drug with nicotinamide adenine dinucleotide (NAD) as its active ingredient. FDA's Pharmacy Compounding Advisory Committee voted in May 2017 not to add NAD (nicotinamide adenine dinucleotide, the ingredient in compounded NAD+) to FDA's list of bulk ingredients pharmacies can use in 503A compounding, and in a 2019 proposed rule FDA proposed not to add it. The committee's votes are advisory, and the rule has not been finalized.
In October 2024, FDA reminded compounders that food-grade NAD+ sold by repackagers, which some compounders were using to make intravenous products, is not suitable for compounding sterile drugs without appropriate processing. FDA said it had received adverse event reports after NAD+ injectable drugs, including severe chills, shaking, vomiting and fatigue, with some patients requiring medical treatment.
NR and NMN are sold as dietary supplements. FDA says it does not have the authority to approve dietary supplements before they are marketed.
What the injections cost
On October 10, 2026, the price per month of compounded NAD+ injections from US telehealth providers, including any required membership fee stated on the product page, ranged from $129 to $224 on month-to-month plans across 17 providers in Cora Health’s Compounded Injection Price Index. Other charges some providers list separately, such as lab tests or consult fees, are not included.
The compounded NAD+ membership through Cora Health is $159 billed monthly, $417 every 3 months, $768 every 6 months, or $1,428 every 12 months. Each price covers your provider visit and check-ins, the medication if it is prescribed, and shipping, with no other fees. Every term renews automatically until you cancel. Prices for IV infusions, nasal sprays and supplements are outside the Compounded Injection Price Index.
Cancellation and refund terms are in the Terms of Service and the Refund Policy.
Questions
Is an NAD+ injection the same as an NAD+ IV?
No. Both are compounded NAD+, but an injection is given under the skin (subcutaneously) or into a muscle (intramuscularly), at home or at a clinic, on a prescription, and an IV infusion is given through a vein at a clinic or infusion center. Neither is FDA-approved. A 2026 systematic review found no outcome trials of intravenous or intramuscular NAD+ for the wellness uses it reviewed, and human data on subcutaneous NAD+ are limited to a three-day safety pilot in six people (2026 preprint, not peer reviewed).
Is NAD+ nasal spray FDA-approved?
No. NAD+ nasal sprays sold on prescription are compounded, and compounded NAD+ is not FDA-approved in any form. Cora Health does not offer NAD+ nasal spray; through Cora Health, NAD+ is available only as a compounded subcutaneous injection.
Are NMN and NR the same as NAD+?
No. Nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) are NAD+ precursors, different compounds from NAD+, and they are sold as dietary supplements, which FDA does not approve before they are marketed. Randomized trials of oral NR and NMN do not show what injected NAD+ does.
What do studies show about NAD+ injections?
A 2026 systematic review found no outcome trials of intravenous or intramuscular NAD+ itself for the wellness uses it reviewed. Human data on subcutaneous NAD+ are limited to a three-day pilot in which six people received it, reported in a 2026 preprint that has not been peer reviewed. Compounded NAD+ is not FDA-approved.
Which form of NAD+ does Cora Health offer?
Only a compounded injectable solution, injected under the skin (subcutaneously), if a licensed provider prescribes it after an online visit. VialsRx, a US-licensed 503A compounding pharmacy, prepares it. Cora Health does not offer NAD+ IV infusions, nasal sprays or pills. Compounded NAD+ is not FDA-approved.
Sources
- Gallagher C, Emmanuel OO. Systematic review of NAD+ and its precursors. Ageing Research Reviews, 2026 (PMID 41655607)
- Grant R et al. Pilot study of 750 mg intravenous NAD+ in healthy men. Frontiers in Aging Neuroscience, 2019 (PMID 31572171)
- Nkrumah-Elie Y et al. Randomized pilot of NAD+ by route, medRxiv preprint, April 30, 2026 (not peer reviewed)
- FDA, Drugs@FDA database (openFDA drugsfda endpoint), searched October 10, 2026
- Federal Register, proposed rule on the 503A bulks list (84 FR 46688), September 5, 2019
- FDA, FDA reminds compounders to use ingredients suitable for sterile compounding, October 30, 2024
- FDA, Questions and Answers on Dietary Supplements
Related
Compounded medications are not FDA-approved. They are prepared by state-licensed pharmacies based on a valid prescription from a licensed provider. Through Cora Health, VialsRx, a US-licensed 503A compounding pharmacy, prepares compounded NAD+, sermorelin, glutathione and MIC + B12. Cora Health connects patients with licensed providers, who decide whether to prescribe; Cora Health does not prescribe, compound or dispense medication. This page is information, not medical advice.