NAD+ Therapy

Important Safety Information

Please read this information carefully before starting NAD+ therapy. This page covers general safety considerations for compounded NAD+ injections and nasal spray.

Last reviewed: August 2026

Read Before Starting Treatment

This page provides general safety information about compounded NAD+. Your provider and dispensing pharmacy can provide contraindications, possible side effects, and instructions specific to your formulation. Review all materials supplied with your medication and contact them if anything is missing or unclear.

Section 1

What Is Compounded NAD+?

Nicotinamide adenine dinucleotide (NAD+) is a naturally occurring coenzyme involved in cellular metabolism. Its presence in the body does not establish that administered compounded NAD+ will improve energy, focus, recovery, aging, or other wellness outcomes. Clinical evidence supporting these outcomes is limited.

Compounded NAD+ is not an FDA-approved drug product. Compounded drugs are not reviewed by the FDA for safety, effectiveness, or quality prior to marketing. For more information, see the FDA’s guidance on the risks of compounded drugs.

MyFastRx provides telehealth services and does not manufacture, compound, or dispense medications. Licensed healthcare providers make all prescribing decisions.

Section 2

Before Starting NAD+

During your intake, your provider will review your health history and determine whether NAD+ therapy is appropriate for you. You should disclose all current medications, supplements, allergies, and medical conditions before your provider submits a prescription.

Your provider and dispensing pharmacy can provide contraindications specific to your formulation. Review all materials supplied with your medication and contact them if anything is missing or unclear.

Section 3

FDA Safety Notice: Compounded Injectable NAD+

FDA Safety Communication

FDA has received adverse event reports following use of NAD+ injectable drugs, including severe chills, shaking, vomiting, and fatigue, with some requiring medical treatment. FDA stated that these reactions were consistent with excessive levels of endotoxins.

Read the full FDA safety communication ↗

Injection Format

Subcutaneous Injection

Injectable compounded products carry risks including injection site reactions and the adverse reactions described in the FDA notice above. Follow all handling and storage instructions from your dispensing pharmacy exactly as written.

Nasal Spray Format

Intranasal Administration

Nasal spray formulations do not carry the same injection-site risks. Use and store your spray according to your pharmacy's instructions. Do not share your spray with others.

Section 4

Possible Side Effects

All medications, including compounded preparations, may cause side effects. Side effects vary by individual, formulation, concentration, and route of administration.

Your provider and dispensing pharmacy can provide possible side effects specific to your formulation. Review all materials supplied with your medication and contact them if anything is missing or unclear.

FDA has received adverse event reports following use of NAD+ injectable drugs, including severe chills, shaking, vomiting, and fatigue, with some requiring medical treatment. See Section 3 for the full FDA safety notice. If you experience any unexpected symptoms after starting treatment, contact your provider or pharmacy promptly.

Section 5

When to Seek Emergency Care

⚠ Call 911 or go to the nearest emergency room immediately if you experience:

Difficulty breathing or shortness of breath
Swelling of the face, lips, tongue, or throat
Chest pain or tightness
Rapid or irregular heartbeat
Sudden severe headache or dizziness
Loss of consciousness or fainting
Severe allergic reaction (anaphylaxis)
Signs of infection at the injection site: spreading redness, warmth, pus, or fever
Severe chills, uncontrollable shaking, or repeated vomiting following injection

☎ Call 911

For non-emergency concerns, contact your prescribing provider or dispensing pharmacy using the contact information in your welcome email and patient portal.

Poison Control: 1-800-222-1222 (available 24/7)

Section 6

Safe Use and Missed Doses

Use NAD+ exactly as prescribed. Do not change your dose or schedule without contacting your provider.

Do not share your medication, nasal spray device, needles, or syringes with anyone else.

Never reuse needles or syringes. Dispose of them in an appropriate sharps container after each use.

If you miss a dose, contact your provider or follow the instructions provided by your pharmacy. Do not double your next dose.

For a possible overdose, contact Poison Control at 1-800-222-1222. Call 911 for severe symptoms.

Section 7

Storage and Handling

Storage and handling requirements vary by formulation and pharmacy. Your dispensing pharmacy will include specific storage instructions with your shipment. Follow them exactly.

If your medication arrives damaged, has a broken seal, looks different than expected, or may have been stored outside the conditions stated on the pharmacy label, do not use it until you contact the dispensing pharmacy.

Section 8

Drug and Supplement Interactions

Tell your provider and pharmacy about all prescription medications, over-the-counter drugs, vitamins, and supplements you are taking before starting treatment.

Interaction data for compounded NAD+ are limited. Your provider and dispensing pharmacy can provide guidance on interactions specific to your formulation and health profile. Do not start, stop, or change any medication without first discussing it with your provider.

Section 9

Reporting Side Effects

If you experience an adverse reaction or unexpected side effect, report it promptly.

MyFastRx Patient Support

For general questions or to reach your care team

Contact Support

Your Prescribing Provider

Available through your MyFastRx patient portal

Open Portal

Your Dispensing Pharmacy

Contact information included in your shipment paperwork

See your welcome package

FDA MedWatch

Report serious adverse events directly to the FDA

fda.gov/medwatch

Section 10

General Disclosures

The compounded NAD+ products offered through MyFastRx are not FDA-approved. Compounded drugs are not reviewed by the FDA for safety, effectiveness, or quality. For more information, see FDA: Understanding the Risks of Compounded Drugs.

MyFastRx provides telehealth services and does not manufacture, compound, or dispense medications. Licensed healthcare providers make all prescribing decisions.

Actual product appearance, formulation, concentration, labeling, packaging, and included supplies may vary by dispensing pharmacy and by the specific prescription written for you.

Information on this website is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your licensed healthcare provider with questions about your treatment.

MyFastRx is a registered trademark of MyFastRx Health LLC.