The honest starting point: there is no established NAD+ dose, because there is no FDA approved NAD+ product and therefore no approved label to derive one from.
Every number you will see quoted, on this site or any other, comes from clinic practice, small studies, or convention rather than from a regulatory standard. Anyone presenting a dose as settled is overstating what exists. What follows is about the factors a clinician actually weighs, which is more useful than a number you should not self apply anyway.
This page is general information, not medical advice and not a dosing recommendation. Dose, route and schedule are decisions for a licensed clinician who has reviewed your health history.
Why the route changes the question
The three routes are not variations on one dose. They behave differently enough that comparing milligram figures across them is close to meaningless.
| Route | What determines the practical limit | Notes |
|---|---|---|
| Intravenous | Infusion rate as much as total dose | Most of the commonly reported acute effects, chest tightness, flushing, nausea, are associated with infusing too quickly rather than with the total amount. Slowing the drip is the usual response |
| Subcutaneous injection | Volume tolerated at the site, and schedule | Self administered. Spread across more frequent smaller doses rather than fewer large ones |
| Nasal spray | Metered by the device | How much is absorbed by this route is not well characterised for this molecule, which makes dose comparison against injection unreliable |
The three are compared directly in NAD+ IV versus injection versus nasal spray.
What a clinician is actually weighing
- Your goal, stated specifically. Vague goals produce vague protocols that never end.
- Tolerance on the first dose. Standard practice across this category is to start low, observe, and adjust. First exposure tells you more than any calculator.
- Route. See above. It changes the arithmetic entirely.
- Other medications and conditions. Disclose everything at intake, supplements included.
- Duration and a stopping point. A protocol without a defined endpoint is a subscription.
Frequency and schedule
Practice varies widely. Some protocols front load a series of doses and then move to a maintenance interval, others run at a steady frequency throughout. There is no published consensus establishing that any one of these is superior, and you should be sceptical of a provider who presents theirs as the standard.
The one pattern that is consistent across careful prescribing is starting conservatively and adjusting on how the person actually responds.
The question people should ask and usually do not
How will we know whether this is doing anything?
It is worth agreeing an answer before starting, because without one there is no basis for deciding to continue, change or stop. Subjective report is legitimate but it is also the most susceptible to expectation. If a provider cannot describe what a non response looks like, the protocol has no exit.
Do not self dose from the internet
This should not need saying, but the vials are sold online and people do it. Product bought outside a prescribing relationship has no verified grade, no lot testing you can inspect, and no one accountable for it. FDA published a reminder in August 2026 after patients were hospitalised from injectable material that was supplement grade rather than pharmaceutical grade. That alert concerned glutathione and the principle covers anything injected. Detail is in glutathione side effects and the sourcing question.
Related
For the overall picture see the NAD+ therapy guide. For the regulatory position see is NAD+ FDA approved. For what is reported clinically see NAD+ side effects.
Sources
Every quotation attributed to the FDA on this page is taken from the documents below. Follow the links and check them.
- FDA, FDA reminds compounders not to use dietary supplement grade glutathione for injectables. https://www.fda.gov/drugs/human-drug-compounding/fda-reminds-compounders-not-use-dietary-supplement-grade-glutathione-injectables
- FDA, Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act. https://www.fda.gov/drugs/human-drug-compounding/bulk-drug-substances-used-compounding-under-section-503a-fdc-act
Last reviewed 9 September 2026. Regulatory status in compounding changes. If you are reading this well after that date, check the FDA sources directly rather than relying on this page.
Related reading
- The FDA peptide compounding status tracker, kept current
- NAD+ therapy: the complete guide
- NAD+ IV versus injection versus nasal spray
- Is NAD+ FDA approved?
- NAD+ injections and what the evidence covers
- NAD+ side effects
- NAD+ nasal spray
- Tesamorelin dosage
- BPC-157 versus TB-500
- Glutathione injection versus nasal spray
Longevity plans from PrescribedRX
PrescribedRX prescribes longevity treatments through clinicians licensed in your state:
- Glutathione Injection. Administered by injection after a provider consultation.
- Glutathione Nasal Spray. A nasal alternative.
- NAD+ Injections. On a schedule set by your provider.
- NAD+ Nasal Spray. A nasal alternative.
- Sermorelin Injections. By prescription after consultation.
Every plan and its current price is on the plans page and the pricing page.
These are compounded preparations. Compounded drugs are not reviewed or approved by the FDA for safety or effectiveness, and treatment outcomes are not guaranteed.
This article is for general information. It is not medical advice and it is not a recommendation for any particular treatment. Whether a treatment is appropriate for you is a decision for a licensed clinician who has reviewed your health history and current medications.
