NAD Injection

NAD Injection

Available presentation(s): 5, 20, 50, 100 mL. Verify the exact concentration and total active quantity on the prescription and dispensing label.

Introduction: Nicotinamide adenine dinucleotide (NAD+) is an endogenous redox coenzyme. Compounded intravenous NAD therapy for fatigue, ageing, addiction or wellness does not have an established approved indication or standard regimen.

Dosage: No validated standard dose, infusion rate or course can be recommended. The 50 mg/mL presentation must be prescribed in milligrams with a clinical rationale, dilution, rate, frequency, duration, stopping criteria and monitoring. Slow administration is often proposed for tolerability, but this is not a substitute for evidence-based dosing.

Mechanisms of Action: Functions as an electron carrier in energy metabolism and as a substrate for sirtuins, PARPs and other enzymes. Whether intravenous administration produces sustained clinically meaningful intracellular effects is uncertain.

Contraindications & Precautions: Avoid in hypersensitivity. Use caution in renal/hepatic impairment and significant cardiovascular disease. Assess product osmolarity, pH, compatibility and infusion setting. Do not represent anti-ageing or detoxification benefits as established.

Interactions: Interactions are not adequately studied. Consider medicines affecting blood pressure, glucose or hepatic metabolism and avoid unvalidated admixtures.

Adverse Reactions / Side Effects: Nausea, abdominal cramping, chest tightness, headache, flushing, palpitations and infusion-site discomfort have been described; the incidence of serious reactions is unknown.

Pregnancy & Breastfeeding: Safety in pregnancy and breastfeeding is not established; avoid non-essential use.

Storage: Store under the conditions stated on the Optimus dispensing label and product-specific worksheet. Protect from light where labelled. Do not freeze unless explicitly validated. Maintain cold chain if the label requires refrigeration. Do not use after the assigned beyond-use date or if there is visible particulate matter, precipitation, colour change, loss of container integrity or evidence of improper storage. Once entered, follow the validated in-use time; do not assume a compounded vial is multi-dose.

References

• New Zealand Formulary (NZF), current online edition; product-specific approved data sheets where available; USP Pharmaceutical Compounding—Sterile Preparations; and Optimus Healthcare validated formulation, sterility/endotoxin controls and assigned beyond-use date.
• US FDA. Compounding and the FDA: Questions and Answers. Updated 16 September 2025. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers