How do I store, handle, and inject NAD+?

📦 Did your vial ship from Olympia? It has a small metal center cap that needs to be removed before your first dose. See how to remove it (includes a short video).

Proper storage and handling of your NAD+ injection helps ensure the medication stays safe and effective throughout your treatment. Please follow the guidelines below carefully.

Refrigeration:

• Keep your NAD+ vial refrigerated at all times (between 36°F–46°F / 2°C–8°C).
• Do not freeze. Freezing can damage the medication and make it unsafe to use.
• Store the vial upright in its original packaging when possible.
• Keep away from the back of the refrigerator where temperatures may be colder.

Handling before injection:

• Remove the vial from the refrigerator and allow it to come to room temperature for 5–10 minutes before injecting. This can help reduce discomfort at the injection site.
• Inspect the solution before each use. It should be clear and colorless. Do not use if you notice cloudiness, discoloration, or particles.
• Wipe the rubber stopper with an alcohol swab before drawing your dose.
• Never shake the vial. Gently swirl if needed.

Where and how to inject:

• NAD+ is injected subcutaneously, just under the skin.
• Rotate between your abdomen (at least two inches from your navel), outer thigh, and the back of your upper arm, using a different site each time.
• Inject slowly. Going slowly makes flushing and nausea less likely.
• Your exact dose and schedule are on your prescription label. If you have questions about either, ask your provider.
• Some patients find that injecting in the belly causes more nausea than injecting in the thigh. If nausea is a problem for you, try your thigh instead.

How often, and when to increase:

• Your prescription label and your care team's instructions come first. The points below are the general pattern. If your label says something different, follow your label.
• Start at the dose on your label, 2 to 3 times a week.
• If you tolerate it, your dose can go up gradually, in small steps, with at least a week between increases. Message your care team before you move up, so they can confirm the step.
• Never go above the maximum on your prescription label, and take no more than 3 injections a week, even if you feel the effects fading.
• If you get side effects, drop back to the last dose that felt fine, and message your care team.

Should I increase my dose?

• Stay at the lowest dose that works for you. You only need to go up if the effects you noticed, such as clarity or energy, start to feel less noticeable. If you feel good, there is no need to increase just because your schedule allows it.

Spacing and timing:

• Space your injections evenly through the week. If you take NAD+ twice a week, that means about 3 to 4 days apart, for example Monday and Thursday.
• Take NAD+ in the morning, after breakfast. Taking it with food can lower the chance of side effects, and a morning dose is less likely to disrupt your sleep. Injecting slowly also helps.

Taking NAD+ with glutathione or B12:

• There is no single best way to space them. Choose days that fit your routine. You do not need to stagger them in a particular order.
• If you feel unusually weak or very fatigued after your injections, do not simply keep going. Message your care team and ask for a call with a provider before your next injection.
• If you ever have trouble breathing, swelling of the face, lips, tongue, or throat, or severe symptoms of any kind, call 911 or go to the ER.

Questions people ask about side effects:

• Spotting or breakthrough bleeding: this is not a known side effect of NAD+. Spotting can happen when you start any new medication. Keep an eye on it, and message your care team if it continues or gets worse.
• Changes in taste: NAD+ is not a known cause of taste changes. Taste can change for many reasons. If it bothers you or does not go away, message your care team.
• For everything else, see "NAD+ side effects and what's normal."

Temperature exposure during shipping:

• Your NAD+ is shipped with temperature-controlled packaging to keep it cool in transit.
• Upon delivery, transfer your vial to the refrigerator as soon as possible.
• If you believe your medication was exposed to excessive heat or was left unrefrigerated for an extended period, check with our Patient Success Team before using it.

What to avoid:

• Do not leave the vial out at room temperature for extended periods.
• Keep out of direct sunlight and away from heat sources.
• Do not store in the bathroom or other warm, humid areas.
• Keep out of reach of children and pets.

Safe disposal:

• Dispose of used needles and syringes in a sharps container. Do not place loose needles in household trash.
• Once a vial is empty, dispose of it according to your local medication disposal guidelines.
• Many pharmacies offer free sharps disposal. Check with your local pharmacy for options.

If you have any questions about your medication or are unsure whether it has been stored correctly, please ask our Patient Success Team before using it.