Important Safety Information: Nicotinamide Adenine Dinucleotide (NAD+) | Compounded Nasal Spray

What is this?

This Important Safety Information summarizes key warnings and precautions for Nicotinamide Adenine Dinucleotide (NAD+), a coenzyme naturally found in the body that plays a role in cellular energy production and metabolic processes. NAD+ participates in redox reactions and supports enzymatic activity involved in ATP production and overall cellular health. This compounded nasal spray formulation has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety or efficacy and should only be used exactly as directed by a licensed healthcare provider. This summary does not include all available information. Always read your medication label and follow your provider’s instructions.

Most Serious Warnings

Product can cause:

• Severe allergic reactions, including rash, hives, swelling of the face, lips, tongue, or throat, and difficulty breathing

• Cardiovascular symptoms such as palpitations or chest discomfort

• Neurological symptoms such as severe headache, confusion, or worsening brain fog

• Significant nausea, cramping, or muscle fatigue

• Local irritation or inflammation depending on route of administration

Compounded NAD+ formulations may carry sterility, stability, or dosing variability risks due to limited FDA oversight.

Who Should NOT Use NAD+

Do not use this medication if you:

• Have a known allergy to Nicotinamide Adenine Dinucleotide or any ingredient in the formulation

• Have experienced a previous hypersensitivity reaction to NAD+ therapy

• Have been advised by your healthcare provider to avoid NAD+ supplementation

Before Using NAD+, Tell Your Healthcare Provider if You:

• Have heart disease or a history of palpitations or arrhythmias

• Have neurological conditions or a history of migraines

• Have kidney or liver disease

• Are pregnant, planning pregnancy, or breastfeeding

• Take any prescription, over the counter, or herbal medications

• Use alcohol, tobacco, or recreational drugs

• Have any chronic medical condition requiring ongoing supervision

Possible Side Effects

Common (mild to moderate):

• Nausea

• Brain fog

• Mild headache

• Muscle cramping or fatigue

• Palpitations

• Nasal irritation or discomfort

Serious (seek medical care immediately):

• Swelling of the face, lips, tongue, or throat

• Difficulty breathing

• Severe chest pain

• Persistent or worsening neurological symptoms

• Severe or persistent allergic reaction

While Using NAD+

Tell your healthcare provider immediately if you:

• Develop worsening palpitations or chest discomfort

• Experience persistent nausea or severe fatigue

• Notice signs of an allergic reaction

• Develop new or worsening symptoms

Do not notice improvement within the expected timeframe discussed with your provider

Pregnancy and Fertility

The safety of compounded NAD+ nasal spray during pregnancy or breastfeeding has not been established. Use only under medical supervision if you are pregnant, planning to become pregnant, or breastfeeding.

Overdose

Symptoms of overdose may include:

• Severe nausea or vomiting

• Intense headache

• Marked palpitations

• Significant muscle cramping or weakness

If overdose is suspected, seek emergency medical attention or contact Poison Control immediately.

Missed Dosage

If you miss a scheduled dose:

• Use the missed dose as soon as you remember unless it is close to your next scheduled dose

• Do not double the next dose

• Contact your healthcare provider if you are unsure how to resume therapy

Storage

• Store as directed on your pharmacy label

• Keep refrigerated if instructed

• Protect from light

• Do not freeze

• Keep out of reach of children and pets

Medication Disposal

Dispose of unused or expired medication according to local medication disposal guidelines. Do not flush medication or pour it down household drains. Consult your pharmacy for proper disposal recommendations.

Provider Oversight and Order Review

This compounded medication requires review and oversight by a licensed healthcare provider. Dosing schedules, titration protocols, and duration of therapy must be discussed directly with your provider to ensure safety and appropriateness. Orders may be adjusted based on clinical response and individual health goals.

Telemedicine Disclosure

This prescription may be issued via telemedicine. If you experience concerning or severe symptoms, contact your prescribing clinician immediately or seek emergency medical care.

Disclaimer

This summary does not include all information about Nicotinamide Adenine Dinucleotide (NAD+) and should not replace medical guidance. Always consult your healthcare provider or pharmacist for complete safety information, potential interactions, and individualized treatment recommendations. This compounded medication has not been evaluated or approved by the FDA for safety or efficacy. 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch at or call 1-800-FDA-1088.