Important Safety Information: NAD+ (Nicotinamide Adenine Dinucleotide) | Compounded Injectable or Oral Therapy

What is this?

This Important Safety Information summarizes key warnings and precautions for NAD+ (nicotinamide adenine dinucleotide), a coenzyme found in every living cell. NAD+ is essential for cellular energy production (ATP), DNA repair, gene expression, and metabolic function. NAD+ levels naturally decline with age. Some therapies aim to support cellular health by replenishing NAD+ levels.

This compounded 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

NAD+ therapy can cause:

• Heart palpitations or cardiovascular changes

• Dizziness, headache, or nausea, especially at higher doses

• Changes in blood phosphorus levels

• Altered insulin sensitivity (rare)

• Allergic reactions, including rash, itching, swelling, or respiratory symptoms

Possible stimulation of abnormal cell growth — NAD+ is not recommended for individuals with active cancer without clearance from an oncologist

Compounded NAD+ may carry sterility or formulation risks due to limited FDA oversight.

Who Should NOT Take NAD+

Do not take this medication if you:

• Have a known allergy or sensitivity to NAD+, nicotinamide riboside, or any ingredient in the formulation

• Have active cancer or are undergoing cancer screening without explicit oncologist approval

• Have been advised to avoid supplements that may influence cellular metabolism

• Are pregnant or breastfeeding without provider clearance

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

• Have a history of heart disease, arrhythmias, or uncontrolled hypertension

• Have diabetes or are taking insulin or medications that affect blood sugar

• Have kidney or liver concerns

• Have low phosphorus or electrolyte imbalances

• Are taking antihypertensive medications

• Have a history of dizziness, migraines, or neurological symptoms

• Are pregnant, breastfeeding, or planning pregnancy

• Take any prescription, over-the-counter, or herbal supplements

Possible Side Effects

Common (mild to moderate):

• Headache

• Nausea

• Dizziness

• Bloating or digestive discomfort

• Skin flushing, itching, or sweating (with oral nicotinamide riboside)

• Temporary fatigue following infusion or injection

Serious (seek medical care immediately):

• Rapid heartbeat or severe palpitations

• Severe headache, visual changes, or confusion

• Rash, hives, swelling of the face or throat, or difficulty breathing

• Severe dizziness or fainting

• Sudden changes in blood sugar

• Any sign of an allergic reaction

While Taking NAD+

Contact your healthcare provider immediately if you:

• Develop persistent dizziness, severe headaches, or unusual fatigue

• Experience chest discomfort, palpitations, or shortness of breath

• Notice skin reactions, itching, or swelling

• Have sudden changes in blood pressure

• Experience unexplained changes in mood or cognition

• Have worsening nausea or vomiting

• Experience any symptoms suggestive of an allergic reaction

Pregnancy and Breastfeeding

NAD+ and nicotinamide riboside are not recommended during pregnancy or breastfeeding without provider approval.

Safety beyond 230 mg/day of oral nicotinamide riboside in pregnancy is unknown.

Drug Interactions

Moderate Interaction — Use Caution:

• Antihypertensive medications (blood pressure–lowering drugs)

• Nicotinamide riboside may lower blood pressure.

• Use with blood pressure medications may result in blood pressure dropping too low.

• Monitor blood pressure closely.

Always tell your provider about all medications and supplements you take.

Overdose

Symptoms may include:

• Severe headache

• Marked dizziness

• Palpitations

• Nausea or vomiting

• Rapid blood pressure changes

• Signs of allergic reaction

• Seek emergency care or contact Poison Control if overdose is suspected.

Missed Dosage

If you miss a scheduled dose:

• Do not double your next dose

• Resume as directed by your provider

• Contact your provider if unsure how to proceed

Storage

• Follow storage instructions exactly as listed on your pharmacy label

• Protect from light

• Do not freeze

• Keep out of reach of children

• Use only within the beyond-use date provided

Medication Disposal

• Dispose of unused or expired medication per local guidelines.

• Do not flush medication or dispose of it in household drains.

• Ask your pharmacy about medication take-back programs.

Provider Oversight and Order Review

This compounded medication requires ongoing review by Superior Health and Wellness providers.

Dosing, scheduling, and monitoring plans may be adjusted based on labs, goals, tolerability, and safety considerations.

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 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, effectiveness, or quality.

You are encouraged to report negative side effects of prescription drugs to the FDA:

Visit MedWatch or call 1-800-FDA-1088.