NAD+ injection dosing: how much, how often, and how to inject at home

Why your prescriber sets the dose, not the internet

Start here, because it changes how you should read every number below. Injectable NAD+ is a compounded preparation. That means a licensed pharmacy makes it on a prescription, and the FDA has not reviewed it for safety, effectiveness or quality, so there is no approved dosing label the way there is for an FDA-approved drug. Clinic protocols are convention and clinical experience, not trial-derived dosing.

The practical consequence is that a dose you read on a forum is somebody else's guess about somebody else's body. Your provider sets your dose based on your history, your goals, what else you take, and how you tolerate the first few injections. If a seller hands you a vial with no dosing conversation, that is the problem, not a feature.

What a typical at-home protocol looks like

The pattern below describes common practice for at-home subcutaneous NAD+. It is orientation, not a prescription for you.

How to inject NAD+ subcutaneously at home

Your kit and your provider's instructions come first. This is the general sequence for a subcutaneous injection:

• Wash your hands and set out a clean surface, your vial, a new syringe and needle, alcohol wipes and a sharps container.
• Take the vial out of the fridge a few minutes early. A cold injection stings more.
• Wipe the vial stopper with alcohol, draw up exactly the dose your provider set, and tap out air bubbles.
• Pick a site and clean it. Abdomen a couple of inches from the navel, or the outer thigh. Clean with alcohol and let it dry.
• Pinch the skin, insert, and push slowly. Slow is the whole trick. Take half a minute or more rather than a few seconds.
• Withdraw, press gently, and log it. Note the site and the date so you rotate properly, and drop the needle straight into the sharps container.

Never reuse a needle, never share a vial, and never inject into skin that is bruised, red, lumpy or sore. If anything about the vial looks wrong, cloudy, discoloured or past its beyond-use date, do not use it and contact the pharmacy.

Rotating sites and going slow

Two habits prevent most of the trouble people have with at-home NAD+.

• Rotate. Work around a mental grid on either side of the abdomen and both outer thighs, moving at least an inch from the last spot and not returning to the same place within a week or two. Repeated injections into one area cause lumps, tenderness and inconsistent absorption.
• Go slow. Flushing, nausea and chest tightness with NAD+ are strongly rate-related. A slow, steady push is the difference between a non-event and an unpleasant ten minutes.
• Start low. If your provider gave you a range, begin at the bottom of it and move up only when the lower dose is comfortable.
• Report it. If slowing down does not fix the flushing or nausea, that is a dose conversation, not something to push through.

The full picture on side effects, including who should not take NAD+ at all, is in the NAD+ safety guide.

Timing, daily use, and how long to stay on it

Time of day. Most people dose in the morning or early afternoon. Some find NAD+ activating, and dosing late can make sleep harder. Consistency matters more than the exact hour, so pick a slot you will keep.

Can you take it every day? That is a prescriber decision. Some protocols use small daily doses and others use larger, less frequent ones, and there is no trial evidence identifying an optimal schedule. Do not increase your own frequency because a week felt good.

How long do you stay on it? Also unsettled. NAD+ is not a course of antibiotics with a defined endpoint, and there is no evidence-based duration. Agree a review point with your provider, be honest about whether it is doing anything for you, and be willing to stop. Given how thin the outcome evidence is, an open-ended subscription you never reassess is the wrong default.

Storage, travel and shelf life

• Refrigerate your NAD+ vial as directed on the label, and do not freeze it.
• Keep it out of light and in its original packaging.
• Respect the beyond-use date. Compounded sterile preparations have a shorter dating than manufactured products for good reason.
• Travelling? Use an insulated bag with a cold pack, keep it in hand luggage rather than a hot car or a checked bag, and take your pharmacy label with you.
• Inspect before every dose. If the solution is cloudy, discoloured or has particles in it, do not use it.

Expert Health ships NAD+ compounded by a licensed US pharmacy, with the supplies and instructions you need, from $249 per month or $675 one time for about a 10-week supply. See the cost guide or how it works.

Frequently asked questions

Sources

1. Compounding and the FDA: questions and answers · U.S. Food and Drug Administration
2. Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults · Nature Communications, via NIH PMC, 2018
3. Effects of nicotinamide riboside on NAD+ levels, cognition, and symptom recovery in long-COVID: a randomized controlled trial · eClinicalMedicine, via PubMed, 2025