The NAD+ is nicotinamide adenine dinucleotide, a coenzyme that is available by prescription as an injection and as a nasal spray. It is found widely in nature and takes part in many enzyme reactions as an electron carrier. BrightSide offers compounded NAD+ in both forms, prescribed by a provider based in Seattle.
What is NAD+?
NAD+ is a coenzyme, a small molecule that enzymes work with. The National Library of Medicine's subject headings describe it as found widely in nature and involved in numerous enzymatic reactions, in which it serves as an electron carrier. It does that by switching between two forms. NAD+ is the oxidized form and NADH is the reduced form. The full name, nicotinamide adenine dinucleotide, describes the structure. PubChem, the library's chemical database, describes it as a dinucleotide of adenine and nicotinamide that has coenzyme activity in redox reactions and also acts as a donor of ADP-ribose groups. Older names for the same molecule include coenzyme I and nadide. PubChem gives its molecular formula as C21H27N7O14P2 and records it as reported in humans and in other organisms. The plus sign in NAD+ marks the oxidized form, and it is the form named on a compounded prescription.
How is NAD+ supplied?
BrightSide offers compounded NAD+ in two forms, an injection and a nasal spray. NAD+ injection comes as a liquid in a vial and goes just under the skin with a small needle, and injection supplies come with every order. NAD+ nasal spray comes in a 15 mL bottle and is used once a day. For both, your provider sets how much you take and how often, and your pharmacy label shows the exact amount. The label is also where the storage directions and the beyond use date appear. Compounded NAD+ is not FDA approved, so it has no FDA-approved prescribing information, and your provider's directions and your pharmacy label come first. Both forms are prescribed after an online or video visit and filled by a licensed US pharmacy. Our pharmacy network page covers how we choose pharmacies, and plans are on our pricing page.
How does FDA treat compounded NAD+?
FDA has not approved compounded NAD+, and it lists the ingredient as under evaluation. A pharmacy that compounds under section 503A can use a bulk ingredient that complies with a United States Pharmacopeia or National Formulary monograph, that is a component of an FDA-approved drug, or that appears on FDA's 503A bulks list. For ingredients that were nominated for that list and are still being reviewed, FDA has an interim policy with three categories. Nicotinamide adenine dinucleotide is in Category 1, bulk drug substances under evaluation, on the list FDA updated on May 14, 2026. FDA says it does not intend to take action against a compounder for compounding with a Category 1 substance, provided the conditions in its guidance are met. That is a statement about enforcement. A place in Category 1 is not an approval, and FDA says it can remove a substance based on, for example, information about safety risks.
| NAD+ | |
|---|---|
| Full name | Nicotinamide adenine dinucleotide |
| Other names | Coenzyme I, nadide |
| What it is | A coenzyme, a dinucleotide of adenine and nicotinamide |
| Two forms | NAD+ (oxidized) and NADH (reduced) |
| Molecular formula | C21H27N7O14P2 |
| FDA status of compounded NAD+ | Not FDA approved; the ingredient is in Category 1, under evaluation for the 503A bulks list |
| How BrightSide supplies it | Injection under the skin, and nasal spray |
Common questions
Is NAD+ FDA approved?
Compounded NAD+ is not FDA approved, and FDA does not review compounded drugs for safety, effectiveness or quality. The ingredient is on FDA's Category 1 list of bulk drug substances under evaluation for the 503A bulks list. A state-licensed pharmacy compounds it for one patient on a prescription from a licensed provider.
What is the difference between NAD+ and NADH?
They are two forms of one coenzyme. NAD+ is the oxidized form and NADH is the reduced form, and the molecule carries electrons by switching between them. FDA's Category 1 list names nicotinamide adenine dinucleotide and its reduced form, NADH, as separate entries. BrightSide's prescriptions are for NAD+.
Related terms
- Glutathione: another compounded injection on our shelf.
- Bulks list (503A bulk drug substances): the list NAD+ is being evaluated for.
- Enforcement discretion: the kind of policy that covers Category 1 ingredients.
- Subcutaneous injection: how NAD+ injection is given.
Sources
- National Library of Medicine, Medical Subject Headings, NAD (D009243): https://www.ncbi.nlm.nih.gov/mesh/68009243
- National Library of Medicine, PubChem compound summary for CID 5892, nadide: https://pubchem.ncbi.nlm.nih.gov/compound/5892
- FDA, Bulk drug substances used in compounding under section 503A of the FD&C Act, content current as of May 14, 2026: https://www.fda.gov/drugs/human-drug-compounding/bulk-drug-substances-used-compounding-under-section-503a-fdc-act
- FDA, Bulk drug substances nominated for use in compounding under section 503A, category list updated May 14, 2026: https://www.fda.gov/media/94155/download
Compounded medications are not FDA approved. They are prescribed by a licensed clinician and filled by a licensed 503A pharmacy.
