NAD+ injections and nasal spray: what they cost in the US

Injection or nasal spray: what the choice changes

The injection is given subcutaneously, by you, on the schedule your prescriber sets. The nasal spray is a daily spray and involves no needle. Those are the two things that are certain from what providers publish.

What is not certain is whether the routes deliver differently, and it matters that no provider on this page publishes a comparison. Two of the three that sell both charge exactly the same for either, which tells you how they price rather than how the routes perform. System Labs is the exception, charging $30 a month less for the spray. This page does not claim one route is better than the other, because nothing published here supports that claim in either direction.

Three providers on this page sell the nasal spray. If the spray is what you want to look at, these links go to each one's NAD+ nasal page where one exists, in the table's order: bmiMD, Embody and System Labs. We earn a commission on these links, as on the partner links further down.

A third route exists, the in-person IV drip, and it is a different purchase: priced per session rather than per month, at a clinic rather than by post. It is not in the table below, because most US clinics selling NAD+ drips publish no price at all, and a table of two examples would imply a market rate that cannot be sourced.

What NAD+ costs in the US right now

Every figure below was read from the provider's own live page on the date shown, and the page it came from is linked. Nothing here is estimated, interpolated between doses, or taken from a third-party "average cost" round-up. Where a provider publishes no dose, the column says so rather than being filled in. Rows are ordered by route and then alphabetically, never by price.

• bmiMD — Injection: $119 is the lowest of four published subscription tiers, and it is the 12-month commitment. bmiMD publishes $119/mo (12 month), $129/mo (6 month), $149/mo (3 month) and $159/mo (1 month), each against a $198.90/mo list price. A reader who signs up month to month pays $159, not $119. bmiMD geo-blocks non-US traffic; this page was read over a US connection on 24 September 2026.
• Embody — Injection: Embody presents $99 as a flat, fixed rate rather than an introductory one, describing it on the page as a "Fixed price of $99/month". It sits under a banner reading "LIMITED FALL SALE. Save $100 Every Month", which implies a $199 standing price, though no $199 figure appears anywhere on the page. The prescription and telemedicine visit are stated as included, with free shipping, no membership fee and cancellation at any time.
• System Labs — Injection: The $89 figure is labelled on System Labs' own page as a first-month rate, so the ongoing monthly cost is $149. One of the few providers in this segment to publish a dose alongside the price.
• Willow — Injection: Willow publishes one figure for NAD+ with no tier ladder and no introductory rate. The page states the plan is HSA and FSA eligible.
• bmiMD — Nasal spray: Priced identically to bmiMD's injection, on the same four-tier ladder: $119/mo (12 month), $129/mo (6 month), $149/mo (3 month) and $159/mo (1 month), against a $198.90/mo list. The $119 shown here is the 12-month tier.
• Embody — Nasal spray: Embody prices its nasal spray identically to its injection, describing both on the same page as a "Fixed price of $99/month". The same "Save $100 Every Month" sale framing applies, and no $199 standing price is shown.
• System Labs — Nasal spray: The $69 figure is labelled as a first-month rate, so the ongoing monthly cost is $119. System Labs prices its nasal route $30 a month below its injection.

Buying NAD+ online

Four providers we work with sell NAD+, and they are listed below in the same order as the table: by route, then alphabetically. That order is not a ranking. We earn a commission if you buy through these links, which changes nothing about the prices above or what we publish about any of them.

Compounded medicines: what that word means here

Every NAD+ product on this page is compounded. That means it is prepared against an individual prescription by a compounding pharmacy rather than manufactured as a finished product and reviewed by the FDA. It is a distinct regulatory category: not approved, and not unlawful either.

The practical consequence is that the pharmacy carries more of the responsibility than it would for a branded medicine, which makes it worth asking which one a provider uses. Two of the four here name no compounding pharmacy on their public pages. That is a gap in what they disclose rather than a finding about what they dispense, and the only way to close it is to ask before you pay.

What the evidence shows, and what it does not

The short answer is that the evidence base for NAD+ injections and nasal sprays is thin. That is a statement about what has been studied, not a finding that NAD+ does or does not work, and each point below is taken from a source listed at the end of this section.

The most recent systematic review. A systematic review published in Ageing Research Reviews in 2026 found 113 eligible studies from 2010 to 2025: 33 in humans, 28 of them randomised and 5 not, and 80 in rodents. In the human studies, oral NAD+ precursors (nicotinamide riboside and nicotinamide mononucleotide) consistently raised NAD-related markers in blood and cells. Their effects on functional, metabolic, vascular and other healthspan-related outcomes were mixed, and often absent or limited to particular measures. The authors describe clinical effectiveness for anti-ageing or wellness as inconclusive. The precursors were generally well tolerated, but only over weeks to months, so long-term safety was not established by those trials. The review also found no eligible outcomes trial that evaluated NAD+ itself, given intravenously or intramuscularly, for anti-ageing or wellness. That means the question has not been tested in such a trial. It does not mean injected NAD+ was tested and found not to work.

Regulatory status. NAD+ is not an FDA-approved drug. A 2021 review prepared for the FDA by the University of Maryland searched FDA's register and found no approved NAD product in the US. The FDA lists NAD, and its reduced form NADH, in Category 1 of the substances nominated for use in compounding: substances it is still evaluating. The FDA says it does not intend to act against a compounder using a Category 1 substance while that evaluation continues, provided the conditions in its guidance are met. That is a policy about enforcement. It is not a finding that the product is safe or effective.

What has been studied in people. The same 2021 review screened the published literature on NAD and found five studies it could include, published between 1961 and 2019, with 154 patients between them. Two were experimental and three descriptive, and the largest enrolled 104 people. They used NAD or NADH mostly by IV drip, with some oral and intramuscular use, for addiction, Parkinson's disease and chronic fatigue syndrome. The review did not grade their quality, and several of the clinicians it interviewed said the clinical evidence for NAD was limited. A 2023 systematic review found ten randomised trials, with 489 participants, but its conclusions concern NADH taken by mouth and NAD+ precursors, which are different products from the injections and sprays on this page.

What the trials measured. The one pilot study we found that tracked NAD+ given directly into a vein followed eleven healthy men, eight of whom received a 750mg infusion over six hours. It measured NAD+ and its breakdown products in blood and urine, and liver enzymes. NAD+ levels in the blood did not change for the first two hours, and no adverse events were observed in the study. It did not measure energy, ageing or any other health outcome, and its authors disclose ties to an IV NAD clinic. A 2023 review of oral NAD+ precursors reports that they can raise NAD+ levels, and describes the evidence that this improves physiological function as unclear, with small studies limiting what can be concluded.

What has not been established. We found no controlled trial of self-injected or nasal NAD+ in people among these sources. The FDA-funded review records one patient who used an intranasal NAD spray, alongside IV treatment, in a case report. The most recent intranasal NAD study we found was carried out in mice and in cultured cells. No source here reports an effect of NAD+ injections or sprays on appearance, skin or lifespan. No source here compares injection with nasal spray, which is why this page does not say one route works better.

What is known about side effects. The 2023 systematic review reported side effects in all of the trials it included, most often muscle pain, nervous disorders, fatigue, sleep disturbance and headache, and described none as a serious risk. Clinicians interviewed for the 2021 review said IV NAD has to be given slowly because a fast infusion caused chest tightness or a stomach sensation. None of this was measured for the self-injected or nasal products sold on this page, so their side effect profile is not established in either direction.

Questions to ask before you pay

• Is the advertised price the ongoing one, or a first month or a long commitment? Three of the four here are one of those.
• What is the month-to-month price if you stop early, and is there a cancellation fee?
• Which compounding pharmacy prepares it, and will they name it before you order?
• What dose does the monthly price cover, and does it change if your prescriber changes the dose?
• Is the product available in your state, and is that confirmed before payment or after?

Frequently asked questions