NAD+ Injections: How to Read Your Dosing Instructions

how to use this page

This is the decoder ring for a typical NAD+ injection instruction — what "subcutaneous" means, how units and ml relate, why your dose steps up over the first few weeks, the flush most people feel, and the 30-day vial rule.

what "subcutaneous" means

NAD+ is given subcutaneously — into the soft, fatty layer just under the skin, not into muscle. The usual spots are the belly (a couple inches from the navel), the front of the thigh, or the back of the upper arm. Rotating where you inject each time keeps any one area from getting sore.

reading the dose: units and ml are the same thing

NAD+ instructions list the dose two ways at once — for example, "inject 0.2 ml (20 units)." Those are the same amount: on an insulin syringe, the 20-unit line is the same fill level as 0.2 ml — "units" are the marks printed on the syringe, and "ml" is the actual volume. You draw up to the line your instructions name.

Those numbers are only an example of how the notation works — your real numbers are on your prescription.

starting low and working up

NAD+ is usually started low and increased gradually. A typical instruction reads something like: begin at 0.2 ml (20 units), then increase by about 0.2 ml each week, up to a maximum your provider sets, taken 3–5 times per week.

The reason for ramping up slowly is comfort — easing into the dose week by week lets your body adjust. Follow the step-up schedule on your prescription, and don't jump straight to the top dose.

the flush is common — and going slow helps

Most people feel something during a NAD+ injection — a warm flush, a wave of pressure in the chest or head, sometimes the urge to cough. It usually passes within a minute or two.

Two things make it more comfortable: pushing the plunger at a slow, steady pace rather than jamming it in all at once, and ramping the dose up gradually (above). Your provider — or the injection guidance that came with your prescription — can show you the right technique.

If the sensation is ever severe, doesn't pass, or worries you, stop and contact your provider. For more on what this feeling is and why it happens, see the NAD+ injection sensation.

how often

NAD+ is typically taken several times a week — often 3 to 5. Your instructions tell you how many. The specific days are usually flexible; pick the ones that fit your routine, and follow the frequency on your prescription.

the 30-day vial rule

Once you first puncture a vial with a needle, it's good for 30 days — then you discard it and open a fresh one, even if there's still plenty of liquid left.

- The moment you first use a vial, write that date on it. - Use that vial until the 30-day mark, then throw it out and start the next one.

The 30 days is about keeping the medication sterile after the seal is broken — not about the vial running empty.

why you may have received more than one vial

If your NAD+ came as more than one vial, it's usually the 30-day rule at work — not because you need that much at once. You move to a fresh vial roughly once a month, and the set is meant to carry you through to your next refill. The short version: open one at a time, discard at 30 days no matter how full it looks, and work through them in order.

your exact dose lives in your patient portal

Everything above is the general "how to read it." Your specific starting dose, how fast to step up, your maximum, and how many times per week are in your patient portal and on your prescription label. If anything here doesn't match what's there, follow your prescriber and pharmacy — and bring them any questions about your case.