NAD+ Sublingual Solution

Medication Description

NAD+ – Visually clear homogenous golden liquid solution (dosage will vary per your prescription)

Compounded Drug Forms: Sublingual Solution

What is NAD+ (Nicotinamide Adenine Dinucleotide)?

NAD+ is an essential coenzyme in the body that plays a crucial role in energy production, DNA repair, and cellular health. It acts as a coenzyme for many enzymes and is central to metabolic processes, with levels declining with age.

What should I tell my health care provider before I take this medicine?

Before taking your medication, make sure your doctor knows about any of the following health conditions:

• Cancer or a family history of cancer
• Liver or kidney disease
• Diabetes/Metabolic disorders
• Cardiovascular conditions
• Mental health conditions
• Allergies (to NAD+ or vitamin B3)
• Pregnancy or breastfeeding
• Inflammatory disorders
• Endocrine or thyroid tumors

Tell your doctor about all your current medication especially:

• Insulin and Blood Sugar-Lowering Medications
• Blood Pressure Medications
• Blood Thinners (Anticoagulants)
• Cancer Treatments
• Antidepressants
• Antioxidants

How should I use this medicine?

Follow the package directions provided by the pharmacy and by your prescriber. Your dosage is based on your medical condition and response to therapy. Follow the dosing schedule provided carefully. Sublingual solutions should be taken as indicated by your healthcare provider. See recommended administration guide for further instruction.

• Prepare for dose: Before use, swirl the container well to ensure the medication is evenly mixed.
• Administer sublingually: Place the prescribed amount, located on your prescription label, of the liquid solution under your tongue.
• Do not swallow immediately: Hold the solution under your tongue for as long as possible, typically 1 minute, to allow it to be absorbed through the blood vessels. Avoid swallowing your saliva during this time.
• The sublingual (under the tongue) delivery allows the medication to be absorbed directly into the bloodstream, bypassing the digestive system. This results in a faster onset of action than traditional oral tablets, often within 15–30 minutes.
• Do not eat, drink, or smoke while the medication is dissolving or for at least 5 minutes afterward.
• Do not brush your teeth immediately before or after medication use.

What if I miss a dose?

• If you miss a dose within 4 hours of the scheduled dose, administer it as soon as possible.
• If more than 4 hours have passed since the missed dose, skip the missed dose, and continue with your regular dosing schedule.
• Do not take double the dose at once, and do not exceed one dose in 24 hours.

What should I watch for while using this medicine?

• Signs of allergic reaction: Difficulty breathing, swelling of the face or throat, widespread hives, or a rapid heart rate.
• Signs of liver problems: Yellowing of the skin or eyes (jaundice), dark urine, or significant abdominal pain.
• Major changes in blood pressure or sudden dizziness/lightheadedness when standing up quickly.
• Persistent or severe symptoms: Nausea, vomiting, or headaches that last more than a few days or are unusually intense.
• Elevated liver enzymes noted on a blood test (requires regular monitoring if on long-term supplementation).
• Other medical conditions: Inform your doctor if you have cancer, cardiovascular, kidney, liver issues or other medical conditions, as dosage adjustments or closer monitoring may be necessary.
• Drug interactions: This medication can interact with many other drugs. Make sure your doctor and pharmacist are aware of all your current medications, including over-the-counter drugs and supplements.

What common side effects may I notice from receiving this medicine?

Side effects that may occur and may go away as your body gets used to the medication include:

• Nausea, diarrhea, or other digestive issues.
• Headaches.
• Fatigue, or in some cases difficulty sleeping.
• Flushing (a warm, tingling, or itching feeling under the skin).
• Dizziness.
• Mild increases in heart rate.

What serious side effects prompt immediate attention?

Contact your doctor immediately or seek medical attention if you experience:

• Allergic Reactions: Symptoms such as hives, rash, facial or throat swelling, difficulty breathing, or rapid heartbeat warrant immediate medical care.
• Liver Issues: High doses and long-term use may stress the liver, potentially leading to elevated liver enzymes or, in rare cases, liver toxicity/damage.
• Blood Pressure Changes: Significant drops or spikes in blood pressure can occur, especially if you are taking blood pressure medications.
• Persistent or Severe Symptoms: Ongoing nausea, vomiting, or severe, frequent headaches beyond the initial adjustment phase may signal intolerance or excessive dosing.
• Blood Cell Count Changes: In some studies, low platelet counts (thrombocytopenia) have been reported.
• Cancer Concerns: Some animal studies have suggested that high doses of certain NAD precursors might be linked to tumor progression in specific cancers, though this has not been confirmed in humans. Individuals with a history of cancer should use caution and consult a doctor.

Seek medical attention if an allergic reaction occurs. Symptoms of an allergic reaction include rash, itching, swelling, severe dizziness, and/or trouble breathing.

Contraindications and Cautions

Individuals who are pregnant or breastfeeding, have a history of cancer, or have pre-existing liver or kidney conditions. They also have significant interactions with certain medications.

What may interact with this medicine?

This is not a complete list of all possible interactions. Always inform your doctor and pharmacist of all medications, supplements, and herbal products you take, especially before starting or stopping any new medication.

Additional Information

• Store medication at room temperature and protect from light.
• Do not share this medication with others to whom it was not prescribed.
• Keep out of reach of children and pets.
• Do not use after Beyond Use Date.
• If an overdose is suspected contact your local poison control center at 1-800-222-1222 or go to the nearest emergency room.
• Do not flush down the toilet or pour down a drain. Check with your pharmacist if you have questions about the best way to dispose of medications. There may be a drug take-back program in your area.

Reporting Side Effects

If you have any questions concerning this or any of your medications, a pharmacist is available during normal business hours to answer your questions. You can report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medication or any other medication. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does not include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. For questions about the source of any of the information provided herein, pharmacists at Pharmacy are available. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of this medicine.