Educational guide · Prescription & process
Do you need a prescription for NAD+ nasal spray?
Published
Yes. At Vivo, NAD+ nasal spray is a compounded prescription medication, so a licensed provider must review your online intake and decide whether a prescription is appropriate. If approved, a licensed U.S. compounding pharmacy prepares it and ships it to you. Compounded medications are not FDA-approved, and every prescription is subject to provider approval.
You may also see NAD+ nasal sprays sold online with no prescription. Those are a different product category with different labeling and rules. This guide explains the difference in plain terms and walks through how the prescription process works. It isn’t dosing advice, and it doesn’t make claims about results.
Why the answer depends on the product category
Two kinds of products use the name “NAD+ nasal spray,” and they sit in different regulatory categories:
- Prescription compounded NAD+ nasal spray. It’s prepared by a licensed compounding pharmacy for one patient, based on a prescription from a licensed provider. It can only be dispensed with that prescription.
- Products sold as supplements. These are sold directly to consumers without a prescription. They’re labeled and marketed under the rules for supplement products, not as prescription medications.
Neither category is an FDA-approved drug. The difference is in how each one is labeled, regulated, and obtained.
| Prescription compounded NAD+ nasal spray | Supplement-labeled NAD+ spray | |
|---|---|---|
| How you get it | Only with a prescription from a licensed provider | Sold without a prescription |
| Who prepares it | A licensed compounding pharmacy, for an individual patient | The product’s manufacturer or distributor |
| Label | Pharmacy prescription label with your name, your provider, and directions written by your provider | Product packaging with a supplement-style label |
| FDA approval | Not FDA-approved. FDA does not review compounded medications for safety, effectiveness, or manufacturing quality before they’re dispensed. | Not FDA-approved. FDA does not approve supplement products before they’re sold. |
| Provider involvement | Provider reviews your intake before any prescription and stays involved through ongoing care | None required to buy |
This table compares labeling and regulatory category only. It doesn’t compare quality, dosing, safety, or effectiveness, and it isn’t a judgment of any specific brand.
How getting a prescription NAD+ nasal spray works at Vivo
- Online intake. You complete a health-history form online at vivoclinic.org/start.
- Provider review. A licensed provider reviews your intake. Review is asynchronous by default. Some states require a synchronous visit, and a video visit may be required if clinically indicated.
- Prescription, if appropriate. Your provider decides whether a prescription is appropriate for you. If it isn’t, no prescription is issued, and you are not charged for medication.
- Licensed compounding pharmacy. If prescribed, your medication is prepared and dispensed by VialsRX, a licensed U.S. pharmacy, with directions for use written by your provider.
- Shipping. Your prescription ships free with discreet 2-day shipping. Ongoing care messaging with your care team continues after delivery.
What Vivo offers
Vivo’s NAD+ Nasal Spray is compounded NAD+ (nicotinamide adenine dinucleotide), 300 mg/mL in a 15 mL bottle, for intranasal use, dosed as prescribed by your provider. The formulation is subject to your prescription and pharmacy availability. Prescription required. Subject to provider approval. Compounded medications are not FDA-approved.
See the NAD+ Nasal Spray page for full product details.
What it costs
As of October 7, 2026, the NAD+ Nasal Spray page displays $89 for the first month, then $129/month. That includes provider review, a prescription if appropriate, the compounded medication, shipping, and ongoing care messaging. There’s no minimum term, and you can cancel anytime. Pricing may change, so check /nad and your checkout disclosure for the current price. For a full breakdown, see NAD+ nasal spray telehealth cost: what’s included.
Checkout accepts HSA and FSA cards. Accepting a card doesn’t mean your plan will treat the purchase as an eligible expense. Your plan administrator decides that.
Other ways Vivo offers NAD+
Vivo also offers a compounded NAD+ Injection, which is also prescription-only and subject to provider approval.
Frequently asked questions
Do you need a prescription for NAD+ nasal spray?
For compounded NAD+ nasal spray, yes. A licensed provider must review your intake and decide whether a prescription is appropriate before a licensed compounding pharmacy can prepare and dispense it. Products sold as supplements without a prescription are a different regulatory category.
Is NAD+ a prescription?
It depends on the product. Compounded NAD+ nasal spray and NAD+ injection from Vivo are prescription medications that require licensed provider review and approval. Some NAD+ products are sold without a prescription as supplements, and they’re labeled and regulated differently.
Is compounded NAD+ nasal spray FDA-approved?
No. Compounded medications are prepared by licensed pharmacies for individual prescriptions and are not FDA-approved drug products. FDA does not review them for safety, effectiveness, or manufacturing quality before they are dispensed.
How do I get a prescription for NAD+ nasal spray online?
Complete Vivo’s online intake. A licensed provider reviews your health history and, if appropriate, prescribes. Your prescription is then prepared by a licensed U.S. compounding pharmacy and shipped to you.
What happens if the provider doesn’t prescribe it?
If your provider decides a prescription isn’t appropriate, no prescription is issued, and you are not charged for medication. Entering payment information at checkout authorizes your payment method — it does not capture a charge. A charge is captured only after a provider approves the prescription.
How much does prescription NAD+ nasal spray cost at Vivo?
As of October 7, 2026, the NAD+ Nasal Spray page displays $89 for the first month, then $129/month for 300 mg/mL × 15 mL. There’s no minimum term, and you can cancel anytime. Pricing may change, so check the /nad page for the current price.
Can I use an HSA or FSA card?
Vivo’s checkout accepts HSA and FSA cards. Whether a purchase counts as an eligible expense is decided by your plan administrator, not by Vivo.
Prescription required. Subject to provider approval. Compounded medications are not FDA-approved. This guide is educational and isn’t medical advice.
Sources
- Compounding and the FDA: Questions and Answers — U.S. Food and Drug Administration
- FDA 101: Dietary Supplements — U.S. Food and Drug Administration
- Terms of Service — Vivo Health LLC