Educational guide · Format & process
NAD+ nasal spray vs injection: how the two formats compare
Published
Vivo offers compounded NAD+ in two prescription formats: a nasal spray used in the nose, and an injection you give yourself at home. Both require an online intake and licensed provider review, and your provider decides which form, if any, is appropriate. Compounded medications are not FDA-approved.
This guide compares the two formats on practical points only: what each one is, how it’s used, what comes in each order, and what it costs. It isn’t dosing advice, and it doesn’t compare how well either format works.
| NAD+ Nasal Spray | NAD+ Injection | |
|---|---|---|
| Form | Compounded nasal spray in a bottle | Compounded solution for injection |
| Route | Intranasal (in the nose) | Injection, self-administered at home as prescribed |
| Needles | None | Yes. Syringes and alcohol pads are included with each order |
| Strengths and sizes listed on Vivo | 300 mg/mL × 15 mL, 300 mg/mL × 30 mL, 150 mg/mL × 15 mL | As prescribed by your provider |
| Dosing | As prescribed by your provider | As prescribed by your provider |
| Storage | Follow your prescription label and pharmacy instructions | Follow your prescription label and pharmacy instructions |
| Prepared by | VialsRX, a licensed U.S. 503A compounding pharmacy | VialsRX, a licensed U.S. 503A compounding pharmacy |
| Shipping | Free discreet 2-day shipping | Free discreet 2-day shipping |
| Product page | NAD+ Nasal Spray | NAD+ Injection |
This table compares format and logistics only. It doesn’t compare effectiveness, and your provider decides which form, if any, is appropriate for you.
How each format is used
Nasal spray. You use it at home, in the nose, following the directions on your prescription label. No needles are involved.
Injection. You give it to yourself at home, following the directions on your prescription label and the pharmacy’s instructions. Each order includes syringes and alcohol pads. Your provider’s directions set the injection route and schedule.
For either format, follow the storage instructions on your label. If you have questions about how to use your prescription, message your care team.
Practical factors a provider may consider
Which format, if either, makes sense is a decision for your provider after reviewing your intake. Practical points that often come up in that conversation include:
- Comfort with needles. The nasal spray involves no needles. The injection requires giving yourself an injection at home.
- Storage and handling. Each product comes with its own label and pharmacy storage instructions.
- Supply. The nasal spray is offered in more than one strength and bottle size. Your provider determines which strength, if any, is prescribed.
- Price. Monthly prices differ by format and size. See the table below.
This is not a ranking. Neither format is presented here as better than the other.
How prescribing 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, and in which form. If it isn’t, 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.
- Licensed compounding pharmacy. If prescribed, your medication is prepared and dispensed by VialsRX, a licensed U.S. 503A compounding 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.
| Product | First month | Then | Quarterly plan |
|---|---|---|---|
| NAD+ Nasal Spray, 300 mg/mL × 15 mL | $119 | $129/month | — |
| NAD+ Nasal Spray, 300 mg/mL × 30 mL | $139 | $209/month | — |
| NAD+ Nasal Spray, 150 mg/mL × 15 mL | $135 | $159/month | $120/month, billed $359 every 3 months |
| NAD+ Injection | $149 | $199/month | $133/month with quarterly plan |
Pricing may change, so check /nad, /nad-injection, and your checkout disclosure for the current price.
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.
Frequently asked questions
What’s the difference between NAD+ nasal spray and NAD+ injection?
They’re two formats of compounded NAD+. The nasal spray is used in the nose. The injection is a solution you give yourself at home, and syringes and alcohol pads are included. Both are prescription-only, prepared by a licensed compounding pharmacy, and dosed as prescribed by your provider.
Which is better, NAD+ nasal spray or injection?
Vivo doesn’t rank one format over the other. Your provider reviews your intake and decides which form, if any, is appropriate. Practical factors such as comfort with needles, storage, supply, and price may come up in that conversation.
Do both formats need a prescription?
Yes. At Vivo, both NAD+ nasal spray and NAD+ injection are compounded prescription medications. A licensed provider must review your intake and approve a prescription before the pharmacy can prepare and dispense either one.
Are compounded NAD+ nasal spray and injection 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 much do NAD+ nasal spray and NAD+ injection cost at Vivo?
As of October 16, 2026, NAD+ Nasal Spray 300 mg/mL × 15 mL is $119 for the first month, then $129/month. NAD+ Injection is $149 for the first month, then $199/month, or $133/month with quarterly plan. Other nasal spray sizes are listed on the /nad page. There’s no minimum term, and you can cancel anytime.
What happens if the provider doesn’t prescribe either one?
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.
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
- Terms of Service — Vivo Health LLC