NAD+ that fits your morning, not an infusion clinic's calendar.
- No needles
- No infusion appointment
- Provider reviewed
NAD+ Nasal Spray
Prescription NAD+, without the infusion appointment.
A provider-guided, compounded NAD+ nasal spray for convenient administration at home.
Starting at $119/month
Intro price applies to your first month, then $129/month.
Starting at $139/month
Intro price applies to your first month, then $209/month.
Starting at $135/month$120/month with quarterly plan
Intro price applies to your first month, then $159/month. Quarterly plan billed $359 every 3 months.
Your prescription, clearly explainedCompounded NAD+ Nasal Spray
- Active ingredient
- Nicotinamide adenine dinucleotide (NAD+)
- Form
- Nasal spray
- Route
- Intranasal
- Concentration
- 150 mg/mL
- Bottle
- 15 mL
- Prescription
- Required
- Dosing
- As prescribed by your provider
- Storage
- Follow your prescription label and pharmacy instructions
- Fulfillment
- Prepared and dispensed by VialsRX, a licensed U.S. pharmacy
- Shipping
- Free discreet 2-day shipping right to your door
NAD+ Nasal Spray is offered in 150 mg/mL and 300 mg/mL strengths; your provider determines which, if any, is prescribed. The formulation shown is subject to your prescription and pharmacy availability.
What’s included
- Provider review
- Prescription, if appropriate
- Compounded medication
- Shipping
- Ongoing care messaging
- Licensed provider review
- U.S. pharmacy fulfillment
- Free discreet 2-day shipping right to your door
Prescription required. Subject to provider approval. Compounded medications are not FDA-approved.
Why NAD+ has become part of the longevity conversation
NAD+ is naturally present in cells throughout your body and has an essential role in cellular energy metabolism. Researchers have become increasingly interested in NAD+ because it takes part in processes related to:
Cellular energy
Helping cells convert nutrients into usable energy.
Cellular signaling
Serving as a substrate for enzymes involved in cellular regulation.
Cellular maintenance
Taking part in pathways involved in DNA repair and cellular stress responses.
Aging biology
Changes in NAD+ metabolism have been observed with aging, making NAD+-related pathways an active area of longevity research.
Already inside every cell
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme naturally present throughout the body. It takes part in redox reactions involved in cellular energy metabolism, and enzymes involved in cellular signaling, metabolic regulation and maintenance use it as a substrate.
The biology, illustrated
Same molecule. A very different experience.
This compares the experience of administration, not clinical effect.
| Compared on | Vivo nasal spray | IV infusion |
|---|---|---|
| Administration | Intranasal | Intravenous |
| Needle | No | Yes |
| At-home use | Yes, as prescribed | Generally clinic-based |
| Infusion appointment | No | Typically |
| Administration time | Brief | An infusion session |
| Prescription and oversight | Vivo-affiliated provider | Depends on the provider |
This comparison describes differences in administration only. It does not imply equivalent dosing, absorption, bioavailability, safety or effectiveness.
The process
How to Obtain NAD+ Nasal Spray
Step 1 of 3: Start online, meet your provider
Complete a quick intake form, 100% online. A licensed provider reviews your health history and, if appropriate, prescribes. The review is asynchronous by default — some states require a synchronous visit, and a video visit may also be required if clinically indicated.
Step 2 of 3: Compounded and delivered
Your prescription is prepared by a licensed US compounding pharmacy and shipped discreetly to your door in insulated cold-chain packaging, with directions for use written by your provider.
Step 3 of 3: Ongoing care, on your schedule
Care continues after delivery. Message your care team any time, and check in with a licensed provider as your treatment continues — no appointments to chase, no waiting rooms.
Starting NAD+ with Vivo
- Your first prescription
- Follow the instructions from your prescribing provider and the dispensing pharmacy.
- Your routine
- Use your medication only as prescribed. Don't change your dose or frequency without talking to your provider.
- Questions along the way
- Contact your care team with treatment questions or unexpected symptoms.
- Refills
- Continued treatment remains subject to your prescription and appropriate clinical oversight.
There isn't a clinically established timeframe in which compounded intranasal NAD+ should be expected to produce a particular effect.
Product details
In your shipment
- Your compounded prescription, labeled by the dispensing pharmacy
- Directions for use, as written by your prescribing provider
- Insulated cold-chain packaging
Shipped discreetly. Refrigerate on arrival, and check the beyond-use date on the pharmacy label.
Quality & testing
A compounded medication is prepared per prescription rather than manufactured in retail batches, which makes verification of each batch the thing worth asking about. Here is what we can tell you about yours.
Each batch is compounded and tested by the licensed US 503A pharmacy that prepares it, and a certificate of analysis is issued for that batch. To request the certificate covering your fill, ask your prescribing provider or contact the dispensing pharmacy identified on your prescription label.
- Compounded by a licensed US 503A pharmacy
- Cold-chain shipped
- Certificate of analysis issued per batch
Safety information
Standard safety information for a compounded prescription medication. Your prescribing provider and the dispensing pharmacy are the authority on your specific prescription — this does not replace either.
This is a compounded medication
This is a compounded medication prepared by a licensed pharmacy for an individual prescription. Compounded medications are not FDA-approved drug products.
FDA does not review compounded preparations for safety, effectiveness, or manufacturing quality before they are dispensed. We state this plainly because you should know it before you decide.
Prescription only
This medication may be used only by the person for whom it was prescribed, exactly as directed by the prescribing provider. Do not share it, and do not use a prescription written for someone else.
Before your visit, tell your provider about
- All medical conditions you have or have had
- Every medication and supplement you take
- Any allergies
- Whether you are pregnant, planning to become pregnant, or breastfeeding
Possible side effects
The side effects associated with your prescription are reviewed with you by your prescribing provider, and the dispensing pharmacy supplies the labeling that accompanies your medication. Ask your provider before you start, and contact them if you notice anything unexpected after you do.
Do not use if
Whether this medication is appropriate for you is a clinical determination your provider makes from your history, your current medications, and your circumstances — which is why the visit exists. Tell your provider everything listed above before a prescription is issued, and do not use a medication prescribed for someone else.
Storage and beyond-use date
Refrigerate on arrival. Keep the bottle closed and upright. Do not use past the beyond-use date printed on the pharmacy label.
Reporting a problem
Questions about your medication go to your prescribing provider or the dispensing pharmacy. Report a suspected adverse reaction to your provider. You may also report it to FDA MedWatch at 1-800-FDA-1088.
Questions, answered directly
What is NAD+?
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme naturally present in cells throughout the body. It takes part in redox reactions involved in energy metabolism and is used by enzymes involved in cellular signaling and maintenance.
Why are NAD+ levels studied in aging?
Research in humans and experimental models has observed that NAD+ metabolism can change with age. That makes NAD+-related pathways an active research area. It does not establish that raising NAD+ slows or changes aging.
What is NAD+ nasal spray?
A compounded prescription preparation of NAD+ supplied as a nasal spray, prescribed by a licensed provider after an intake and prepared by a licensed compounding pharmacy.
What are the potential benefits of NAD+?
NAD+ has established roles in the body's own energy metabolism and cellular maintenance. Those roles are why people are interested in it. They are not the same as demonstrated treatment outcomes: clinical evidence for compounded intranasal NAD+ is limited, and Vivo does not claim that it improves energy, focus, recovery or longevity.
Will NAD+ give me more energy?
NAD+ is essential to how cells produce energy, but that biology doesn't establish that adding NAD+ through a nasal spray changes how energetic you feel. That hasn't been shown for compounded intranasal NAD+. Fatigue has many causes, and your provider can help look at them.
Does NAD+ help with brain fog or focus?
There isn't evidence that compounded intranasal NAD+ improves focus or clears brain fog. If you're having trouble concentrating, tell your provider; it can have causes that deserve their own evaluation.
How is nasal NAD+ different from IV NAD+?
The route and the experience differ: a nasal spray is used at home without needles or an infusion appointment, while IV NAD+ is generally given in a clinic over a longer session. Different routes should not be assumed to have equivalent absorption, bioavailability or effects.
Is nasal NAD+ better than injections?
Vivo doesn't claim it is. The nasal spray is a different way to administer NAD+, chosen for convenience. It is not presented as more effective or better absorbed than an injection.
How quickly does NAD+ work?
There isn't a clinically established timeframe in which compounded intranasal NAD+ should be expected to produce a particular effect. Individual experiences vary.
How do I use NAD+ nasal spray?
Exactly as your prescription and the pharmacy's instructions direct. Don't change your dose or frequency without talking to your provider.
Is compounded NAD+ FDA-approved?
No. Compounded medications are not FDA-approved, and FDA does not review them for safety, effectiveness or quality before they are marketed.
Do I need a prescription? How does that work?
Yes. Every Vivo protocol is prescription-only. When you complete your intake, a licensed US provider in your state reviews your medical history and, if appropriate, writes the prescription. The compounded medication is then shipped directly to your door.
Provider information
Arora Health & Aesthetics, LLC provides the clinical care for this program. Its licensed providers serve patients across the United States in accordance with applicable state licensure requirements and telehealth regulations.
For provider-related questions, contact medicalcompliance@arorahealthgroup.com.
Arora Health & Aesthetics, LLC300 Lenora Street, Seattle, WA 98121Website: www.arora-health.com
What happens if I'm not approved?
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.
Partner pharmacy information
Vivo works with the following independent, state-licensed 503A compounding pharmacy:
VialsRX — 6220 Westpark Drive, Suite 111, Houston, TX 77057 — vials.ai
Services are available across all 50 U.S. states through affiliated providers and our pharmacy partner operating in accordance with applicable state licensure requirements.
Please note that medication availability, formulations, and fulfillment options may vary depending on state-specific pharmacy regulations and dispensing restrictions.
How do I cancel?
You can cancel a subscription at any time from your account dashboard, or by emailing care@vivoclinic.org. Cancellation takes effect at the end of your current billing period, provided we receive it before that period's order is transmitted to the pharmacy. Once an order has been transmitted to the pharmacy, or compounding has begun, it can't be canceled or refunded — it's being prepared specifically for you. Full details are in our Refund Policy.
How long does the visit take?
About 10–15 minutes, online, whenever suits you. There's no appointment and nothing to schedule.
Where does Vivo Clinic serve?
Vivo Clinic serves patients across all 50 U.S. states through our affiliated medical provider, Arora Health & Aesthetics, LLC. Treatment and medication availability may vary depending on provider licensure, state telehealth requirements, and pharmacy dispensing restrictions.
Vitality, by design.
Prescription NAD+. Provider-guided and delivered to your door.
Starting at $119/month
Intro price applies to your first month, then $129/month.
- Provider review
- Prescription required
- U.S. pharmacy fulfillment
Important information about compounded medications
Vivo is a telehealth platform and does not manufacture or compound medications. Treatment requires evaluation by a licensed healthcare provider. A prescription is issued only when the provider determines treatment is medically appropriate.
Compounded medications are not FDA-approved. FDA does not review compounded medications for safety, effectiveness or quality before they are marketed. Compounded medications may be prescribed when a healthcare provider determines that a compounded preparation is appropriate for an individual patient.
Information on this page is educational and does not replace individualized medical advice. Treatment availability, formulation and fulfillment may vary based on provider judgment and pharmacy availability.