Updated 10/24/2025

NAD+ (nicotinamide adenine dinucleotide) therapy—available in injectable or nasal spray form—is used to support cellular repair, energy production, and overall vitality. While most people tolerate NAD+ therapy well, it may not be suitable for everyone. Certain individuals should avoid or use NAD+ cautiously due to underlying health conditions or potential interactions.

Here’s a comprehensive guide on who should avoid NAD+ therapy and why.

Why: If you have ever experienced an allergic reaction (such as rash, swelling, dizziness, or shortness of breath) to NAD+ or any ingredient in the compounded formulation, you should not use this medication.

Why: NAD+ is metabolized in the liver and kidneys. Individuals with significant impairment in these organs may have difficulty processing the medication, increasing the risk of side effects or toxicity.

Why: NAD+ supports cellular repair and energy production. In some cases, this may theoretically interfere with cancer treatment by aiding the survival of rapidly dividing cells. Patients with a history of or active cancer should consult their oncologist before starting NAD+ therapy.

Why: NAD+ can promote mild vasodilation (widening of blood vessels), which may lower blood pressure. Those with chronic hypotension or who take blood pressure–lowering medications should avoid NAD+ or use it only under close medical supervision.

Why: There is limited research on the safety of NAD+ therapy during pregnancy or breastfeeding. To ensure the safety of both parent and child, NAD+ therapy should be avoided during these periods unless specifically recommended by a healthcare provider.

Why: NAD+ may influence glucose metabolism and insulin sensitivity. Individuals with unstable blood sugar levels should use caution, as it could lead to unexpected drops in glucose levels.

Why: Chronic alcohol consumption depletes NAD+ levels and can affect how the body metabolizes the supplement. Heavy drinkers may not experience the intended benefits of therapy or could experience exaggerated side effects.

Why: NAD+ may interact with certain medications, including blood pressure drugs, diabetic medications, or supplements that affect metabolism (such as niacin or CoQ10). Always inform your healthcare provider of any prescription medications, over-the-counter products, or supplements you are taking.

Why: NAD+ can influence vascular tone and mitochondrial activity, which may affect individuals with specific heart conditions. Patients with arrhythmias, angina, or congestive heart failure should consult their cardiologist before starting therapy.

Before starting NAD+ therapy, discuss your full medical history with your healthcare provider. This includes:

Your provider will determine whether NAD+ is appropriate for you, and will tailor your dosage and frequency to your unique needs.

If you are prescribed NAD+ therapy, regular follow-ups are important to:

Report any unusual symptoms—such as dizziness, severe flushing, or persistent fatigue—to your provider promptly.

While NAD+ therapy can provide significant benefits for cellular health, energy, and recovery, it isn’t suitable for everyone.
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At GobyMeds, your well-being is our priority. If you have any questions about NAD+ therapy or whether it’s right for you, please reach out to our support team or contact your provider through your Patient Portal.
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Thank you for choosing GobyMeds—we’re here to support your journey toward improved energy, focus, and long-term wellness.

⚠️ Important Disclaimer About Compounded Medications

Compounded medications are custom-prepared by licensed compounding pharmacies based on an individual prescription from your healthcare provider. These formulations are designed to meet the specific needs of patients when an FDA-approved medication may not be available or suitable.
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While compounded medications are made using active pharmaceutical ingredients sourced from FDA-registered suppliers, the final compounded product has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety, effectiveness, or quality.
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GobyMeds works only with licensed 503A and 503B compounding pharmacies that adhere to strict federal and state quality standards for purity, potency, and sterile production.
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Patients should always consult with their licensed healthcare provider before starting any compounded medication and report any unexpected side effects or concerns immediately.