DNA Repair
A coenzyme involved in energy metabolism and DNA repair in every cell.
Prescription · Clinical Monograph
NAD+
A coenzyme involved in energy metabolism and DNA repair. Prologue offers it as an injection.
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in energy metabolism and DNA repair in every cell. Its levels fall with age, which is well established. There is no FDA-approved NAD+ injection. Prologue's is compounded by a licensed pharmacy partner and prescribed as part of Energy & Recovery.
Injections raise NAD+ levels in the blood. Whether that produces a benefit you'd notice is still being studied.
Cellular Energy
Coenzyme involved in cellular energy metabolism.
Restores What Age Depletes
NAD+ levels decline with age. That part is solid.
What getting it involves
A consultation
A consultation and a prescription, with a Prologue physician.
A physician reads it
Your history, and a conservative dose to start.
No approved version exists
There is no FDA-approved NAD+ injection.
Dispensed
Subcutaneous injection, often several times a week, compounded by a licensed pharmacy partner.
Where the evidence stands
Solid
NAD+ levels decline with age.
Thin
Human trials of NAD+ repletion have been small, often twelve to sixty people, and they measure things like blood NAD+ levels and muscle function rather than whether people end up healthier.
No long-term randomized trial
Untested
Whether those higher blood levels reach the tissues that matter, and whether that produces a benefit you would notice, no trial has tested directly.
Your physician will say the same: plausible, unproven, and your decision to make.
Why Prologue offers it anyway
Given those gaps, the fair question is why prescribe it at all. Two reasons. The mechanism is real and the age-related decline is real, which makes NAD+ a reasonable thing to try under supervision. And people ask for it either way, so the useful thing a practice can do is offer it with honest framing, physician oversight, and pharmacy-grade material, instead of leaving people to source it somewhere careless.
Your physician will say the same: plausible, unproven, and your decision to make.
What your physician screens for
Dose and speed
The risks with NAD+ are dose- and speed-related. Given too quickly, it can cause flushing, chest tightness, or nausea, which is why the injection goes in slowly and the starting dose is conservative. Your physician reviews your full medical history, starts low, and may ask for recent lab results depending on what they find.
How it's prescribed
Subcutaneous injection, on a schedule your physician sets, often several times a week. There is no established longevity dose, protocols vary widely, and your physician sets and adjusts yours.
Compounded by a licensed pharmacy partner and tested for potency, sterility, and endotoxin levels before shipment.
PotencySterilityEndotoxin
Disclosures
There is no FDA-approved NAD+ injection. Prologue's NAD+ is compounded by a licensed pharmacy partner and tested for potency, sterility, and endotoxin levels before shipment. NAD+ is prescribed as part of a longevity protocol, and its longevity benefits remain unproven in long-term controlled trials. Treatment is not appropriate for every patient, and outcomes vary. Talk with your physician about whether this fits your situation.
Begin
How to get it.
NAD+ requires a consultation and a prescription.
Everyone else starts by joining the practice.
Members can bring it up at their next consultation.
Questions
Nothing is charged when you join. Billing begins only after a physician has approved your plan. If they decide treatment isn't appropriate for you, you are not charged.
It is gentler than most people expect. The needle is the size of an insulin pen — thin and short, designed for subcutaneous tissue rather than muscle. Your physician can walk you through the technique at your consultation, and most patients are comfortable with the routine by the end of the first week.
NAD+ and sermorelin are compounded by a licensed pharmacy partner and shipped monthly with everything you need — vials, syringes, alcohol swabs, sharps disposal. Your physician adjusts dosing based on how you're responding.
It's a subcutaneous injection, given at home. Your physician sets the schedule, so the frequency is decided for you rather than fixed in advance.
The first dose takes about a minute. Your physician can walk you through the technique at your consultation, and you'll have everything you need in the first shipment.
Tell your physician at your intake. The needle is short and fine, and most people settle into the routine within the first couple of weeks — but if self-injection isn't workable for you, say so and your physician will talk through the alternatives.
For anything urgent, call 911 or your primary care physician — Prologue is not an emergency service. For everything else, write to the care team. Clinical questions get a reply within 24 hours.
Standard shipping for oral medications. Cold-chain shipping for injectables.
Protocol adjustments happen as your response shows up. If the dose or cadence changes, your next shipment reflects the change. There is no additional fee for protocol adjustments within your existing protocol.
Refills go out on the cadence your physician sets, without you having to ask.
Not listed here? Read the full FAQ.