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NAD+ Nasal Spray vs Injection, Troche, and Cream
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NAD+ Nasal Spray
Research on NAD+ given through the nose, called intranasal use, began in animals. Rat studies in 2007 and 2012 examined how NAD+ given through the nose affects the brain (4,9).
These early studies are part of why the nose has drawn interest as a way to deliver NAD+.
Because these studies used rat models, their findings describe those settings rather than daily use by healthy adults.
Most research on intranasal NAD+ so far comes from animal studies. Available through Mochi Health with a prescription from an affiliated Mochi Medical provider, this NAD+ nasal spray comes as 300 mg/mL in a 15 mL bottle and is sprayed into the nose, which makes it a convenient, needle-free option for an everyday routine.
NAD+ Through IV Infusions
Most human data on NAD+ given into the body come from intravenous (IV) infusions, which drip the dose into a vein over hours. In a small 2019 pilot study, researchers infused NAD+ over six hours and tracked NAD+ and its breakdown products in blood and urine (2).
NAD+ in the blood rose about two hours after the infusion started, and urine levels were higher by the six-hour mark, according to a later paper summarizing the results (2,3). The study focused on how NAD+ moves through the body.
An injection takes far less time than a six-hour drip, so the infusion findings describe that longer method.
NAD+ Troches
A troche is a small medicated tablet that dissolves slowly in the mouth, usually between the cheek and gum or under the tongue. The NAD+ troche available through Mochi Health is 250 mg, supplied as a pack of 30 troches, which makes it an easy, needle-free option to keep on hand.
Research on taking NAD+ building blocks under the tongue is also emerging. In a 2026 trial of 14 healthy men who each tried both methods, NMN held under the tongue raised certain breakdown products faster than swallowed NMN, while blood NAD+ levels were similar between the two routes (6).
Because the trial tested NMN, its results describe that molecule rather than an NAD+ troche.
Topical NAD+
Also available through Mochi Health is an NAD+ topical cream, which is applied to the skin rather than taken into the body. Your prescriber can tell you the strength being dispensed.
Human research on NAD+ applied to the skin includes a 2007 study in 37 people that examined 1% and 0.3% topical NAD+ preparations over four weeks (5). The same researchers found that NAD+ is sensitive to temperature, so storage instructions matter for any NAD+ cream (5).
The Four Forms Differ Mostly in How They Are Used
The table below sets the four forms next to each other, using the strengths Mochi lists.
Form | What Mochi lists | How it is used |
|---|---|---|
NAD+ nasal spray | 300 mg/mL, 15 mL | Sprayed into the nose |
NAD+ injection | 100 mg/mL, 10 mL vial | Injected as the prescriber directs |
NAD+ troche | 250 mg, 30 troches | Dissolved in the mouth |
NAD+ topical cream | Strength not listed here | Applied to the skin |
With four forms to choose from, the decision comes down to what fits your routine, from needle-free options to a quick injection. A provider can talk through which of those preferences matters most to you.
Side Effect Reports So Far Come From IV Use
The clearest side effect data involve IV infusions. In a retrospective review, a look back at the records of 14 clinic clients, all six who received 500 mg of NAD+ by IV on four consecutive days reported symptoms during the infusion, including abdominal cramping, nausea, vomiting, a faster heart rate, and chest pressure (3).
The NAD+ infusions also ran longer, averaging 96 minutes against 37 minutes for nicotinamide riboside, and the authors described their findings as preliminary (3).
Published side effect data come mainly from IV use, so a provider will talk through what to watch for with each form. The NAD+ injections explainer covers questions specific to the shot in more depth.
Check your eligibility to talk with a provider about whether any NAD+ form fits your goals and history.
Share Your Health History With a Provider First
No NAD+ product has an FDA label, so there is no official list of contraindications (reasons not to use a medicine) the way there is for an approved drug. That is why a provider reviews your health history before prescribing any form.
Safety in pregnancy and breastfeeding has not been established in the studies cited here, so a provider will want to know if either applies to you. Tell the prescriber about any liver or kidney condition, nasal or sinus problems, and a history of fainting around needles.
List every medication and supplement you take as well, including over-the-counter NR or NMN products, because those raise NAD+ through the same pathway.
Symptoms That Need Attention
Seek emergency care for chest pain or pressure, trouble breathing, swelling of the face or throat, or fainting after any dose of NAD+. Contact your prescriber about whether to continue treatment if you have ongoing nausea, vomiting, or a racing heart.
Call the prescriber promptly about spreading redness or pain at an injection site, a blistering rash where the cream was applied, or nosebleeds after the spray.
A Short List of Questions Makes the Visit More Useful
None of these steps replaces the visit itself, although they help you get clearer answers from it.
Write down what you hope NAD+ will do, because a provider can tell you whether any human study has tested that specific goal.
Decide how you feel about needles, since that single preference often settles the choice between the spray, the troche, and the injection.
List every supplement you take, including NR, NMN, or niacin, so the provider can see your total intake.
Ask which strength and schedule the prescription would use, and how the product should be stored at home.
Agree on when you will check in with the provider again to review how things are going.
The Bottom Line
With a nasal spray, an injection, a troche, and a cream all available through Mochi Health, you and an affiliated Mochi Medical provider can decide together which NAD+ form fits your routine and health history. For people who prefer to avoid needles, the nasal spray is an easy option to raise at the visit. Mochi's longevity care page sets out the wider program, and the nasal spray details cover that form specifically. Check your eligibility to talk through the options with a provider.
FAQs
How Do the Ways of Taking NAD+ Compare?
How the forms compare depends on your goals and preferences, and research on the nasal spray, injection, troche, and cream is still developing. The choice usually comes down to comfort with needles, daily routine, and a provider's view of your health history.
What Does Research Say About NAD+ as a Nasal Spray?
Research on NAD+ given through the nose began in animal studies, including a 2007 rat study (4). An affiliated Mochi Medical provider can talk through how the spray fits your goals.
Which Is Better, Nasal Spray or Injection?
Which is better, nasal spray or injection, depends mostly on your preference. The spray is needle-free and simple to use at home, while the injection is given as your prescriber directs.
What Is the Downside of Taking NAD+?
The downsides of taking NAD+ to discuss with a provider are that no form is FDA approved, human research is still developing, and side effects have been reported with IV use. In a review of 14 clinic clients, all six given NAD+ by IV reported symptoms such as nausea or cramping during the infusion (3).
References
Radenkovic D, Reason, Verdin E. Clinical Evidence for Targeting NAD Therapeutically. Pharmaceuticals (Basel), 2020. A narrative review. NAD clinical evidence review
Grant R, Berg J, Mestayer R, Braidy N, et al. A pilot study investigating changes in the human plasma and urine NAD+ metabolome during a 6 hour intravenous infusion of NAD+. Frontiers in Aging Neuroscience, 2019. A small human pilot study. pubmed.ncbi.nlm.nih.gov/31572171/
Intravenous infusion of nicotinamide adenine dinucleotide (NAD+) versus nicotinamide riboside (NR): a retrospective tolerability pilot study in a real-world setting. 2026. A retrospective review of clinic records. IV NAD+ tolerability study
Ying W, Wei G, Wang D, et al. Intranasal administration with NAD+ profoundly decreases brain injury in a rat model of transient focal ischemia. Frontiers in Bioscience, 2007. An animal study. pubmed.ncbi.nlm.nih.gov/17127275/
In search for new antipsoriatic agents: NAD topical composition. 2007. A small clinical study in 37 patients with psoriasis. pubmed.ncbi.nlm.nih.gov/17035720/
Sublingual NMN administration increases early circulating terminal catabolites 2PY and 4PY compared with oral administration in healthy adult men. 2026. A randomized crossover trial of a precursor, not NAD+. pmc.ncbi.nlm.nih.gov/articles/PMC13534420/
US Food and Drug Administration. Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act. FDA 503A bulks page
ClinicalTrials.gov. NCT06919328, Absorption and Tolerability of Injectable Administration of Niagen®+, as Compared to NAD+. A registered trial record. clinicaltrials.gov/study/NCT06919328
Prevention of traumatic brain injury-induced neuron death by intranasal delivery of nicotinamide adenine dinucleotide. 2012. An animal study. pubmed.ncbi.nlm.nih.gov/22352983/
Imai S, Guarente L. NAD+ and sirtuins in aging and disease. Trends in Cell Biology, 2014. A review. pmc.ncbi.nlm.nih.gov/articles/PMC4112140/
Covarrubias AJ, Perrone R, Grozio A, Verdin E. NAD+ metabolism and its roles in cellular processes during ageing. Nature Reviews Molecular Cell Biology, 2021. A review. pmc.ncbi.nlm.nih.gov/articles/PMC7963035/
Cleveland Clinic. What Is NAD and Why Does It Matter for Your Health? my.clevelandclinic.org/health/body/nad-nicotinamide-adenine-dinucleotide
This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting, stopping, or changing any medication or treatment plan. NAD+ nasal spray, NAD+ injection, NAD+ troches, and NAD+ topical cream require a written prescription from a licensed provider. Speak with a provider to determine if any of these NAD+ products is appropriate for you. NAD+ is not FDA approved for any condition in any form, and these products are compounded medications. Compounded medications are not approved or evaluated by the FDA for safety, effectiveness, or quality. Individual results are not guaranteed and may vary from person to person. All professional medical services are provided by licensed physicians and clinicians affiliated with independently owned and operated professional practices. Mochi Health Corp. provides administrative and technology services to affiliated medical practices it supports, and does not provide any professional medical services itself.
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