NAD+, NMN and NR are three different purchases
Sources read September 2026. 14 documents cited.
They are sold beside each other at wildly different prices, and they are not three brands of the same thing. One is a coenzyme that is not a dietary supplement at all; the other two are precursors whose legal status has moved twice in four years.
Three molecules, not three brands of one
Walk a NAD+ storefront and you will be offered a subcutaneous injection at $149 a month, a nasal spray, a sublingual troche, and — a click away on the same site — a capsule of something called NMN or NR at a fraction of the price. The page will imply these are routes to the same destination. Chemically that is roughly fair. Commercially and legally it is not, and the difference decides both what you can lawfully buy and what anyone has actually measured.
NAD+ is the coenzyme itself: nicotinamide adenine dinucleotide, the molecule every one of these products is named after. Nicotinamide riboside and nicotinamide mononucleotide are precursors — smaller molecules the body converts toward NAD+, NMN one enzymatic step closer than NR. Selling a precursor is selling a raw material and hoping the conversion happens. Selling NAD+ by injection is selling the finished coenzyme and hoping it gets where it is needed. Those are different bets, and neither of them is settled.
What is settled, and what this page is about, is the paperwork. Each of the three reaches a US buyer by a completely different legal route, and each route carries a different amount of scrutiny.
What each one is allowed to be sold as
A dietary supplement, a food ingredient and a compounded drug are three regulatory categories with three different burdens. NR has travelled the first two. NMN has been thrown out of the first and let back in. NAD+ itself, in the form most of this site’s index sells, is in the third.
| Molecule | What it is | Route to a US shelf | What FDA has said |
|---|---|---|---|
| Nicotinamide riboside (NR) | A vitamin B3 form; a precursor the body converts toward NAD+ | Notified as a new dietary ingredient, and separately the subject of a GRAS notice for use in food | “No questions at this time” on the notifier's own GRAS conclusion — and FDA states plainly that it “has not, however, made its own determination” |
| β-Nicotinamide mononucleotide (NMN) | A precursor one enzymatic step closer to NAD+ than NR | New dietary ingredient notifications; excluded from the supplement definition in 2022, reinstated from 2025 | Excluded November 2022 under the drug-preclusion clause; that position reversed 29 September 2025 and the 2022 letters set aside through 2026 |
| NAD+ itself, injected or infused | The coenzyme, given by IV, intramuscular or subcutaneous injection | Compounded. It is not a dietary supplement and there is no FDA-approved NAD+ drug product | Sits in 503A Category 1, “Bulk Drug Substances Under Evaluation”, and does not appear on the 503B bulks list at all |
| NAD+ itself, taken by mouth | The same coenzyme in a capsule, troche or spray | Sold as a supplement | No FDA determination this site could find that speaks to oral NAD+ specifically, as distinct from its precursors |
“No questions at this time” is not approval, and acceptance of a notification for filing is not a finding of safety — FDA says so in its own words in both letters. Neither phrase means what a marketing page usually uses it to mean.
Source: FDA GRAS response GRN 000635 (3 August 2016); FDA response to citizen petition FDA-2023-P-0872 (29 September 2025); FDA NDI 1267 reinstatement and NDIN 1444 filing letter (28 January 2026); FDA bulk drug substances nominated under section 503A (updated 14 May 2026). All captured 2026-09-05.
Two phrases in that table do the most work and are the most often misread. FDA’s response to the NR GRAS notice says the agency “has no questions at this time” about the notifier’s own conclusion, and then, in the next sentence, “The agency has not, however, made its own determination regarding the GRAS status of the subject use of NR.” That is a decision not to object, on a conclusion somebody else reached. And on the supplement side, FDA’s January 2026 letter accepting an NMN notification says “acceptance of this notification for filing is a procedural matter, and thus, does not constitute a finding by FDA that the new dietary ingredient or supplement that contains the new dietary ingredient is safe.” Neither sentence is approval. Both get used as if they were.
| What was counted | Out of 18 notifications naming NMN or NR |
|---|---|
| Naming nicotinamide mononucleotide | 12 |
| Naming nicotinamide riboside | 6 |
| Filed after the September 2025 reversal | 2 |
The two post-reversal filings are NDIN 1444 (accepted 28 January 2026) and NDIN 1451 (accepted 17 April 2026). A notification is a filing, not an approval; FDA's own letter says acceptance for filing “does not constitute a finding by FDA that the new dietary ingredient … is safe”.
Source: FDA, “Submitted 75-Day Premarket Notifications for New Dietary Ingredients”, last updated 5/28/26, captured 2026-09-05. Counted by matching the ingredient name FDA prints.
Injectable NAD+ is a different world again. There is no FDA-approved NAD+ drug product, so every vial in this category is compounded, and NAD+ sits on FDA’s 503A list in Category 1 — Bulk Drug Substances Under Evaluation, on a list whose printed date is May 2026. It is not on the 503B bulks list at all, which is the point FDA made in a January 2026 warning letter to one outsourcing facility. “Under evaluation” is not a prohibition and it is not an endorsement; it is the absence of a finding, on a product being sold at scale while the finding is pending.
The NMN reversal, and an authoritative page that is still wrong
In November 2022 FDA sent letters telling NMN notifiers that their ingredient was excluded from the dietary supplement definition. The mechanism was the drug-preclusion clause: an article authorised for investigation as a new drug, and the subject of substantial clinical investigations made public, cannot then be sold as a supplement. NMN was in clinical trials as MIB-626 — a study this page cites below for a different reason — and that was enough.
A citizen petition followed in March 2023. On 29 September 2025 FDA granted it in part. The reasoning is narrow and worth reading exactly, because it is not a safety finding:
“FDA has reconsidered its position that the dietary supplement or food marketing must be lawful to ‘count’ for purposes of the race-to-market clause, and, in light of this change in interpretation, we have determined that NMN is not excluded from the dietary supplement definition.”
FDA response to citizen petition, docket FDA-2023-P-0872, 29 September 2025.
Through December 2025 and into 2026 FDA sent “reinstatement” letters setting aside the 2022 exclusions one notifier at a time — “Because NMN is not excluded from the dietary supplement definition, we are setting aside our November 4, 2022 superseding letter.” Two new NMN notifications have been accepted since, the first in January 2026.
Now the part that matters more than the history. The NIH Office of Dietary Supplements’ niacin fact sheet — a genuinely authoritative document, and one of the sources cited at the foot of this page — still says today that “FDA ruled in November 2022 that NMN may not be legally marketed as a dietary supplement”. It is not careless. The page carries its own date, “Updated: November 18, 2022”, and it was correct on that date. It has simply not been revised, and a writer copying the most reputable available source would publish a claim FDA abandoned three years ago.
That is the whole reason this site records the date printed on a document separately from the date it was fetched. A live URL will happily serve you something that stopped being true.
What the human trials actually measured
There is real randomised evidence here, and it is almost entirely about the two precursors rather than about NAD+ itself. That asymmetry is the single most useful thing to know before comparing prices across the category.
| What was counted | Out of 45 randomised human trials of NR or NMN |
|---|---|
| Matching nicotinamide riboside | 31 |
| Matching nicotinamide mononucleotide | 17 |
| Systematic reviews and meta-analyses | 8 |
31 and 17 do not sum to 45, and that is correct: three records match both terms, so the union is 45 rather than 48. The first version of this search used a filter tag that is silently invalid — it returned zero for both compounds AND zero for aspirin and metformin. The positive control caught it; without one, this figure would have said no randomised trials exist.
Source: PubMed E-utilities, searched 2026-09-05. Filter: "randomized controlled trial"[pt] AND humans[mh]. Positive control through the identical filter in the same run: aspirin, 5,052.
The trials are consistent about one thing and inconsistent about everything else. They consistently show the precursors raise blood NAD+ and are tolerated: a 2018 crossover trial concluded that NR “is well tolerated and effectively stimulates NAD+ metabolism in healthy middle-aged and older adults”, and a 2023 trial of a pharmaceutical-grade NMN found “substantial dose-related increases in blood NAD levels”. Raising a blood level is a real result. It is not a clinical outcome.
On outcomes the picture thins fast. A 2020 trial in the American Journal of Clinical Nutrition gave 1,000 mg of NR a day for six weeks and found changes in body composition and muscle acetylcarnitine, then said flatly: “However, no other metabolic health effects were observed.” A 2025 meta-analysis of both compounds in adults over 60 concluded that “current evidence does not support NMN and NR supplementation for preserving muscle mass and function”. A 2026 meta-analysis of fifteen NMN trials found the compound well tolerated and reported that “broad metabolic benefits were not evident”, with a small reduction in diastolic blood pressure the clearest signal anywhere in it.
One 2024 trial is worth reading twice, because its title lists three positive findings — raised NAD levels, maintained walking speed, improved sleep quality — and its abstract opens the results with “At primary outcome, at both 4 weeks and 12 weeks, the NMN and placebo groups had no significant differences in a stepping test.” The primary endpoint missed and the secondary endpoints are in the title. That is not misconduct and it is extremely common; it is also exactly the shape a seller quotes.
For NAD+ given directly, by injection or infusion, there is no randomised evidence at all. There are two human studies of intravenous NAD+ in existence, and a separate page here goes through both of them. Neither is a trial.
What any of this changes about a price
This site’s index reads what 106 NAD+ sellers publish. Across 376 figures, 374 are for NAD+ itself and 1 is for an oral precursor. That is the commercial reality behind the chemistry: the sellers this site tracks are almost entirely selling the coenzyme, by injection, on a subscription — the one form of the three with no randomised human evidence and no FDA-approved product behind it, and the one that costs the most.
Three practical consequences for reading a price:
- A precursor price and an injection price are not comparable, at any dose. A milligram of NR is not a milligram of NAD+, and there is no published conversion that would let you turn one into the other. Any page that ranks them in one column is comparing two different products.
- “Pharmaceutical grade” on a supplement means nothing in particular. There is no FDA-approved NAD+, NMN or NR drug product to be a grade of. The one pharmaceutical-grade NMN in the literature is an investigational drug that was not for sale.
- The legal status of NMN changed within the last year, and pages have not caught up. A seller still describing NMN as banned, or a seller still selling it on the strength of a 2022 exclusion having been “wrong all along”, is reading a story rather than the letters. FDA changed an interpretation of a marketing clause. It did not make a finding about the molecule.
What each seller in the index actually charges, and what kind of figure it is, is on the price index, and the sellers publishing a standing monthly rate are the minority — 46 of 106, read September 2026.
What this page cannot tell you
Nothing above says whether any of these is worth taking, because none of the documents cited answers that and this site has not run a trial. Specifically:
How much NAD+ does a person need, by any route, and does more cost buy more effect? Nothing this site holds answers that.
A human dose-ranging study of NAD+ itself with a clinical endpoint. The two human intravenous studies that exist are a six-participant metabolome pilot and a retrospective chart review; the randomised evidence is all for the oral precursors NR and NMN, at doses that cannot be translated to an infusion.
It also does not tell you what dose to take. FDA’s letters quote conditions of use that notifiers stated in their own filings — one names up to 600 mg a day for up to 60 days, and up to 300 mg a day for chronic use, excluding pregnancy, lactation, infants and children — and the same letter says in terms that accepting the filing is not a finding that any of it is safe. Those are a company’s numbers appearing in a government document, which is not the same as a government recommendation, and this page will not launder one into the other.
About this page
Nobody at this site holds a medical license and nothing here is medical advice, diagnosis or treatment. This is a price index; the pages like this one exist because a reader cannot judge a price without knowing what the thing is. Talk to a licensed clinician before starting or stopping anything, and see the medical disclaimer.
Every factual claim above points at a numbered document below. Each was fetched on September 2026, and each entry records the date printed on the document itself, which is not always the date on the page serving it. If something here is wrong, the corrections page says how that gets fixed and what has been fixed before.
Sources
- Response to Citizen Petition, Docket Number FDA-2023-P-0872 (Natural Products Association / Alliance for Natural Health USA)
- NDI 1234 — Reinstatement response letter to Willy Nutra Inc.
- NDI 1267 — Reinstatement Response Letter to Effepharm Ltd., and filing letter for NDIN 1444
- Agency Response Letter GRAS Notice No. GRN 000635
- Submitted 75-Day Premarket Notifications for New Dietary Ingredients (complete list)
- Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act
- Niacin — Health Professional Fact Sheet
- MIB-626, an Oral Formulation of a Microcrystalline Unique Polymorph of β-Nicotinamide Mononucleotide, Increases Circulating Nicotinamide Adenine Dinucleotide and its Metabolome in Middle-Aged and Older Adults.
- Chronic nicotinamide riboside supplementation is well-tolerated and elevates NAD+ in healthy middle-aged and older adults.
- Nicotinamide riboside supplementation alters body composition and skeletal muscle acetylcarnitine concentrations in healthy obese humans.
- Ingestion of β-nicotinamide mononucleotide increased blood NAD levels, maintained walking speed, and improved sleep quality in older adults in a double-blind randomized, placebo-controlled study.
- The Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis.
- Safety and Metabolism-Related Outcomes of Oral Nicotinamide Mononucleotide Supplementation in Adults: A Systematic Review and Meta-Analysis.
- Effects of Nicotinamide Mononucleotide Supplementation on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.