NAD+ protocol · PepGuide

Standard

Week 1

10u

25 mg · M/W/F

Tolerance ramp. Start gentle to assess flushing and chest-pressure tolerance. Inject slowly over 30–60 seconds.

Week 2–3

20u

50 mg · M/W/F

Step up if Week 1 was tolerated. Continue slow injection.

Weeks 4+

30u

75 mg · M/W/F

Step up if Week 2 was tolerated.

Advanced

40u

100 mg · M/W/F

Working dose (300 mg/week, aligned with Empower/Olympia/Tailor Made compounded SubQ ceiling). Hold at lower step if headache, chest pressure, or fatigue developed at the prior step.

Escalation (optional)

30–40u

75–100 mg · M-F (5×/week)

Optional escalation after the working dose is well tolerated for at least 4 weeks. 375–500 mg/week, above the standard compounded ceiling but within research-community range. Step back to 3×/week if any new flushing, headache, fatigue, or chest pressure appears.

Off

4 weeks

Recovery cycle for sirtuin/PARP balance. Quarterly 2-week breaks acceptable for ongoing chronic use.

Phase	How often	Dose	Units	Notes
Week 1	M/W/F	25 mg	10u	Tolerance ramp. Start gentle to assess flushing and chest-pressure tolerance. Inject slowly over 30–60 seconds.
Week 2–3	M/W/F	50 mg	20u	Step up if Week 1 was tolerated. Continue slow injection.
Weeks 4+	M/W/F	75 mg	30u	Step up if Week 2 was tolerated.
Advanced	M/W/F	100 mg	40u	Working dose (300 mg/week, aligned with Empower/Olympia/Tailor Made compounded SubQ ceiling). Hold at lower step if headache, chest pressure, or fatigue developed at the prior step.
Escalation (optional)	M-F (5×/week)	75–100 mg	30–40u	Optional escalation after the working dose is well tolerated for at least 4 weeks. 375–500 mg/week, above the standard compounded ceiling but within research-community range. Step back to 3×/week if any new flushing, headache, fatigue, or chest pressure appears.
Off	4 weeks	–	–	Recovery cycle for sirtuin/PARP balance. Quarterly 2-week breaks acceptable for ongoing chronic use.

Cycle & timing

Cycle: 8–12 weeks on / 4 weeks off. Max: ongoing with quarterly 2-week breaks. Cycling supports sirtuin/PARP balance.

Timing: 3×/week SubQ, slow injection (30–60 sec); AM preferred (alerting).

Where: Outer thigh preferred for volume tolerance.

What to expect

Stimulating warmth and energy during/after injection, normal. Cognitive clarity and metabolic improvement over 4–8 weeks. 14-day stability limit after reconstitution.

How much to buy

For 4-wk ramp (25 → 50 → 75 mg, M/W/F), about 600 mg total:

2

× 500mg vials

1

× 1000mg vials

Men & women

Unisex, dose by protocol, no sex difference. Infuse slowly regardless of sex (fast infusion causes flushing / cramping). Avoid in pregnancy.

Dilution calculator

Set to the guide's typical mix for NAD+. Change anything to see where to draw.

Vial size

BAC water added

Dose you want

Draw to

40u

Volume

0.40 mL

Strength

250 mg/mL

Doses per vial

5

Assumes a U-100 insulin syringe (100 units = 1 mL). Double-check against the compound's page before you draw.

Recommended mixes

Vial	Water	Strength
500 mg	2 mL	250 mg/mL
1000 mg	4 mL	250 mg/mL

500 mg: 1 unit = 2.50 mg

Storage

PowderFreeze-dried: -4°F.
MixedReconstituted: 36–46°F, maximum 14 days; firm limit. One vial at a time.

Don't use if: Active migraine (NAD+ infusions can trigger) · Severe cardiovascular disease (BP fluctuations)

Stop if you notice

Persistent headache, chest pressure during injection

Side effects

Flushing, stimulation, insomnia if dosed late. Nausea at higher doses.

Drug interactions

Antihypertensives and vasoactive medications: NAD+ administration can cause transient BP changes and chest pressure, monitor BP, especially with rapid push or large doses. Stimulants (caffeine high-dose, ADHD medications): additive activation; reduce dose or shift timing if combined. Sedatives/sleep medications: NAD+ is alerting and counteracts sedation; avoid evening dosing if combining. Methylating agents (TMG, methylfolate, methylcobalamin): theoretical complementary pathway support but no human data; some users titrate methyl donors when NAD+ doses are high. Chemotherapy: NAD+ supplementation in active cancer treatment is contested, coordinate with oncology before starting.

Labs

Compound-specific: Liver enzymes AST/ALT (baseline), monitor closely if >200 mg/day. Out of range? Rising ALT/AST = liver stress → cut the dose (watch closely above 200 mg/day).

What these labs mean →

Warnings

Stimulating effect can disrupt sleep if dosed late. Inject slowly to avoid acute flushing/chest pressure.

Patient education

Inject slowly over 30–60 seconds. Don't dose evening if sleep disruption occurs.

These apply on top of the universal safety rules.

Pairs well with

MOTS-c

mitochondrial stack

MOTS-c

SS-31

additive mitochondrial protection

SS-31 (Elamipretide)

5-Amino-1MQ

NAD-preserving NNMT inhibition

5-Amino-1MQ

Glutathione

antioxidant

Glutathione

Resveratrol

sirtuin activation

Avoid with

Active migraine

NAD+ infusions can trigger

Severe cardiovascular disease

BP fluctuations

Can NAD+ + MOTS-c share a syringe?

Give it its own pin. NAD+ is a large volume with a slow push. Own pin, and never with copper or vitamin C.

Changes from the guide

The guide contradicted itself or had a slip here, so this page differs from the PDF:

The guide labeled the vial counts "4-wk @ 100 mg × 3/wk", but they match the 4-week ramp (about 600 mg). Relabeled.

What it does

Evidence: human data is oral precursors (NR/NMN) or IV; no SubQ outcomes trial.

Master cellular energy coenzyme, declines 50% between age 20 and 50. Injectable achieves levels impossible with precursor supplements. Coenzyme in 500+ enzyme reactions. Substrate for sirtuins (epigenetic repair) and PARP (DNA repair). Powers ATP production.

References

agelessrx researchdosing peptidedosages PubMed

From the guide, page 70.