Important Safety Information

1The honest limitation

2What NAD+ is

Nicotinamide adenine dinucleotide (NAD+) is a coenzyme present in every cell in the body. It carries electrons in the reactions that convert food into usable energy, and it is consumed by enzymes involved in DNA repair and cellular signalling. Tissue levels measured in humans decline with age.

That is a description of a molecule, not a claim about a treatment. A plausible mechanism is not the same thing as a demonstrated clinical benefit, and we will not present it as one.

3Do not use if you

• Are pregnant, trying to conceive, or breastfeeding — there are no safety data in pregnancy or lactation;
• Have had a serious allergic reaction to NAD+ or to any ingredient in the preparation;
• Have an active malignancy, unless your treating oncologist has cleared it in writing;
• Are under 18 years of age.

4Tell your clinician if you

• Have any history of cancer, treated or in remission;
• Have kidney or liver disease;
• Have a heart rhythm problem, low blood pressure, or a history of fainting;
• Have unexplained fatigue that has not been medically worked up;
• Take any prescription medication, over-the-counter product, or supplement — interactions with NAD+ are not well characterized;
• Have a bleeding disorder or take an anticoagulant;
• Have any history of a severe allergic reaction to an injectable product.

5On cancer, plainly

6Possible side effects

Commonly reported

• Injection-site reactions — pain, redness, swelling, bruising, or itching at the site.
• Dose- and rate-dependent effects, particularly if a dose is given too quickly: flushing, nausea, chest tightness, abdominal cramping, headache, lightheadedness, and a racing heartbeat. These usually settle when the dose is reduced or given more slowly.
• Fatigue or a transient feeling of being unwell in the hours after a dose.

Less commonly reported

• Muscle cramping, transient blood-pressure changes, sweating, or anxiety during administration.
• Sleep disturbance if dosed late in the day.

This is not a complete list. Because there is no approved labeling, uncommon and long-term effects may not yet be recognized. Report anything unexpected to your care team.

7Using your medication safely

• Use only the dose and schedule your clinician set. Do not increase the dose, add a second dose, or change the route on your own.
• Inject slowly. Most acute symptoms are rate-related.
• Rotate injection sites and use a new sterile needle and syringe every time. Never reuse or share needles.
• Store refrigerated at 2–8 °C (36–46 °F) unless your pharmacy label says otherwise. Do not freeze. Protect from light.
• Inspect before each use. Do not use a vial that is cloudy, discolored, contains particles, or is past the beyond-use date on the label.
• Dispose of sharps in an FDA-cleared sharps container, following your municipality’s rules.
• Keep out of the reach of children and pets.
• The medication is dispensed to you alone. Never give it to another person.

8What we will not tell you

Persistent fatigue deserves a real workup. Thyroid disease, anemia, diabetes, sleep apnea, depression, and medication side effects are common, treatable causes. Your clinician will ask about them and may order testing before assuming NAD+ is the answer. A clinician who never looks for a cause is doing you a disservice.

9Reporting a problem

Report side effects to your CoreScripts care team through secure messaging, by emailing support@getCoreScripts.com, or by calling 1-888-888-8888. See Report an Adverse Event for what to include.

You may also report adverse events directly to the FDA at www.fda.gov/medwatch or by calling 1-800-FDA-1088.