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NAD+

1000mg Vial
500mg Vial
2 July 2026Updated 2 September 2026
Warning

Important information. The data compiled from scientific literature is provided for educational purposes. Dosage ranges reflect what is reported in studies and do not constitute a recommendation, prescription, or usage guidance. Health decisions should always be made with a qualified professional.

Peptide Interactions

// 16 known interactions

Works exceptionally well with this peptide

Nicotinamide riboside (NR) / Nicotinamide mononucleotide (NMN)

NAD+ precursors increase intracellular NAD+ biosynthesis and can amplify the intended effect of exogenous NAD+ on cellular redox and sirtuin-dependent pathways.

Sirtuin activators (e.g., resveratrol, pterostilbene)

Sirtuin activators act on NAD+-dependent deacetylases and may enhance downstream metabolic and mitochondrial benefits when NAD+ availability is increased.

Coenzyme Q10 (ubiquinone)

CoQ10 supports mitochondrial electron transport and may synergize with NAD+-driven improvements in mitochondrial function and cellular energy metabolism.

Omega-3 fatty acids (EPA/DHA)

Omega-3s support mitochondrial health and anti-inflammatory pathways and can complement NAD+-mediated metabolic and cell-survival effects.

All interaction categories

Synergistic (4)

  • Nicotinamide riboside (NR) / Nicotinamide mononucleotide (NMN): NAD+ precursors increase intracellular NAD+ biosynthesis and can amplify the intended effect of exogenous NAD+ on cellular redox and sirtuin-dependent pathways.
  • Sirtuin activators (e.g., resveratrol, pterostilbene): Sirtuin activators act on NAD+-dependent deacetylases and may enhance downstream metabolic and mitochondrial benefits when NAD+ availability is increased.
  • Coenzyme Q10 (ubiquinone): CoQ10 supports mitochondrial electron transport and may synergize with NAD+-driven improvements in mitochondrial function and cellular energy metabolism.
  • Omega-3 fatty acids (EPA/DHA): Omega-3s support mitochondrial health and anti-inflammatory pathways and can complement NAD+-mediated metabolic and cell-survival effects.

Compatible (4)

  • Vitamin D: Vitamin D supplementation has a neutral co-administration profile with NAD+ and does not require specific adjustment or monitoring.
  • Standard multivitamin (excluding high-dose niacin): Routine multivitamin formulations are generally compatible with NAD+ therapy provided they do not contain pharmacologically high doses of NAD+ precursors or niacin.
  • Magnesium (oral or IV formulations): Magnesium is frequently co-administered for general metabolic support and poses no known direct interaction with NAD+ supplementation.
  • Paracetamol (acetaminophen): Paracetamol has no established pharmacodynamic interaction with NAD+ at therapeutic doses and is compatible for symptomatic analgesia/antipyresis.

Monitor (4)

  • PARP inhibitors (e.g., olaparib, niraparib): PARP enzymes consume NAD+ during DNA repair, so co-administration can alter NAD+ dynamics and may require monitoring of clinical efficacy and adverse effects.
  • Metformin: Metformin modifies cellular NAD+/NADH ratios via AMPK and mitochondrial effects, so glycaemic control and tolerance should be monitored when combined with NAD+ therapy.
  • Antidiabetic agents (insulin, sulfonylureas): Because NAD+ can influence insulin sensitivity and cellular metabolism, glucose levels and antidiabetic dosing should be monitored to avoid hypoglycaemia or dosing mismatch.
  • CD38-targeting therapies (e.g., daratumumab): CD38 modulates NAD+ catabolism, so concurrent use with NAD+ supplementation may alter pharmacodynamics and warrants monitoring of therapeutic response and immune-related adverse events.

Avoid (4)

  • High‑dose niacin (nicotinic acid): High-dose niacin increases NAD+ precursor load and carries hepatotoxicity and flushing risks, so clinicians should evaluate cumulative NAD+ precursor exposure and liver function before combining.
  • Ethanol (alcohol): Chronic or heavy alcohol use disrupts NAD+/NADH balance and increases hepatic stress, so combining with NAD+ supplementation requires careful assessment of liver function and alcohol intake.
  • Active chemotherapy (cytotoxic agents): Cytotoxic chemotherapy can perturb cellular NAD+ metabolism and organ function, so NAD+ use should be carefully evaluated for potential effects on treatment efficacy and toxicity.
  • Severe hepatic impairment: Because NAD+ precursors and related metabolism involve hepatic processing, clinicians should exercise caution and consider dose modification or avoidance in patients with significant liver dysfunction.