The default delivery route for compounded NAD+ is subcutaneous injection. A vial arrives by mail, you administer it at home into the fat layer under the skin. Over the past year, more online clinics have added a second option: nasal spray. A few offer three or more. The question this comparison answers: when a clinic offers both, does it price nasal spray the same as injection, or does one route cost more?
What NAD+ Nasal Spray Is
The spray contains the same molecule as NAD+ injections, made up by a compounding pharmacy for an individual prescription. Clinics present the nose as a shortcut that avoids needles. Whether a meaningful amount of NAD+ reaches the rest of the body this way has not been established in published human research we could locate.
What the Research Covers
- Humans: a 2026 systematic review in Ageing Research Reviews looked for every human and rodent study of NAD-related compounds. It concluded that clinical effectiveness for anti-aging or wellness outcomes remains inconclusive, and that no eligible outcomes trials evaluated intravenous or intramuscular NAD+ for those uses.
- Animals: the only intranasal NAD study our search surfaced is a 2026 paper in Experimental and Molecular Medicine. In that work, mice with ZnSO4-induced anosmia were treated with i.n. NAD, meaning the researchers were testing whether it could restore a damaged sense of smell in mice. That is a different question from longevity, in a different species.
So the honest position is: the spray may be easier to use than an injection, but there is no published evidence that it does what clinics imply, and no published data on how often its side effects occur.
Which Delivery Routes Exist
Three routes appear most commonly in our ranking of 28 online clinics:
- Subcutaneous injection: the most common form. A compounded solution is drawn from a vial and administered with a small needle, usually into the abdomen. Most clinics that publish NAD+ prices use this as their reference product.
- Nasal spray: a compounded solution sprayed into one or both nostrils per dose. Several clinics offer it alongside injection; a few list it as a separate product with its own page and price.
- Oral forms: capsules, tablets, troches (dissolving lozenges), liposomal liquid, and sublingual drops all appear in the set. These are the cheapest to produce and ship, and furthest from the intravenous NAD+ administered in a clinical drip setting.
This comparison focuses on injection versus nasal spray, because both are compounded drugs administered directly, not dietary supplements, and because several clinics publish separate prices for each.
The Price Comparison: Injection vs Nasal Spray
Among the clinics in our ranking that publish prices for both routes, the findings split into two categories: those that charge the same price regardless of route, and those that charge more for nasal spray.
Same price across routes
Luvo Health prices its NAD+ routes the same: NAD+ injection, NAD+ oral drops, and NAD+ nasal spray are all $199 per 4-week period at entry. Plans run up to 24 weeks and cost less per week, but as of October 6, 2026 the pricing page no longer lists the longer plans' prices. The page does not distinguish between routes; one price covers all three. Worth noting: billing is every 4 weeks rather than monthly, which means 13 cycles per year. The real annual cost is about $215 per month, not $199. (Source: luvohealth.com/services/longevity, verified September 2026.)
More expensive for nasal spray
bmiMD publishes separate product pages for NAD+ injection and NAD+ nasal spray, and the ladders no longer match:
| Commitment | Injection | Nasal spray | Premium |
|---|---|---|---|
| 1 month | $119/mo | $159/mo | +$40 |
| 3 months | $109/mo | $149/mo | +$40 |
| 6 months | $99/mo | $129/mo | +$30 |
| 12 months | $89/mo | $119/mo | +$30 |
At the month-to-month rate, the nasal spray is 34% more expensive than the injection. The gap narrows at the longest commitment tier but does not close. The injection page's prices reflect a recent update; the nasal spray page still carries an older, higher ladder that has not been revised to match. (Sources: bmimd.com/nad-injection and bmimd.com/nad-nasal-spray, verified September 2026.)
Multiple routes, one published price
MYRNK offers NAD+ in three forms: injection, nasal spray, and liposomal liquid. A single public price ladder applies, $169/month to $129/month on the 6-month plan, with the route chosen on the product page. Whether the published price reflects any per-route difference at checkout is not stated. (Source: myrnk.com, verified September 2026.)
Ivy Rx offers NAD+ injection and nasal spray alongside glutathione in both injection and nasal form, plus sermorelin. NAD+ is listed from $179/month; no per-route price breakdown is published on the product listing. Ivy Rx is one of the few clinics in the set that names its medical advisory board with credentials. Three board-certified physicians, all publicly listed. (Source: ivyrx.com/anti-aging, verified September 2026.)
He & She MD offers NAD+ in three forms (injection, nasal spray, and topical cream) at a single entry price of $229/month, with no per-route breakdown. A full commitment ladder runs to $139/month on the annual plan. (Source: heandshemd.com/longevity/nad/plans, verified September 2026.)
What the Data Does Not Tell You
The prices above are facts about what each clinic charges. They do not tell you:
- Whether nasal spray delivers NAD+ as effectively as injection. Published pharmacokinetic comparisons between subcutaneous and intranasal NAD+ administration are limited; the relative bioavailability is not settled.
- Whether the same dose applies across routes. Most clinic pages that offer multiple routes do not publish separate dose figures per route, nor do they explain how they determined equivalence.
- What the compounding pharmacy produces for each form. The concentration, excipients, and preservatives differ between an injectable solution and a nasal spray; they are not the same product in a different container.
The bmiMD premium for nasal spray over injection is a pricing observation, not a quality judgment. Whether a $40/month premium is justified depends on evidence that the clinic pages themselves do not provide.
The Broader Menu
Beyond injection and nasal spray, System Labs offers NAD+ as both injection and nasal spray, plus glutathione in both forms, alongside sermorelin and a sublingual sermorelin dissolving tablet. Six longevity products priced on a single page. RxSpan MD lists NAD+ injection at $249 and nasal spray as a separate line item, both carrying first-month-only pricing, with ongoing rates not published anywhere on the page.
The full ranking, with verified prices for every clinic that publishes them, is at /best. Every clinic's injection price sits in one table in our NAD+ injection price comparison, and what the studies say about tolerability is in NAD+ injection side effects.
Prices sourced from each clinic's own product pages. bmiMD injection and nasal spray prices verified from bmimd.com (September 2026). Luvo Health price and billing structure verified from luvohealth.com/services/longevity (September 2026). MYRNK public price ladder verified from myrnk.com (September 2026). Ivy Rx price verified from ivyrx.com/anti-aging (September 2026).
