Key Takeaways
- NAD+ helps your cells turn food into energy and supports enzymes that maintain DNA.
- LIV's nasal spray and injection contain the same active ingredient, NAD+.
- The nasal spray is a metered spray you use once or twice a day, with no needle.
- With the injection, you give yourself a shot twice a week.
- Tell your provider which you'd prefer, and they'll help you choose based on your health history.
Some people would rather never give themselves a shot. Others would rather think about their medicine twice a week than every morning. If you're choosing between an NAD+ nasal spray and an injection, it usually comes down to which of those feels more comfortable to you.
How Your Cells Use NAD+
Your body builds NAD+ from niacin, and more than 400 enzymes need it, more than any other coenzyme made from a vitamin. Here's where it shows up:
- Feel more in the tank: Every cell you have converts food into usable energy, and that conversion runs on NAD+.
- Built to bounce back: Your DNA takes small hits every day. The enzymes that repair it spend NAD+ to do the work.
- Firing on all cylinders: Cells coordinate through enzymes that manage stress and signaling. Those enzymes depend on NAD+.
How Do the Nasal Spray and Injection Compare?
Both contain NAD+, the same active ingredient that's in LIV's oral drops. The difference is how you take it and how often.
| Nasal spray | Injection | |
|---|---|---|
| How you take it | A metered spray in each nostril | A shot under the skin |
| How often | Once or twice a day | Twice a week |
| LIV protocol schedule | One spray per nostril, once or twice daily (60 to 120 mg a day) | 100 mg twice weekly, then 200 mg twice weekly from month 2 |
| What it asks of you | A daily habit | Comfort with a needle on two set days |
| Active ingredient | NAD+ | NAD+ |
| Provider review | Before every refill | Before every refill |
The main difference is how often you take it: a spray every day, or an injection on two set days a week.
SAME MOLECULE, TWO RHYTHMS
The choice is a rhythm, not a rank.
| Nasal spray | Injection | |
|---|---|---|
| How often | One to two times daily | Twice weekly |
| What it asks of you | No needle. A daily habit to keep | A shot under the skin on two fixed days |
| Evidence it beats the other | None held | None held |
The schedules do not convert into one another.
Which Form Fits Your Routine?
The form that fits you best is the one you'll stick with.
Would You Rather Skip the Needle?
Then the nasal spray may be right for you. You take NAD+ without injections, and because it's a metered spray, each use gives a set amount. It easily fits into your existing morning routine.
Would You Rather Think About It Twice a Week?
Then the injection may be right for you, as long as you're comfortable with a shot. You take it on two set days a week, which can be easier to remember than something you do every day.
Do Pills Get in Your Way?
Neither form is swallowed. Trouble absorbing medicine through your gut, and not wanting to add another pill to the ones you already take, are the practical reasons to choose an injected form. Tell your provider if either applies to you.
What Your Provider Weighs With You
Your health history, your goals and how you'd like to take NAD+. You share them on a short online health form, and a licensed provider then decides whether NAD+ is right for you and helps you choose between the spray and the injection. If it's right for you, they choose your dose and how much medicine you'll get.
Your provider stays with you after you start. Before each refill, you tell LIV how you're doing, and your provider reviews your progress and adjusts your plan as needed. You'll also have a check-in every three months.
Side Effects and What to Tell Your Provider
Tell your provider about any side effects before you change how you use either form. With the injection, LIV's protocol lets your provider keep the same strength and prescribe it less often, or keep you on the first-month schedule instead of stepping up. If you already take nicotinamide riboside, say so, because a separate NAD+ prescription alongside it may not be right for you.
Getting Started
Once you've sent your health form, a licensed provider reviews it within 48 hours. After approval, delivery usually takes 3 to 5 days, and compounding can add time. Your provider reviews your plan before every refill at no extra cost, and you can change your plan, skip a shipment or cancel from your account.
If you choose the injection, the dosage chart shows how its schedule steps up. The NAD+ supplement guide covers the other forms people ask about. When you're ready, start with an evaluation.
Frequently Asked Questions
Is NAD+ nasal spray as effective as an injection?
No study or data supports a difference in effect between LIV's NAD+ injection, nasal spray and oral dropper. All three contain NAD+, so the choice is about how you'd like to take it: a daily spray or a twice-weekly shot. Tell your provider which you'd prefer, and they'll help you choose.
Will either form make me feel more energetic?
There isn't enough evidence to know whether NAD+ injections or nasal spray improve day-to-day energy. NAD+ helps cells use energy from food, but that alone doesn't tell us how you might feel after taking it. The three lines under "How Your Cells Use NAD+" explain cellular roles of NAD+; they don't establish improved energy, recovery or focus from LIV's NAD+ products. Tell your provider about tiredness or other changes so they can review what may be causing them.
Can I switch from the spray to the injection, or back?
Talk it over with your provider. A switch is a new prescription rather than a conversion: the daily spray and the twice-weekly injection run on separate schedules, so one doesn't convert into the other. Your provider reviews your plan and sets the new schedule.
Where do the dosing schedules come from?
They come from LIV's prescribing protocol, not from an FDA label, because there's no FDA-approved NAD+ product to carry one. Your provider decides your dose, how much to prescribe and whether NAD+ is right for you, based on your health history. Some people aren't eligible after the health form.
Are NAD+ nasal spray and injections FDA-approved?
Both of LIV's forms are compounded, which means a licensed pharmacy mixes your NAD+ for you rather than making it in large batches. Compounded medicines aren't FDA-approved, and the FDA doesn't review their safety, effectiveness or quality before they're marketed. Follow the instructions that come with your prescription.
Is NMN from the supplement shelf the same thing?
No. NMN and NAD+ are different molecules. LIV's NAD+ spray and injection are prescription medicines prepared by a licensed pharmacy, and a supplement from a store is a different product. Ask your provider before substituting a supplement for your prescribed medicine.
References
National Institutes of Health, Office of Dietary Supplements. (n.d.). Niacin: Fact sheet for health professionals. Read 2026-08-20. https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/
U.S. Food and Drug Administration. (2026). Compounding and the FDA: Questions and answers. Read 2026-08-20. https://www.fda.gov/drugs/human-drug-compounding/compounding-and-fda-questions-and-answers
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