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Who actually makes your NAD⁺?

The company selling you compounded NAD⁺ is usually not the company that makes it. A licensed pharmacy does that — and most sellers will not tell you which one, which removes every check you could otherwise run.

Michael Reyes6 min read
Who actually made it?10 name the compounding pharmacy118 do notThe seller is the storefront. The pharmacy is the manufacturer.

When you buy compounded NAD⁺, the company whose website you are on is very often not the company that makes the drug. It runs the storefront, the intake form and the subscription. Somewhere behind it, a licensed compounding pharmacy actually mixes the vial, fills it, tests it and ships it.

That pharmacy is the manufacturer in every sense that matters. It holds the sterility data. It is the entity a state board licenses and the FDA inspects. If something goes wrong with a batch, it is the name on the recall. And across the 131 sellers we have confirmed sell compounded NAD⁺, only 10 tell you what it is called8% of the 128 where we could establish an answer either way.

Why a name is worth more than a category

Plenty of sellers offer you a category instead. “A licensed US compounding pharmacy.” “An FDA-registered facility.” “A 503B outsourcing facility.” Those sentences are usually true, and the difference between 503A and 503B is real. But a category is not checkable and a name is.

With a name you can do four things that are otherwise impossible:

  • Confirm the license. Every state board of pharmacy publishes a license lookup. A pharmacy that ships into your state generally needs to be licensed there as well as at home.
  • Settle the 503A/503B question yourself, rather than accepting the seller’s summary of it. FDA publishes the list of registered outsourcing facilities; a pharmacy either appears on it or does not.
  • Look up its inspection history. FDA publishes warning letters and inspection findings by firm name. A search that returns nothing is itself informative.
  • Ask it directly for a certificate of analysis for the lot you received — which is a document you can actually read once you know who to ask.

None of that is available to you if the answer stops at “a licensed US pharmacy”. The sentence has told you the category of thing you are buying from and withheld the identity, and the identity is the part you can verify.

Why the pharmacy, specifically, is the unit of accountability

This framework was not designed in the abstract. In September 2012 the CDC and FDA began investigating infections in patients who had received contaminated steroid injections from a single compounding pharmacy in Massachusetts. The final count was 753 cases and 64 deaths across 20 states [1]. The federal law that created the 503A and 503B categories followed the next year.

Nothing in that history is a claim about NAD⁺, about any seller we review, or about any pharmacy named on this page. It is here for one reason: it is why the pharmacy, rather than the brand in front of it, is the entity the whole oversight system is pointed at. A regulator inspects a facility. A recall names a facility. If you do not know which facility, you are outside the system that was built after 2012 — not because anyone did anything wrong, but because you cannot look anything up.

What the 10 who answer actually publish

The ones that do name a pharmacy tend to do it properly rather than grudgingly. Some name a single partner pharmacy and its city. One names four pharmacies, each with a phone number, and says which product comes from which. Another names both the compounding pharmacy and the separate laboratory that performs its sterility testing — which is a further step again, because sterility testing sent to an outside lab is harder to be casual about than sterility testing you assert.

You can see exactly which sellers answer this question in the transparency scorecard, where naming the pharmacy is one of four questions we put to every seller, and in the reviews themselves. Be careful what you conclude from it, though. Naming a pharmacy is a fact about disclosure, not a grade: a seller who names a pharmacy has made itself checkable, which is not the same as having passed the check. The point is that you get to do the checking.

How to ask

Before you pay is the moment to ask, because afterwards you are asking a company that already has your money. The question is short:

Which pharmacy compounds your NAD⁺, what state is it licensed in, and does it operate under 503A or 503B?

A seller who answers all three has told you something you can verify in ten minutes. A seller who answers with a category has answered a different question. And a seller who will not answer at all has told you something too — the same thing that a price you cannot see until you hand over your details tells you, which is that disclosure here is a choice and this one has been made.

One note on our own numbers: 3 of the 131 compounded sellers are in neither count above, because we could not establish an answer either way. They are not counted as refusing. The rest of what a vial’s paperwork should tell you — the beyond-use date and how it was stored — is a separate question, and one more sellers answer than this one.

Frequently asked

Does my NAD⁺ seller have to tell me which pharmacy compounds it?
No rule we are aware of requires the name to appear on the product page, which is why so few carry it. But a pharmacy cannot dispense you a prescription anonymously — the label on the vial that arrives should identify the dispensing pharmacy. Asking before you pay simply moves that disclosure to a point where it can still affect your decision.
What does it mean if a seller says its pharmacy is FDA-registered?
Outsourcing facilities registered under section 503B do register with FDA, so the phrase often points that way. It is a fact about a facility, not a review of the medicine: FDA does not approve compounded drugs or verify their safety, effectiveness or quality before they are marketed. If the designation matters to you, ask which section the pharmacy operates under and what the pharmacy is called.
Is a seller that names its pharmacy safer than one that does not?
It is more checkable, which is not the same thing. Naming the pharmacy lets you look up the license, the registration and the inspection history yourself, and that is a genuine advantage. It is not evidence that any particular batch was well made, and we do not treat it as a quality grade.
How do I look a pharmacy up once I have the name?
Start with your own state board of pharmacy's license lookup, which will show whether the pharmacy is licensed to ship to you. FDA publishes its list of registered outsourcing facilities, which settles the 503B question, and publishes warning letters and inspection findings searchable by firm name. Each of those takes a couple of minutes and none of them is possible without the name.

Sources

  1. [1] Centers for Disease Control and Prevention (2015). Multistate Outbreak of Fungal Meningitis and Other Infections — final case count: 753 cases, 64 deaths, 20 states CDC (archived; last reviewed 30 October 2015). Source
  2. [2] U.S. Food and Drug Administration (2026). Compounding and the FDA: Questions and Answers — oversight of 503A pharmacies and 503B outsourcing facilities FDA.gov. Source

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