NAD+ Nasal Spray & Sermorelin
Compare Options. See Your Price.
Support cellular energy, recovery, and healthy aging with clinician-reviewed NAD+ and peptide programs. Multiple delivery options when clinically appropriate. Prescriptions issued only when clinically appropriate. Medications fulfilled by licensed pharmacy partners. Available nationwide in all 50 states.
NAD+ nasal spray 900 mg: $112 for 1 month; oral sermorelin low dose: $149 for 1 month or $429 for 3 months; injectable sermorelin low dose: $169 for 1 month.
Provider review required · Available nationwide in all 50 states
5+
NAD+ & peptide therapy options reviewed by licensed providers
100%
Online - no waiting room, no in-person visit required in most cases
U.S.
Telehealth coverage: available nationwide in all 50 states
No
Insurance Required. Clear cash-pay pricing. No prior authorization needed.
The Science
Why NAD+ Declines, and Why It Matters
NAD+ levels decline with age — a pattern documented across muscle, brain, and other tissues, though the rate varies by tissue and by person. That decline is associated with reduced mitochondrial function, slower DNA repair, and decreased sirtuin activity. Clinician-reviewed NAD+ therapy is built around that biological role in cellular energy metabolism.
Clinician-reviewed peptide therapies may work alongside NAD+ programs by supporting recovery and metabolic function when prescribed by an independent licensed provider. All peptide and NAD+ therapies are prescribed only when clinically appropriate for the individual patient.
Through Open Water Rx, eligible patients receive an independent licensed clinician review and, if a prescription is issued, medication ships from a licensed pharmacy partner directly to their door. Available nationwide in all 50 states.
Program Options
Compare NAD+ Nasal Spray & Sermorelin Plans
All therapies are reviewed and prescribed only when clinically appropriate by independent licensed providers. Availability and options vary by state and individual health profile.
NAD+ Nasal Spray+ (1200 mg)
Nasal spray · 1200 mg
Sermorelin Injections High Dose
Injectable · High dose
Sermorelin Injections Low Dose
Injectable · Low dose
Sermorelin Orals High Dose
Oral · High dose
Sermorelin Orals Low Dose
Oral · Low dose
Prices are totals for the stated supply, not monthly charges for multi-month plans. View full pricing.
Same price at every dose applies to GLP-1 weight-loss programs — your monthly cost does not increase as your provider adjusts your dose. The NAD+ and sermorelin options shown here are separate products, each with its own listed price.
All treatments are prescribed only when clinically appropriate by independent licensed providers. Availability and product options vary by state.
Buying Guide
NAD+ Nasal Spray Buying Guide
Compare the current 900 mg and 1,200 mg nasal-spray options. Every figure below is a one-time cycle total for the stated supply term — not a recurring monthly charge — with a monthly equivalent shown alongside for comparison only.
NAD+ Nasal Spray (900 mg)
Nasal spray · 900 mg
Cycle total for the stated supply term. Monthly equivalents are shown for comparison only and are not a separate charge.
NAD+ Nasal Spray+ (1200 mg)
Nasal spray · 1200 mg
Cycle total for the stated supply term. Monthly equivalents are shown for comparison only and are not a separate charge.
Multi-month prices are one-time totals for the full supply term, not monthly fees. No insurance required. Provider review is required and available nationwide in all 50 states.
Evidence limitations
NAD+ plays a well-established role in cellular energy metabolism and remains an active area of research, but that biological rationale is not the same as established clinical benefit. Compounded NAD+ nasal spray has not been shown in controlled trials to be equivalent to intravenous or injectable NAD+, and this page does not promise energy, anti-aging, recovery, or any other specific outcome. Individual results vary and are not guaranteed. An independent licensed provider determines whether a nasal-spray program is clinically appropriate for you.
Common buying questions
What does a NAD+ nasal-spray plan cost?
NAD+ Nasal Spray (900 mg) - 1 month: $112 total. NAD+ Nasal Spray+ (1200 mg) - 1 month: $179 total; 3 months: $507 total (about $169/mo); 6 months: $954 total (about $159/mo). Multi-month figures are one-time cycle totals for the stated supply, not monthly charges. No insurance is required, and provider review is required before any prescription.
What is included in the plan?
A brief online health evaluation, review by an independent licensed provider, the compounded medication if a prescription is issued, and discreet shipping from a licensed pharmacy partner where applicable. Pricing is disclosed before you pay, and no insurance is required.
How does provider review work?
After you complete a brief online health evaluation, an independent licensed medical provider reviews your health history, current medications, and goals, then determines whether NAD+ nasal spray is clinically appropriate. Prescriptions are issued only when there is a valid individual clinical reason, and some states may require a synchronous initial visit. Available nationwide in all 50 states.
Product details
Surfbound Health is a consumer brand operated by Open Water Rx LLC — the two sites share the same operator, so this is an affiliated destination, not an independent third-party review or rating. Compounded NAD+ preparations are prescribed only when an independent licensed provider determines there is a valid individual clinical reason.
View NAD+ product details on SurfboundSimple Process
How to Get Started with NAD+ & Peptide Therapy
Everything is handled online. No waiting rooms. No in-person visits in most cases. A licensed provider reviews your case and determines what, if anything, is clinically appropriate for you.
Complete Your Health Evaluation
Answer a brief online health questionnaire covering your health history, goals, and current medications. Available 24/7 from any device. No appointment needed.
Licensed Provider Reviews Your Case
An independent licensed medical provider reviews your evaluation and determines which therapies, if any, are clinically appropriate. Prescriptions are issued only when there is a valid individual clinical reason. Some states may require a synchronous initial visit.
Medication Delivered to Your Door
If a prescription is issued, your medication ships from a licensed pharmacy partner directly to your address. Discreet packaging. Shipping included in your program price where applicable. Available nationwide in all 50 states.
Who It's For
Is NAD+ & Peptide Therapy Right for You?
These programs are designed for adults who want to proactively support their energy, recovery, and long-term health. A licensed provider will determine clinical appropriateness based on your individual health profile.
Persistent fatigue or low energy
Despite adequate sleep and nutrition, you feel chronically low on energy or mental clarity.
Slower recovery from exercise
Muscle soreness lasts longer than it used to, or you feel you can't push as hard as before.
Interested in healthy aging
You want to proactively support cellular health and longevity, not just treat symptoms.
Complementing a GLP-1 program
Peptide programs can complement weight loss programs for metabolic support.
Included With Every Program
Built-in support, not an add-on.
Ongoing Provider Support
Async provider review and sync video visits when needed or required. Your provider guides your program.
Lab-Guided Care
Labs through Quest Diagnostics and Labcorp when clinically indicated. Results reviewed before treatment decisions.
Discreet Delivery
When medication is prescribed, it ships directly to your door. Discreet packaging. Shipping included where applicable.
No Insurance Required
Clear, upfront pricing. No prior authorizations, no insurance battles. Everything disclosed before you pay.
FAQ
NAD+ & Peptide Therapy Questions Answered
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell of your body. It plays a central role in cellular energy production (ATP synthesis), DNA repair, and the activation of sirtuins - proteins linked to healthy aging. NAD+ levels naturally decline with age, which is associated with reduced cellular energy and slower recovery. Clinician-reviewed NAD+ programs are designed to support cellular energy metabolism when a licensed provider determines they are appropriate.
Peptides are short chains of amino acids that act as signaling molecules in the body. Therapeutic peptides may support tissue repair, recovery, and metabolic function when clinically appropriate. BPC-157 is studied for tissue repair and gut health. Each peptide has a specific mechanism and is prescribed only when clinically appropriate by a licensed provider.
Current NAD+ options are nasal sprays in 900 mg and 1200 mg strengths. Sermorelin is a separate peptide program with oral and injectable options. A licensed provider determines which treatment, if any, is clinically appropriate. Available nationwide in all 50 states.
Peptide therapy involves clinician-reviewed options that may support recovery, metabolic function, and tissue repair through signaling pathways. These are prescribed only when a licensed provider determines clinical appropriateness. Individual results vary and are not guaranteed.
B12 MIC (Methionine, Inositol, Choline) is a combination of vitamin B12 with the metabolic compounds methionine, inositol, and choline, which support liver function and energy levels. B12 MIC is described here for educational purposes and is not currently offered as a program through Open Water Rx.
Complete a brief online health evaluation (about 5 minutes). A licensed medical provider reviews your intake and determines which therapies, if any, are clinically appropriate for you. If a prescription is issued, your medication ships from a licensed pharmacy partner directly to your door. No in-person visit required in most cases. Available nationwide in all 50 states.
Compounded NAD+ and peptide preparations are compounded by licensed pharmacies for individual patients when a licensed medical provider determines there is a valid individual clinical reason. Open Water Rx does not manufacture, compound, or dispense medications. All prescribing decisions are made solely by independent licensed providers.
NAD+ nasal spray 900 mg is $112 for a 1-month supply. NAD+ nasal spray 1200 mg is $179 for 1 month, $507 total for 3 months, or $954 total for 6 months. Oral sermorelin low dose is $149 for 1 month or $429 for 3 months; injectable sermorelin low dose is $169 for 1 month. Compare all listed strength and supply options on this page. Multi-month prices are totals for the stated supply, not monthly charges. Provider review is required; available nationwide in all 50 states.
Ready to Support Your Energy & Longevity?
Get started today. Provider review required. Available nationwide in all 50 states.
Start Intake FormHigh Quality
Licensed pharmacy partners.
Zero Friction
Simple online intake. Provider reviewed.
Radical Transparency
Clear pricing before checkout.
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Am I Eligible?
Check your eligibility for any Open Water Rx program. Available nationwide in all 50 states.
Check eligibility →
Full FAQ
All your questions about Open Water Rx programs answered in one place.
Read the FAQ →
Research & Evidence
The Science Behind NAD+ Decline and Therapeutic Intervention
The scientific understanding of NAD+ biology has expanded dramatically over the past two decades. NAD+ was first identified in 1906 as a fermentation factor in yeast, but its role in human aging and metabolic health has only become clear through modern molecular biology research. Today, over 500 enzymatic reactions in the human body require NAD+ as a cofactor, making it one of the most critical molecules for cellular function. NAD+ exists in two forms — NAD+ (oxidized) and NADH (reduced) — and the ratio between these forms regulates cellular redox state, energy metabolism, and signaling pathways.
Research published in Cell Metabolism, Nature Reviews Molecular Cell Biology, and the Proceedings of the National Academy of Sciences has established that NAD+ levels decline with age across multiple tissues including muscle, liver, brain, and adipose tissue. This decline is attributed to several factors: increased consumption by DNA repair enzymes (particularly PARP1) due to accumulated DNA damage, upregulation of NAD+-consuming enzymes like CD38 on inflammatory cells, reduced NAD+ biosynthesis from precursors, and impaired salvage pathway recycling. The size of that decline varies by tissue and by individual, and studies generally report a substantial age-related drop rather than a single fixed percentage.
Animal studies have shown that restoring NAD+ levels through precursor supplementation or direct NAD+ administration can improve mitochondrial function, enhance insulin sensitivity, increase physical performance, and extend healthspan in model organisms. In human clinical trials, NAD+ precursors like NMN and NR have demonstrated safety and have been associated with improved markers of cardiovascular health, muscle function, and metabolic parameters. Direct NAD+ administration — by injection, nasal spray, or sublingual delivery — skips the multi-step enzymatic conversion that precursors require. But head-to-head human trials have not shown that it delivers greater clinical benefit, and bioavailability from a nasal spray specifically has not been well characterized in humans.
Peptide therapies represent a complementary approach to longevity medicine when prescribed by an independent licensed provider. Research into various peptides continues, with some showing promising effects in animal models including accelerated tendon healing, gut mucosal protection, and anti-inflammatory activity. All peptide and NAD+ therapies offered through Open Water Rx are prescribed only when an independent licensed provider determines clinical appropriateness for the individual patient.
Clinical Research
NAD+ biology is covered extensively in peer-reviewed literature, including Cell Metabolism and PNAS. Human trials of the oral precursors NMN and NR have reported safety and some biomarker signals — those trials did not study the compounded nasal spray offered here. Peptide therapies continue to be studied in clinical research settings.
Safety Profile
NAD+ precursors have favorable safety profiles in published human studies, where reported side effects were generally mild. Direct NAD+ has been used clinically, most often intravenously under monitoring; published safety data specific to compounded nasal spray is limited. Peptide therapy safety profiles vary by specific compound and require individual clinical assessment.
Individual Assessment
Not all patients are candidates for NAD+ or peptide therapy. Your licensed provider reviews your complete health history, current medications, and goals before determining clinical appropriateness.
Regulatory and Quality Standards
Every compounded medication on this page is prepared by an independent, state-licensed 503A compounding pharmacy — licensed and overseen by its state board of pharmacy, not an FDA-registered 503B outsourcing facility. These are traditional patient-specific pharmacies: they compound only against a prescription written for you by an independent licensed provider. Injectable sermorelin is compounded under USP <797>, the standard for sterile compounding, which addresses sterility assurance and bacterial endotoxin testing. NAD+ nasal spray and oral sermorelin are non-sterile and are compounded under USP <795>. Open Water Rx does not manufacture, compound, or dispense any medication — we connect you with independent licensed providers who make prescribing decisions and independent licensed pharmacies that prepare and ship your order, so those decisions rest on clinical judgment rather than commercial interest.
Important Notice: Compounded NAD+ and peptide preparations are not FDA-approved drug products and have not been evaluated by the FDA for safety, efficacy, or quality. They are prescribed only when an independent licensed medical provider determines there is a valid individual clinical reason. A valid patient-provider relationship (VPPPR) must be established before any prescription is issued. Open Water Rx does not manufacture, compound, or dispense medications. Individual results vary and are not guaranteed. Read full consent →