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Support Your Energy, Recovery, and Long-Term Health
Clinician-guided NAD+, peptide, and metabolic programs designed to support how you feel, perform, and age — reviewed by licensed providers and delivered when prescribed. Explore all clinician-guided programs or review transparent pricing.
Treatment is prescribed only when clinically appropriate. Availability varies by state.
Important: Compounded NAD+ and peptide preparations are not FDA-approved drug products. They are prescribed only when an independent licensed medical provider determines a valid clinical need. Open Water Rx does not manufacture or dispense medications. Results vary and are not guaranteed. Read full consent →
What We Support
Feel the Difference in Your Daily Life
These programs are built around outcomes that matter. Not vague wellness promises. NAD+ and peptide therapies target cellular mechanisms that decline with age, supporting measurable improvements in energy metabolism, physical recovery, cognitive function, and long-term cellular health.
Energy
More consistent daily energy without relying on stimulants.
Recovery
Support faster recovery between workouts and daily demands.
Focus
Improved mental clarity and cognitive sharpness.
Longevity
Support healthy aging at the cellular level.
The Science Behind NAD+ and Peptide Therapy
How Do NAD+ and Peptides Support Energy and Longevity?
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell and is essential for cellular energy production, DNA repair, and the activation of sirtuins — proteins often called "longevity genes" that regulate cellular health and aging. NAD+ levels decline naturally by approximately 50 percent between the ages of 40 and 60, which researchers associate with reduced mitochondrial function, slower metabolism, and diminished cellular repair capacity.
Clinician-reviewed NAD+ therapy aims to replenish these depleted levels through targeted delivery methods. Injectable NAD+ offers the highest bioavailability, delivering the coenzyme directly into systemic circulation. Nasal spray options provide blood-brain barrier penetration for neurological support. Oral sublingual formulations offer convenience for daily maintenance routines. Your licensed medical provider selects the most appropriate delivery method based on your individual health profile and therapeutic goals.
Peptide therapies such as Sermorelin work by stimulating the body's natural growth hormone axis through the pituitary gland, supporting improved sleep architecture, lean muscle recovery, metabolic efficiency, and tissue repair. Unlike direct growth hormone administration, Sermorelin works with the body's own feedback mechanisms, potentially offering a more physiologically balanced approach. B12 MIC (Methionine, Inositol, Choline) injections combine essential vitamin B12 with lipotropic compounds that support liver function, fat metabolism, and cellular energy production.
These therapies are prescribed only when an independent licensed medical provider determines there is a valid individual clinical reason based on your complete health evaluation. They are not one-size-fits-all solutions, and they are not intended to treat, cure, or prevent any disease. Individual responses vary significantly based on age, baseline health status, adherence to protocol, and biological factors. Compounded peptide preparations are not FDA-approved finished drug products.
Compounded NAD+ and peptide preparations are not FDA-approved drug products. They are prescribed only when an independent licensed medical provider determines a valid clinical need. Open Water Rx does not manufacture or dispense medications. Results vary and are not guaranteed. Individual eligibility depends on provider review and state regulations.
Transparent Pricing
Know the cost before you start. No hidden fees.
Open Water Rx is built around clear, upfront pricing. Review program costs before you begin, with no insurance required and no surprise charges hidden behind the intake.
Clear program pricing
See starting costs before you commit.
No insurance required
Cash-pay programs with transparent pricing.
No surprise add-ons
Provider review, support, and shipping details are clearly explained.
Program Options
Clinician-Guided Longevity Programs
All therapies are reviewed and prescribed only when clinically appropriate by independent licensed providers.
NAD+ Therapy
NAD+ is a coenzyme central to cellular energy, DNA repair, and sirtuin activation. Available in injection, nasal, or oral formats when clinically appropriate.
- Injection — highest bioavailability
- Nasal spray — needle-free
- Oral sublingual — simple daily routine
- Delivery method selected by your provider
Peptide Therapy
Sermorelin and metabolic peptides support the body's natural growth hormone axis, improving sleep quality, lean muscle recovery, and metabolic efficiency.
- Sermorelin — natural GH stimulation
- Supports muscle recovery and sleep
- Works with your body's own feedback
- Prescription-only, provider-reviewed
Metabolic Support
B12 MIC combines vitamin B12 with lipotropic compounds that support fat metabolism, liver function, and energy. Often paired with GLP-1 programs.
- Vitamin B12 for energy support
- Lipotropic compounds for fat metabolism
- Liver function and detox support
- Pairs well with GLP-1 programs
Final treatment decisions are made by an independent licensed provider. Availability and options vary by state.
Pricing
Transparent, Flexible Pricing
Longer plans offer lower monthly pricing. No hidden fees. All pricing disclosed before any payment is required.
NAD+ Therapy
Sermorelin / Peptides
Metabolic Support
Microdosing Option
Longer plans offer lower monthly pricing.
Final treatment plan and pricing are determined after provider review. Pricing shown is estimated and may vary based on clinical assessment.
Our Philosophy
Support how you feel.
Not just how you look.
Longevity isn't about aesthetics. It's about having the energy, clarity, and resilience to live fully. At every age.
Why Open Water Rx
Built Around Real Medical Guidance
No shortcuts. No automated prescribing. Every program is reviewed by a licensed provider who knows your health history.
Independent licensed provider review
Every program is reviewed by a licensed medical provider — not an algorithm.
Multiple delivery methods
Injection, nasal, or oral options when clinically appropriate for your profile.
Transparent pricing before treatment
Full pricing disclosed upfront. No hidden fees, no insurance required.
Discreet shipping if prescribed
Medication ships from a licensed pharmacy partner directly to your door.
Ongoing support
Async provider access and sync visits when needed or required by your state.
Simple Process
How It Works
Everything is handled online. No waiting rooms. No in-person visits in most cases.
Complete your intake online
Answer a brief, secure health questionnaire covering your history, medications, and goals. Available 24/7. No appointment needed.
Provider reviews your health history
An independent licensed medical provider reviews your evaluation and determines which therapies, if any, are clinically appropriate for you.
If appropriate, treatment is prescribed and delivered
If a prescription is issued, medication ships from a licensed pharmacy partner directly to your door. Discreet packaging. Availability varies by state.
Eligibility
Is This Right for Me?
A licensed provider makes the final determination. This is a general guide only.
May be considered for
- Adults seeking clinician-guided energy and longevity support
- People experiencing persistent fatigue or slower recovery
- Patients seeking private, online care without insurance
- Those wanting to proactively support healthy aging
- Patients complementing a GLP-1 weight loss program
May not be appropriate for
- Pregnant or breastfeeding patients
- Patients with certain endocrine or cancer history
- Those with contraindications identified during provider review
- Patients in states where these programs are not available
- Anyone seeking guaranteed results or outcomes
FAQ
Common Questions
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell that drives cellular energy production, DNA repair, and sirtuin activation. NAD+ levels decline naturally with age. Clinician-reviewed NAD+ therapy aims to support these depleted levels through targeted delivery — injection, nasal, or oral formats.
Compounded peptide preparations are not FDA-approved finished drug products. They are compounded by licensed, FDA-registered 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.
No. Treatment is only prescribed when an independent licensed provider determines it is clinically appropriate for your individual health profile. Not all patients qualify. Completing an intake does not guarantee a prescription.
Availability varies by state. Some states require a synchronous video consultation before treatment can be initiated. You will be informed of your state's requirements during the intake process.
Pricing depends on the program selected and the plan length. Longer plans offer lower monthly pricing. Final treatment plan and pricing are confirmed after provider review. All pricing is disclosed before any payment is required.
Start with clarity. Continue with real support.
Complete your intake to see which longevity program may be appropriate for you. No commitment required to begin.
Compounded NAD+ and peptide preparations are not FDA-approved drug products. They are prescribed only when an independent licensed medical provider determines a valid clinical need. Open Water Rx does not manufacture or dispense medications. Results vary and are not guaranteed.
Longevity Science
Understanding NAD+ and Peptide Therapy for Energy and Healthy Aging
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell and is essential for over 500 enzymatic reactions in the human body. It serves as a critical cofactor in cellular energy production through the Krebs cycle and oxidative phosphorylation, powers the DNA repair enzyme PARP, and activates sirtuins — a family of proteins often called "longevity genes" that regulate cellular stress resistance, inflammation, and metabolic health. Research published in peer-reviewed journals including Cell Metabolism and Nature Reviews Molecular Cell Biology has documented that NAD+ levels decline by approximately 50 percent between the ages of 40 and 60, correlating with reduced mitochondrial function, slower metabolism, and diminished cellular repair capacity.
Clinician-reviewed NAD+ therapy aims to replenish these depleted levels through targeted delivery methods selected by your licensed medical provider based on your individual health profile. Subcutaneous injection offers the highest bioavailability, delivering NAD+ directly into systemic circulation for maximum cellular uptake. Intranasal spray provides an alternative delivery route that some research suggests may offer blood-brain barrier penetration for neurological support. Oral sublingual formulations use absorption under the tongue to bypass first-pass liver metabolism, potentially improving bioavailability compared to standard oral supplements. Your provider determines the most appropriate delivery method based on your therapeutic goals, health history, and individual circumstances.
Peptide therapies represent another frontier in longevity medicine. Sermorelin, a growth hormone-releasing hormone analogue, works by stimulating the pituitary gland to increase endogenous growth hormone production. Unlike exogenous synthetic human growth hormone, which can suppress natural production and carries significant side effect risks, Sermorelin works with the body's own feedback mechanisms to maintain physiological balance. Clinical studies have associated Sermorelin therapy with improved sleep architecture, increased lean muscle mass, enhanced recovery from exercise, and improved metabolic markers including lipid profiles and insulin sensitivity.
B12 MIC injections combine essential vitamin B12 with three lipotropic compounds — Methionine, Inositol, and Choline — that support liver function, fat metabolism, and cellular energy production. Methionine is an essential amino acid that aids in breaking down fats and preventing their accumulation in the liver. Inositol supports insulin sensitivity and mood regulation. Choline is critical for neurotransmitter synthesis and cellular membrane integrity. Together, these compounds provide foundational metabolic support that complements both weight loss and longevity programs. All therapies are prescribed only when an independent licensed provider determines clinical appropriateness for your individual health profile.
Cellular Mechanisms of NAD+
Energy Production: NAD+ is an essential electron carrier in mitochondrial respiration, transferring energy from nutrients to ATP, the cellular energy currency. Without adequate NAD+, mitochondria cannot efficiently convert food into usable energy.
DNA Repair: When DNA damage occurs from oxidative stress, UV exposure, or normal metabolic byproducts, the enzyme PARP consumes NAD+ to execute repair processes. NAD+ depletion impairs this critical maintenance function.
Sirtuin Activation: Sirtuins are NAD+-dependent enzymes that regulate gene expression, inflammation, and metabolic health. They are considered central mediators of the health benefits associated with calorie restriction and exercise.
Circadian Rhythm: NAD+ synthesis follows a circadian pattern, and adequate levels help maintain proper sleep-wake cycles and metabolic timing. Disrupted NAD+ rhythms have been associated with metabolic syndrome.
Peptide Therapy Overview
Sermorelin: A GHRH analogue that stimulates natural growth hormone release from the pituitary gland. Supports muscle recovery, sleep quality, and metabolic efficiency without the risks of synthetic HGH.
BPC-157: A pentadecapeptide studied for its regenerative effects on tissues including tendons, ligaments, and the gastrointestinal tract. Research suggests anti-inflammatory and wound-healing properties.
Ipamorelin: A selective growth hormone secretagogue that stimulates GH release without significantly increasing cortisol or prolactin, offering a targeted approach to growth hormone support.
B12 MIC: Combines vitamin B12 with Methionine, Inositol, and Choline to support liver function, fat metabolism, and cellular energy. Often paired with GLP-1 weight loss programs for comprehensive metabolic support.
Important Clinical Information
Compounded NAD+ and peptide preparations are not FDA-approved finished 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 based on your complete health evaluation. Open Water Rx does not manufacture, compound, or dispense medications. All compounding is performed by independent licensed pharmacies. Individual results vary significantly based on age, baseline health status, adherence to protocol, and biological factors. These therapies are not intended to diagnose, treat, cure, or prevent any disease. Establishing a valid patient-provider relationship through our telehealth platform is required before any prescription can be issued.
Clinician-guided longevity programs
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