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NAD+ & Peptide Therapy
Clinician-Reviewed Online
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, FDA-registered pharmacy partners. Availability varies by state.
No commitment required · Availability varies by state
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 →
What We Offer
What is NAD+ & Peptide Therapy?
NAD+ (nicotinamide adenine dinucleotide) is a coenzyme essential for cellular energy production and DNA repair. Peptides like Sermorelin support natural growth hormone release, muscle recovery, and metabolic health. Through Open Water Rx, eligible patients complete a brief online health evaluation, receive a licensed provider review, and if approved, have their prescription shipped to their door. No insurance required. No in-person visit in most cases. Compounded NAD+ and peptide preparations are not FDA-approved.
5+
NAD+ & peptide therapy options reviewed by licensed providers
100%
Online - no waiting room, no in-person visit required in most cases
50
States served: patients accepted nationwide
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Insurance required - clear upfront pricing, no prior authorizations
The Science
Why NAD+ Declines, and Why It Matters
NAD+ levels decline by roughly 50% between ages 40 and 60. This decline is associated with reduced mitochondrial function, slower DNA repair, decreased sirtuin activity, and the general fatigue and recovery slowdown many people attribute to "just getting older." Clinician-reviewed NAD+ therapy aims to replenish these levels through targeted delivery methods.
Peptide therapies like Sermorelin work alongside NAD+ programs by supporting the body's natural growth hormone axis, improving sleep quality, lean muscle recovery, and metabolic efficiency without the risks associated with synthetic HGH.
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. Availability varies by state.
Program Options
NAD+ & Peptide Therapy Options
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+ Injection
Subcutaneous NAD+ injection delivers the coenzyme directly into the bloodstream for maximum cellular uptake. Clinician-reviewed and prescribed only when appropriate.
- Supports cellular energy (ATP)
- DNA repair pathways
- Sirtuin activation
- Fastest onset of options
NAD+ Nasal Spray
A convenient intranasal delivery option for patients who prefer to avoid injections. Clinically reviewed and prescribed when appropriate.
- No needles required
- Convenient daily use
- Supports energy & focus
- Easy travel-friendly format
NAD+ Oral Dropper
Sublingual oral NAD+ dropper for patients seeking a simple, non-injectable option. Absorbed under the tongue for improved bioavailability vs. standard oral supplements.
- Sublingual absorption
- Simple daily routine
- No injection required
- Clinician-reviewed dosing
Sermorelin Injection
Sermorelin is a GHRH analogue that stimulates your pituitary to produce its own growth hormone. Supports muscle recovery, fat metabolism, and sleep quality.
- Stimulates natural GH production
- Supports lean muscle recovery
- Improves sleep quality
- Works with body's own feedback
B12 MIC Injection
Combines vitamin B12 with lipotropic compounds (Methionine, Inositol, Choline) to support energy, fat metabolism, and liver function. Often paired with weight loss programs.
- Supports fat metabolism
- Boosts energy levels
- Liver function support
- Pairs well with GLP-1 programs
All treatments are prescribed only when clinically appropriate by independent licensed providers. Compounded medications are not approved finished drug products. Availability and product options vary by state.
Simple 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. Availability varies by state.
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
B12 MIC injections and peptides 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.
Find Your Match
Which Medication Should I Choose?
Answer 3 quick questions and we'll surface a personalised recommendation. Your licensed medical provider makes the final decision. This is just a starting point.
What is your monthly budget for treatment?
Both medications include provider review, prescription if approved, and shipping included if prescribed.
This quiz is for informational purposes only. Final medication selection is made by a licensed medical provider.
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 energy, slower recovery, and accelerated cellular aging. Supplementing NAD+ through clinician-reviewed programs may help support cellular energy and longevity pathways.
Peptides are short chains of amino acids that act as signaling molecules in the body. Therapeutic peptides like Sermorelin stimulate the pituitary gland to produce more growth hormone, supporting muscle recovery, fat metabolism, and sleep quality. 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.
Open Water Rx offers multiple NAD+ delivery formats when clinically appropriate: subcutaneous injection (highest bioavailability), nasal spray (convenient, no needles), and oral sublingual dropper. Your licensed provider will recommend the most appropriate option based on your health profile and goals.
Sermorelin is a growth hormone-releasing hormone (GHRH) analogue that stimulates your pituitary gland to produce its own growth hormone naturally. Unlike synthetic HGH injections, Sermorelin works with your body's own feedback mechanisms, which many clinicians consider a safer and more physiologically appropriate approach. It is a prescription-only medication reviewed and prescribed only when clinically appropriate.
B12 MIC (Methionine, Inositol, Choline) injections combine vitamin B12 with lipotropic compounds that support fat metabolism, liver function, and energy levels. They are commonly used alongside weight loss or longevity programs. As with all treatments, they are prescribed only when clinically appropriate by a licensed provider.
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. Availability varies by state.
Compounded NAD+ and 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. All prescribing decisions are made solely by independent licensed providers.
Pricing varies by program and delivery method. Your provider will outline specific costs during your clinical review. All pricing is disclosed upfront before you pay. No insurance required. No hidden fees.
Ready to Support Your Energy & Longevity?
Get started today. No commitment required. Availability varies by state.
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Am I Eligible?
Check your eligibility for any Open Water Rx program. Availability varies by state.
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 cumulative effect is a roughly 50 percent reduction in tissue NAD+ levels between ages 40 and 60.
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. However, direct NAD+ administration — through injection, nasal spray, or sublingual delivery — may offer more immediate bioavailability compared to precursor conversion, which requires multiple enzymatic steps.
Peptide therapies represent a complementary approach to longevity medicine. Sermorelin has been studied in clinical settings for over two decades and has demonstrated a favorable safety profile compared to synthetic growth hormone. Research suggests it can improve body composition, bone density, sleep quality, and cardiovascular risk markers in adults with age-related growth hormone decline. BPC-157, while less extensively studied in humans, has shown promising regenerative 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+ and peptide therapies are supported by peer-reviewed research published in journals including Cell Metabolism, NEJM, and PNAS. Human clinical trials have demonstrated safety and efficacy signals for NMN, NR, and Sermorelin.
Safety Profile
Sermorelin and NAD+ precursors have favorable safety profiles in published human studies. Direct NAD+ administration has been used in clinical settings with monitored dosing. Side effects are typically mild and transient.
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
All compounded medications provided through Open Water Rx are prepared by independent licensed compounding pharmacies registered with the FDA and operating under Section 503A or 503B of the Federal Food, Drug, and Cosmetic Act. These pharmacies adhere to United States Pharmacopeia (USP) standards including USP <797> for sterile compounding and USP <795> for non-sterile compounding. Quality assurance includes testing for potency, sterility, and endotoxins. Open Water Rx does not manufacture, compound, or dispense any medications. We connect patients with independent licensed providers who make prescribing decisions and independent licensed pharmacies that prepare and ship medications. This separation of clinical and pharmacy services ensures that prescribing decisions are based solely on clinical judgment rather than commercial interests.
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