Q: Is there an FDA recall on compounded NAD injections?

Compounded NAD+ recalls and FDA warnings

A:Yes, the FDA classified Apothecary Pharma's recall of compounded NAD+ injection as Class II on Oct. 8, 2026, meaning serious health problems are unlikely, FOX 10 Phoenix reports.¹ A compounded drug is a medication made by a compounder, such as a 503B outsourcing facility, and the FDA does not review it for safety, effectiveness, or quality before it reaches patients.² FOX 10 Phoenix says patients holding the recalled 200 mg/mL vial from lot AP-202647 should stop using it and contact their pharmacist or prescriber.¹

The FDA's openFDA enforcement data, updated Oct. 28, 2026, lists 14 recall records for nicotinamide adenine dinucleotide (NAD+) products. One is a GenoGenix recall started in 2025, classified Class I, that cites microbial contamination with high endotoxin levels in NAD+ for injection. The openFDA site says to assume all its results are unvalidated, so a practice should confirm any NAD+ lot against the recall letter from its compounder.³

In 2024, the FDA reminded compounders to only produce sterile drugs from components suitable for sterile compounding, warning that some were making intravenous NAD+ products from food-grade NAD+. The FDA said food-grade ingredients need appropriate processing for sterile use, due to the higher risk of microbe and endotoxin contamination. It has received NAD+ injection adverse event reports, including severe chills, shaking, vomiting, and fatigue, consistent with excessive endotoxins.⁴ For more about FDA findings on compounded injectables, see our compounded injectable risks.