What volume of bacteriostatic water is required to reconstitute a 1000 mg vial of NAD⁺ (nicotinamide adenine dinucleotide)?

NAD+ Reconstitution Protocol

For a 1000 mg vial of NAD+, add 10 mL of bacteriostatic water to achieve a standard concentration of 100 mg/mL. This follows established pharmaceutical reconstitution principles where stock solutions should be prepared at concentrations of 1000 mg/L (equivalent to 1 mg/mL) or greater, with higher concentrations preferred for stability and dosing flexibility 1, 2.

Standard Reconstitution Approach

• Add 10 mL of bacteriostatic water to the 1000 mg vial to create a 100 mg/mL solution 1, 2
• This concentration allows for flexible dosing while maintaining solution stability
• The powder itself contributes approximately 1 mL to the final volume, similar to other lyophilized medications, resulting in a total volume of approximately 11 mL 3

Alternative Concentrations

If different dosing requirements exist, you can adjust the reconstitution volume:

• For 50 mg/mL concentration: Add 20 mL bacteriostatic water 1
• For 200 mg/mL concentration: Add 5 mL bacteriostatic water 1
• Higher concentrations reduce injection volumes but may affect stability

Critical Reconstitution Technique

• Sanitize the vial stopper with 70% isopropanol before needle puncture 1
• Use sterile technique throughout to avoid direct contact contamination of the needle, syringe, and vial stopper 1
• Inject the bacteriostatic water slowly down the side of the vial to minimize foaming
• Gently swirl (do not shake vigorously) until completely dissolved
• Perform visual inspection after mixing for clarity, particulate matter, and physical integrity of the solution 1

Storage and Stability Considerations

• Label the vial clearly with the patient's name, concentration, reconstitution date, and beyond-use date 1
• Bacteriostatic water contains preservatives (typically 0.9% benzyl alcohol) that allow for multi-dose use over 28 days when refrigerated
• Store reconstituted NAD+ refrigerated at 2-8°C (36-46°F)
• Do not store reconstituted solutions long-term unless stability data supports it, as many compounds are particularly unstable after reconstitution 3, 2
• Discard if solution becomes discolored or develops particulate matter

Common Pitfalls to Avoid

• Never use sterile water for injection (SWFI) without preservative for multi-dose vials, as this creates contamination risk 1
• Avoid over-dilution, which may compromise stability and require larger injection volumes
• Do not use if the powder has been exposed to moisture or is discolored before reconstitution
• Reconstituted solutions have limited stability; use within the recommended timeframe and do not assume extended shelf life without data 3, 2