If you experience persistent discomfort, discontinue use and consult a healthcare provider
Nevertheless, regardless of which medication you use, counting begins from first use, not from when you first removed it from refrigeration

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These can include: Nausea Vomiting Diarrhea Constipation Stomach pain or discomfort Often, these side effects are mild and tend to get better as your body adjusts to the medication
In a study that examined urinary excretion of NAM and niacin metabolites, both oral NAM and NAD + produced similar excretion levels, suggesting the NAD + had similar (but not better) niacin activity
No regulatory body has cleared it for any medical use