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Supplement · Grade C

NMN and medications.

Every documented pair, every citation. Below: 3 documented pairs grouped by mechanism.

NMN is classified as a targeted supplement in the Distil database, evidence Grade C. The page below lists every medication we have explicitly assessed it against.

NMN is a precursor to NAD+, a coenzyme central to energy metabolism that declines with age, most steeply after 40. It is graded C but upgrading, since human RCTs since 2020 consistently show NMN raises blood NAD+ and point to emerging functional benefits. Yoshino 2021 found 250mg/day improved muscle insulin sensitivity in prediabetic women, Igarashi 2022 showed muscle effects in older men, and Pencina 2023 reported improvements in cholesterol, blood pressure, and body weight at 1,000mg/day; a 2026 meta-analysis found modest blood pressure reductions in people over 60. The honest position is that this is an informed personal choice, not an established recommendation, and 500mg appears a reasonable midpoint. The single most important point is a hard one: NMN is contraindicated with any cancer history, because NAD+ fuels cell proliferation, so a cancer history must always be confirmed clear before use. It is otherwise well tolerated, with mild stomach upset and a common five-days-on, two-days-off pattern.

Below are the 3 documented pairs we have explicitly assessed for NMN: 3 amber. The pairs cluster around 1 mechanism: Additive glucose lowering. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not listed here is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by medication, and the missing-item form at the bottom of the page routes any uncatalogued medication into our next curation pass.

Documented interactions

Additive glucose lowering

Amber Gliclazide

NMN may modestly improve how your body responds to insulin. If you take gliclazide, which lowers blood sugar, the two together could in theory push blood sugar lower than intended. This has not been studied directly. If you take both, monitor for signs of low blood sugar and speak to your diabetes team before starting.

PMID 33888596 · PMID 38191197 · BNF: Gliclazide

Reviewer-flagged: awaiting clinical-reviewer sign-off.

NMN may modestly improve how your body responds to insulin. If you inject insulin, the two together could in theory lower blood sugar more than your current dose is set for. This has not been studied directly. If you take both, monitor your blood sugar and speak to your diabetes team before starting.

PMID 33888596 · PMID 38191197 · BNF: Insulin aspart

Reviewer-flagged: awaiting clinical-reviewer sign-off.

NMN may modestly improve how your body responds to insulin. If you inject insulin, the two together could in theory lower blood sugar more than your current dose is set for. This has not been studied directly. If you take both, monitor your blood sugar and speak to your diabetes team before starting.

PMID 33888596 · PMID 38191197 · BNF: Insulin glargine

Reviewer-flagged: awaiting clinical-reviewer sign-off.

What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope. Use the checker below to surface any medication, and submit a missing item if you take something we have not catalogued.

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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.
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How we decide

How we grade severity, choose what's in scope, and what we exclude.

Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.