NMN and medications.
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; trials used 250mg (Yoshino, Igarashi) and 1,000mg (Pencina), and no trial has tested 500mg. The single most important point is a hard one: NMN is contraindicated with any cancer history. Preclinical studies show NAD+ precursors can support tumour cell survival and spread, and while human data are absent, the safe position is to exclude it entirely, so a cancer history must always be confirmed clear before use. On drug interactions, the one to raise is diabetes medication: NMN may modestly improve how the body responds to insulin, so alongside gliclazide or injected insulin your blood sugar could in theory go lower than your dose is set for. This has not been studied directly, and the people in the NMN trials were taking no diabetes medication, so treat it as a precaution rather than a finding: monitor your levels and speak to your diabetes team before starting. 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
Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive glucose lowering
Amber Does interact with Gliclazide?
Taking NMN with gliclazide could in theory push blood sugar lower than intended, because NMN may modestly improve how your body responds to insulin and gliclazide also lowers blood sugar. 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.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Insulin aspart?
Taking NMN while you inject insulin could in theory lower blood sugar more than your current dose is set for, because NMN may modestly improve how your body responds to insulin. This has not been studied directly. If you take both, monitor your blood sugar and speak to your diabetes team before starting.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
Amber Does interact with Insulin glargine?
Taking NMN while you inject insulin could in theory lower blood sugar more than your current dose is set for, because NMN may modestly improve how your body responds to insulin. This has not been studied directly. If you take both, monitor your blood sugar and speak to your diabetes team before starting.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
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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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.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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