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NAC with NMN or NR: daily dose, symptom and lab log

List what you take, check whether you belong to a group this page says should see a clinician first, then log each day's NAC and NMN or NR doses with any stomach symptoms, and record homocysteine, liver tests and creatinine at baseline and about 3 months.

Companion to “Can I Take NAC with NMN or NR? A Clinical Review of Safety, Interactions, and Dosing” · healthrx.com/supplements-nad-nmn/with-nac · Facts checked 2026-10-18

What you take

NAC: product, mg per dose and doses a day
NMN or NR: product and mg a day
Other supplementsfor example TMG or B vitamins
Prescription medicinesfor example metformin, clomiphene, letrozole or cancer treatment

See a clinician before combining if any apply

  • Chronic kidney disease, stage 3 or worse
  • PCOS treated with metformin, clomiphene or letrozole
  • Current cancer treatment
  • Pregnancy, or under 18
  • Planning more than 1,000 mg of NMN a day

What single-supplement trials found

  • Oral NAC 1.8 g/day for 4 weeks lowered fasting plasma homocysteine by 11.7% on average (placebo: up 4.1%) and raised plasma cysteine by 28.1%.[1]
  • NR at 3,000 mg/day for 4 weeks raised serum homocysteine by 1.66 µmol/L on average, without depleting the methyl group pool.[2]
  • Only 6 to 10% of an oral NAC dose reaches the bloodstream unchanged, and about 30% of its clearance is through the kidneys.[3]

Daily log

DateNAC dose and timeNMN or NR dose and timeWith food?Nausea, bloating or loose stoolsNotes

Labs at baseline and about 3 months

TestBaseline date and resultFollow-up date and resultNotes
Homocysteine
ALT and AST
Creatinine or eGFR
Other

Questions for your clinician or pharmacist

  1. Should we check my homocysteine before I start and again in about 3 months?
  2. Does my kidney function change whether NAC suits me?
  3. Do any of my prescriptions interact with NAC?
  4. If my homocysteine rises, which of the two should I stop first?
Sources for the facts on this sheet
  1. Hildebrandt W, Sauer R, Bonaterra G, et al. Oral N-acetylcysteine reduces plasma homocysteine concentrations regardless of lipid or smoking status. Am J Clin Nutr 2015. PMID 26447155. https://pubmed.ncbi.nlm.nih.gov/26447155/
  2. Berven H, Kverneng S, Sheard E, et al. NR-SAFE: a randomized, double-blind safety trial of high dose nicotinamide riboside in Parkinson's disease. Nat Commun 2023. PMID 38016950. https://pubmed.ncbi.nlm.nih.gov/38016950/
  3. Borgström L, Kågedal B, Paulsen O. Pharmacokinetics of N-acetylcysteine in man. Eur J Clin Pharmacol 1986. PMID 3803419. https://pubmed.ncbi.nlm.nih.gov/3803419/

This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.