Class
This group collects compounds marketed on cellular energy and metabolic aging: a coenzyme, a tripeptide antioxidant, a mitochondrially encoded peptide, and one approved drug that no provider menu offers. The first three are sold by the same providers to the same customers, and the pairing is commercial rather than biochemical.
Their legal positions could hardly differ more. NAD+ sits in Category 1 and is compounded lawfully every day; MOTS-c awaits rulemaking after an advisory vote and may not be compounded at all; elamipretide holds an approval for a rare genetic disorder and reaches nobody through this market. A provider menu that lists the first two without distinction is collapsing exactly the line this index exists to draw.
Molecules in this class
| Molecule | Class | US status | Position |
|---|---|---|---|
| NAD+Nicotinamide adenine dinucleotide | Mitochondrial | Compoundable (503A) | Category 1 of the interim 503A bulks list; compoundable with a valid prescription while FDA evaluates. Verified August 2026. |
| Glutathione | Mitochondrial | Compoundable (503A) | Category 1 of the interim 503A bulks list; compoundable with a valid prescription. Verified August 2026. |
| MOTS-c | Mitochondrial | PCAC-recommended · pending | Removed from Category 2 in April 2026; PCAC recommended 503A listing in July 2026 on a reported tally; no FDA final rule. Verified August 2026. |
| ElamipretideSS-31; MTP-131; Forzinity | Mitochondrial | FDA-approved | Approved September 2025 as Forzinity under accelerated approval for Barth syndrome; the only approved product in this index's mitochondrial group. |
Nicotinamide adenine dinucleotide
Category 1 of the interim 503A bulks list; compoundable with a valid prescription while FDA evaluates. Verified August 2026.
Category 1 of the interim 503A bulks list; compoundable with a valid prescription. Verified August 2026.
Removed from Category 2 in April 2026; PCAC recommended 503A listing in July 2026 on a reported tally; no FDA final rule. Verified August 2026.
SS-31; MTP-131; Forzinity
Approved September 2025 as Forzinity under accelerated approval for Barth syndrome; the only approved product in this index's mitochondrial group.
The particulars are at NAD+ and MOTS-c; glutathione shares the group's market position and NAD+'s legal one, and elamipretide is the only member with an approved product behind it.
The advisory committee voted on one member in July 2026, as reported in secondary accounts (FDA has published no vote record): MOTS-c 7–5 with 2 abstaining.
The 2026 WADA Prohibited List names MOTS-c (section S4.4.1). It does not name NAD+ and Glutathione, and that is not the same as permitted: the relevant sections are expressly non-exhaustive, and section S0 covers any substance with no current approval for human therapeutic use.
The vote ledger and the WADA table carry the sources.
Evidence reviews
Reference tables
Definitions