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Contact Your Doctor Immediately If You Experience: Severe pain: Pain that worsens progressively after 48 hours or becomes unbearable [3] High fever: Temperature above 100.4F (38C), which could indicate infection Severe swelling: Significant joint swelling that increases rather than decreases after 2-3 days Numbness or tingling: These neurological symptoms require prompt evaluation [3] Signs of infection: Increasing redness spreading beyond the injection site Hot skin around the knee Red streaks extending from the injection site Discharge or drainage Inability to bear weight: If you cannot put any weight on your leg 24 hours after injection Understanding Post-Injection Flare Reactions Approximately 1% of patients experience whats called an injection flarea more pronounced inflammatory reaction than typical post-injection discomfort [3]

Elevated NAD+ levels activate sirtuins, particularly SIRT1, which are NAD+-dependent deacetylases that regulate numerous metabolic processes including fat oxidation, glucose metabolism, mitochondrial biogenesis, and cellular stress responses

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Rare adverse reactions may include allergic reactions like skin rash, hives, itching, or swelling of the face

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