Rapamycin
Sirolimus · mTOR inhibitor (longevity research)
What it is
A transplant-rejection drug that became the longevity field's single most-hyped molecule after it extended lifespan in every organism tested — the only drug to do so reproducibly in mammals. Longevity clinics now prescribe it off-label, typically as intermittent low doses.
What human evidence shows
Mouse lifespan extension is real and replicated (ITP, multiple labs, both sexes). Human longevity evidence: none yet — the PEARL trial was small and mostly null, and the dog (TRIAD) and further human trials are still running. Everything a longevity clinic tells you is extrapolation from mice plus mechanism. That does not make it wrong; it makes it unproven.
Risks
Immunosuppression is the mechanism, so infections are the risk — mouth ulcers are the common one, and intermittent dosing is an attempt to dodge this, not proof it does. Metabolic effects (glucose, lipids) at continuous doses. Long-term intermittent-use safety in healthy humans is simply unknown. Grey-market powder purity is its own problem for a drug this potent.
Legal status
US: prescription-only (not scheduled). Off-label prescribing is legal; longevity clinics operate in that space.
Evidence base
established literature
Large human evidence base: several phase 3 or 4 trial reports, plus multiple meta-analyses or systematic reviews.
- phase 3/4
- 35
- randomised
- 413
- reviews
- 243
- human trials
- 911
Counts are of published papers, not distinct trials, and measure how much research exists — not whether this works or is safe for you.
Research (12)
- Rapamycin for longevity: the pros, the cons, and future perspectivesFront Aging · 2025
- Evaluation of off-label rapamycin use to promote healthspan in 333 adultsGeroscience · 2023
- Rapamycin not dietary restriction improves resilience against pathogens: a meta-analysisGeroscience · 2023
- Rapamycin: A Bacteria-Derived Immunosuppressant That Has Anti-atherosclerotic Effects and Its Clinical ApplicationFront Pharmacol · 2018
- Why Is Rapamycin Not a Rapalog?Gerontology · 2023
- The effect of rapamycin treatment on mouse ovarian follicle development in dehydroepiandrosterone-induced polycystic ovary syndrome mouse modelZygote · 2024
- Cancer prevention with rapamycinOncotarget · 2023
- A mixed blessing for liver transplantation patients - RapamycinHepatobiliary Pancreat Dis Int · 2023
- Rapamycin golden jubilee and still the miraculous drug: a potent immunosuppressant, antitumor, rejuvenative agent, and potential contributor in COVID-19 treatmentBioresour Bioprocess · 2022
- Rapamycin Does Not Compromise Exercise-Induced Muscular Adaptations in Female MiceAging Cell · 2025
- Rapamycin: an anti-cancer immunosuppressant?Crit Rev Oncol Hematol · 2005
- Molecular and therapeutic insights of rapamycin: a multi-faceted drug from Streptomyces hygroscopicusMol Biol Rep · 2023
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