Rapamycin for Health & Longevity - Quick Reference Sheet

Rapamycin for Health & Longevity

Created on 07/10/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 4.8 Audit

Rapamycin is a decades-old transplant drug now studied as a possible way to slow aging by easing a core cellular growth signal and shifting cells toward repair. In animals it reliably extends healthy lifespan; in people the evidence is early and mixed, with the clearest benefit for immune function and real but manageable trade-offs. (Full Review)

Protocol

Standard longevity regimen
5–8 mg / week
Once-weekly oral pulse; the most widely used off-label longevity approach, chosen to inhibit mTORC1 while sparing mTORC2
Timing and administration
Same day each week
Taken consistently with or without food; splitting the weekly dose is unnecessary given the ~60-hour half-life
Competing approaches
Daily microdosing
A minority favor low daily microdosing; continuous daily ~2 mg is the transplant regimen most linked to metabolic and immune side effects
Time to effect
Immune & Biomarker Changes
Weeks–months
Immune and biomarker changes may appear over weeks to a few months
Longevity Benefit
Not directly observable
Any true longevity benefit can only be inferred from surrogate markers over time, not felt directly

Benefits

Contraindications
  • Pregnancy and breastfeeding
  • Active or recent serious infection
  • Within ~2 weeks of planned surgery
  • Severe liver impairment (Child-Pugh Class C)
  • Poorly controlled diabetes or severe dyslipidemia until stabilized
Key Interactions
  • Strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, grapefruit juice)
  • Strong CYP3A4 inducers (rifampin, carbamazepine, phenytoin, St. John's Wort)
  • Cyclosporine
  • Other immunosuppressants (corticosteroids, calcineurin inhibitors, biologics)
  • ACE inhibitors (lisinopril, ramipril)
  • Statins (e.g., simvastatin)
  • Supplements with additive or metabolic overlap (grapefruit-derived supplements, metformin, berberine)
  • Live vaccines

Risk & Side Effects

  • High: Mouth ulcers; immunosuppression and infection risk; dyslipidemia
  • Medium: Impaired glucose metabolism and insulin resistance; impaired wound healing and peripheral edema; cytopenias
  • Low: Non-infectious pneumonitis; proteinuria and kidney effects
  • Speculative: Long-term effects of chronic mTOR inhibition in healthy people; male reproductive and hormonal effects

Monitoring

Marker Target Why
Fasting glucose 75–90 mg/dL Detects glucose dysregulation from mTOR inhibition
HbA1c < 5.4% Tracks longer-term glucose control
Fasting insulin / HOMA-IR Insulin < 6 µIU/mL; HOMA-IR < 1.5 Early signal of insulin resistance before glucose rises
Lipid panel (LDL, triglycerides, HDL) LDL < 100 mg/dL; triglycerides < 90 mg/dL Rapamycin commonly raises cholesterol and triglycerides
Complete blood count (CBC) Within normal reference, stable trend Detects anemia, low platelets, or low white cells
Comprehensive metabolic panel (liver enzymes, creatinine, eGFR) ALT/AST normal; eGFR > 90 mL/min/1.73m² Monitors liver and kidney function
hs-CRP < 1.0 mg/L Tracks chronic inflammation, a target of the drug
Sirolimus blood trough level ~5–15 ng/mL if daily dosing Confirms exposure and avoids toxicity
Total testosterone (men) Mid-to-upper reference range Screens for possible hormonal effect in men

Cadence: Repeat the core panel ~4–8 weeks after starting or after a dose increase, then every 3–6 months once stable, with extra checks around any illness or side effect

Qualitative Assessment

  • Frequency and severity of mouth ulcers
  • Frequency of infections and time to recover from them
  • Wound-healing speed after minor cuts or dental work
  • Energy, exercise recovery, and perceived strength
  • Mood, cognitive clarity, and overall sense of well-being