Rapamycin programs, scored

This page keeps the rapamycin prescribers from the metformin and rapamycin lineup, in the same order and with the same scores. A program is here because rapamycin appears on its own price list, whether it fills generic sirolimus tablets or a compounded capsule.

AgelessRx is first at 78. On a list this short, one changed price or one newly published refund policy can swap two rows, so the gap between neighbors matters more than the rank number.

Rapamycin, also sold as sirolimus, is approved to prevent kidney-transplant rejection and to treat a rare lung disease. Prescribing it for healthy aging is off-label, which a licensed prescriber may do, but the FDA hasn't weighed its benefits and risks for that use.

That shifts the comparison. With an off-label drug, the program's judgment is most of what you're paying for. Look first at who prescribes, whether labs come before the first fill, and how you reach a clinician if a side effect shows up.

Next, check the product. Compounded rapamycin shows up on 1 of the 7 price lists here; the others carry a prescription product. Generic sirolimus went through FDA review as a copy of the brand. A compounded capsule didn't.

Last, read what the program claims. No trial has shown that rapamycin lengthens human life. PEARL, the year-long trial longevity sellers cite most, missed its primary outcome, and several of its authors work for AgelessRx, a telehealth company that sells rapamycin.

• Price (35). The plate is the parent lineup's figure: the lower of a program's metformin and rapamycin prices. On 3 of the 7 cards that lower figure is metformin, so open the review for the rapamycin price.
• Care (25). The labs and follow-up checks carry real weight for an immunosuppressant. A program that skips them loses points it can't make up on price.
• Pharmacy (25). Naming the pharmacy, its license type, and whether the product is generic or compounded are all scored. With rapamycin, the generic-versus-compounded line is the one to read twice.
• Clarity (15). A price before intake, published cancellation terms and a state list. Each is spelled out in how we score.

Because the plate can be a metformin price, the rapamycin figure deserves its own line. Across the 7 programs here, rapamycin lists at $65 to $207 a month, and the middle program charges $115.

Site-wide, 5 programs list oral rapamycin at $65–$207 a month. The drug itself is often the smaller part of that bill; visits, membership and labs make up the rest.

Lab work changes the first month most. The sirolimus label calls for watching blood fats and urine protein, and it recommends checking blood levels of the drug in the patients it's approved for. Ask which of those a program orders and whether the plate covers them.

A local doctor can also prescribe generic sirolimus off-label, filled at your own pharmacy. That route can cost less, though you'd pay for the visit and labs separately.

1. Is it generic sirolimus or a compounded product, and why that one for me?
2. Which labs do you order before the first prescription, and which repeat?
3. What should I do about rapamycin before surgery, a dental procedure or a vaccine?
4. How do you check my other medicines for interactions?
5. What would make you stop the prescription?