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LongevityModerate evidence

Rapamycin (Sirolimus)

mTOR inhibitor / immunosuppressant

Also known as: Sirolimus, Rapamune

An approved immunosuppressant (transplant, certain cancers) studied intensively for longevity via mTOR inhibition. Anti-aging use in humans is investigational.

Evidence gradeModerate evidence

Strong animal lifespan-extension evidence and some human immune studies; long-term human longevity benefit is unproven.

Some human RCTs, but limited size, replication, or scope.

Intended use

Approved for organ-transplant rejection prophylaxis and specific conditions; used off-label/experimentally for longevity.

Mechanism of action

Inhibits the mTOR pathway, mimicking aspects of caloric restriction and modulating cellular growth, autophagy, and immune function.

Reported benefits

  • Lifespan extension (animals)

    Extends lifespan across multiple species in controlled studies.

  • Immune modulation

    Low-dose regimens improved vaccine response in older adults in trials.

  • Autophagy

    Promotes cellular clean-up mechanisms linked to aging.

Risks & side effects

  • Immunosuppression

    high risk

    Can increase infection risk, especially at higher doses.

  • Metabolic effects

    moderate risk

    May affect lipids and glucose metabolism.

  • Mouth ulcers

    low risk

    Common dose-dependent side effect.

Research & citations

Studies are ordered by design strength. Dots indicate the rigor of each study type — meta-analyses and double-blind RCTs rank highest, case reports and in vitro work lowest.

Legal status by region

Regulatory status varies widely and changes often. Verify against current local law before acting.

RegionStatusNotes
United StatesPrescriptionFDA-approved (Rapamune); longevity use is off-label.
European UnionPrescriptionApproved immunosuppressant.
United KingdomPrescriptionPrescription-only medicine.

Sourcing & prescribing

Where a compound can legally be obtained, and who is able to prescribe it.

  • Licensed pharmacy (prescription)

    On-label via specialist; off-label via longevity-focused physicians.

    Legal
  • Longevity clinics

    Some physicians prescribe off-label with monitoring.

    Legal

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