Rapamycin Cost

Let me clear some things up for people considering rapamycin (generic sirolimus).  I am taking it and so are my dogs!!  (I have a very open-minded vet who trusts my judgement.)

Dr. Green, a very impressive individual, gave me my personal prescription for sirolimus.  I have a very good PPO (Blue Cross/Blue Shield).  I took it to CVS, the affiliated pharmacy, and got a great price of about $2.90/mg.  (Remember, you are only going to take about 3-6 mg/week.)  With a PPO you can probably do this also.  CVS wants to meter it to you with a month's worth of doses at a time, but that's just how they do things.  You still have access to the full quantity prescribed. 

With the prescription from my vet for my dogs, I was forced to take to the open sea.  Armed with only a prescription and no insurance, the picture is quite different, but you can still get a good price.  Cutting to the chase, I ended up at Walmart.  The prescription was for 90 mg - price $1440.  But wait! after presenting a coupon downloaded from GoodRX (that's right, just anonymously downloaded and printed) - price $396!!!!  As my vet remarked, that's a hell of a charge for not looking around first!  ($4.40/mg is better than taking a risk buying online, in my opinion.)  Costco is pretty close to that price.  At CVS/RiteAid, etc., you will pay vastly more.

You can't touch the original drug rapamune (Pfizer) unless you are wealthy or go to Canada.  The problem with the online pharmacies is that a lot of them are scams.  Just because they have a website doesn't mean anything.  At least check to see if they have a brick and mortar location.  Example: At one point I was excited by the online infomercials and wanted to take NMN instead of NR; however, when I looked up the reputations of the suppliers only one was unsullied, and on further investigation their brick and mortar location turned out to be a residential dwelling!

FYI, more than one company makes sirolimus.  From CVS the sirolimus was made by Greenstone, LLC, apparently a wholly owned subsidiary of Pfizer.

Hope that helps some people who are considering rapamycin but think it might be out of their reach.  If you know a doctor, great, but if you don't a visit to Dr. Green is worth the trip, and I live in CA!  (round trip less than $300)  Do your homework first and you will learn a great deal.

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    • Maximus Peto
    • Researcher, website & forum admin
    • Maximus
    • 5 yrs ago
    • Reported - view

    Thanks for posting Rob. This is interesting information. I suspect a number of members will find it useful. 

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      • Rob8311
      • Rob8311
      • 5 yrs ago
      • Reported - view

      Maximus Please correct my answer to Ozone8!  The dosages I gave are exactly 10x too high!!!

      Like 1
    • Ted
    • Living long enough to prove them all wrong
    • Ted
    • 5 yrs ago
    • Reported - view

    Thanks for this excellent look at cost, something we all experience and don't  often talk about. I am also interested in hearing about anecdotal experience from taking rapamycin. Notice any changes, positive or negative? I'm not doing this as of yet. I have focused on NAD+ using NR.

    Like 1
      • Rob8311
      • Rob8311
      • 5 yrs ago
      • Reported - view

      Ted Have been taking NR for a few months and not noticing much.  My energy is pretty good, though.  Apparently it's best to take it in the morning on an empty stomach.  Took me a while before I learned that.  I was interested in NMN, but when I looked into it I found none of the so-called companies selling it actually had a brick-and-mortar facility.  The one I liked the most lost its luster when I learned it's address was actually a dwelling.  Can't imagine taking something like that without knowing there is a solid business behind it.

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      • Ted
      • Living long enough to prove them all wrong
      • Ted
      • 5 yrs ago
      • Reported - view

      Rob8311 My experience with NR has been subtle but important. I do notice a positive energy change and my immune system seems to function better. I really notice it when I stop. I start dragging until I start again.

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    • Ted Today--- I'm a 69 year old mason. In 2016 and 2017 the work days left me totally exhausted to the point that I was about to put the tools away and search out another job. I read about Dr Green and Rapamycin in the spring of 2018 and after a little research made my appointment. I explained my work and fatigue and asked the Doctor if he thought I could work another 5 years with this therapy. He felt that was a reasonable request and I began 4mg weekly of Sirolimus from Walmart. That along with Lisinopril and otc Mito-Q. This was now Sept 2018.

      This routine doesn't provide any immediate results but after six weeks I just felt a little better at days end. Winters are slow and in spring I went back at my work with enthusiasm now on 5 mg. In July I developed a hernia. I was working and staying about 6 hours away from home and decided to use the elastic devices available online to keep the hernia under control. By September it was obvious my right shoulder wasn't working properly. I had a left rotator cuff tear repaired 12 years earlier so I had a good idea what was going on. And the final insult came with a hurtful case of carpal tunnel in my right wrist.

      I worked through the fall till the holidays, returning home to see my family doc for the referrals. ( He is supportive of Dr Green's therapy and supports me with new prescriptions. ) Two weeks ago I had my hernia surgery. Feb 3 will be my shoulder surgery followed in 6 weeks by the carpal tunnel repair.

      I attribute this cascade of structural failures to the increased energy level from the Sirolimus and MitoQ. That and my ignorance of the increased wear on my 69 year old frame. I expect rehab will be long and uncomfortable but I will return to work in June mindful of all the gifts I've been given. So far for me the Sirolimus is wildly successful.

       I would end with this caution, Be careful what you wish for.

      Like 4
    • Patient 139 And yes I stopped the Sirolimus at Christmas and will begin again in June.

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    • Rob8311
    • Rob8311
    • 5 yrs ago
    • Reported - view

    Addendum: My insurance, after charging me for the first month, gave me a 90-day supply at no copay!  They reevaluated after a month as part of their internal process.  I have very good insurance, though.  I haven't noticed anything after one month, but it has been a tumultuous month for me.  I will now be increasing from 3 mg/week to 6 mg/week.  After 10 weeks, one of my dogs seems more energetic with a better appetite.  The other is very high on both counts so difficult to tell.  Was hoping for some dramatic changes in their arthritis, but haven't seen any.  I will be comparing lab values soon.  No negatives that I can attribute to rapamycin.

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    • Ozone8
    • Ozone8
    • 5 yrs ago
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    What is the dosage of rapamycin for the dogs?  How are you measuring such a small quantity?

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      • Rob8311
      • Rob8311
      • 5 yrs ago
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      [Dosing edited/corrected by Maximus Peto at Rob8311's request]

      Ozone8 Don't mess with rapamycin unless you study it first because large doses are harmful. Sirolimus comes in 0.5 mg and 1 mg tablets. I based my dosage on the U of WA study where one group of dogs was MWF at 0.05mg/kg and the other at 0.1 mg/kg. The head of the study told me in an email that their larger, followup study is using a dose of 0.025 mg/kg. Also be aware that the half life of rapamycin in dogs is approximately 39 hours and 62 in people. It is important to give the body time between doses. Read Dr. Green at rapamycintherapy.com and the U of WA study (see attached PDF) before trying rapamycin.

      Also, for dosage: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642271/.

    • Mermaid
    • Mermaid
    • 5 yrs ago
    • Reported - view

    Hi Rob,  I really appreciate your post.  I tried to sign up for the rapamycin trial but was turned down because I had already been taking metformin, and the researchers didn't want me--they were concerned that the test results might not look as good, because  metformin creates some of the same effect as rapamycin. I wrote Bill Faloon and he was kind enough to provide a couple of Canadian pharmacy sources of the drug, though they were much more expensive than your price with your insurance.  However, when I found that no one at Life Extension was willing to vouch for the quality of the drugs from those sources, I felt discouraged. (I trust them even less after hearing what you have to say about Canadian pharmacies.)  In addition, I wasn't eager to take a drug without further information or any doctor supervision. If I don't find anyone closer,  your suggestion of Dr. Green would solve that. Thank you.  ( I have, however, just received a list of so called "innovative doctors" in my area from the Life Extension, and I will check those out before traveling to New York).  I am on Medicare, with a supplemental Part D plan for medications that   works through Walgreens, but based on past experience, I have little faith that I could get a price nearly as good as the $2,90 you mention.    I would appreciate it  if you could let me know the exact name of the drug  your prescription was for. Was it simply for Rapamycin or was there some other name for the form of Rapamycin you were prescribed?  If I knew exact name of the drug, I could probably find out what that drug would cost through my plan.  Also, if I succeed on getting on the drug, I would be interested in trading notes on the results of taking the drug.  Have you considered taking Metformin?  It is much easier and very inexpensive to get?  My dermatologist is a Life Extension reader, knew of Bill Faloon's recommendations about metformin, and was willing to give me a prescription.

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      • Rob8311
      • Rob8311
      • 5 yrs ago
      • Reported - view

      Mermaid I'm glad.  Much of this info isn't easy to come by. Rapamune is the Pfizer drug, which is very expensive.  Sirolimus is the generic, and what I am using.  Walmart or Costco are close to the $2.90 with a downloaded coupon from GoodRX.  I went to Walgreens for my pups (so without insurance) and they were awful, but how they would be with Medicare D I can't predict.  They will likely assume you are using it to control transplant rejection and they might very well give you a decent price.  Metformin does not seem to be as strong, but I may take it depending on an analysis of my insulin resistance.  First thing to check for any distributor is if they have an actual physical location that is not a residence.  You can Google their address.  Can you share the list of innovative doctors and tell us how you got LE to give you that info?

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      • Mermaid
      • Mermaid
      • 5 yrs ago
      • Reported - view

      Rob8311 Thanks for giving me the specific name of the generic drug- Sirolimus, and suggesting Walmart and Costco.  Yes, of course, I can share the information about the "Innovative Doctors."  Turns out Life Extension has a website online where such doctors are listed, and you can find the ones in your area just by putting in your zip code.  I found out about it by asking one of the health advisors.  They seem to be well trained and invariably work hard to try to help you with whatever question you might have.  Below  is the link to the "Innovative Doctors" website:

       http: //health.lifeextension.com/innovative doctors 

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  • Another option is a laboratory supply wholesaler. LC Labs charges by the mg. The dawbacks are (1) you have to measure yourself and divide into doses. I did this just by diluting with chocolate powder so that 1/8 teaspoon = 1 dose. (2) you need a friend at a university address. They won't deliver to a home address. http://www.lclabs.com/products/r-5000

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    • Ozone8
    • Ozone8
    • 5 yrs ago
    • Reported - view

    Rob8311 Actually I have  personally been taking rapamycin for over 6 months now, loosely following the Green website and papers by  Blagosklonny. My dosage is 6-7 mg every 7-9 days. So far its value to me is questionable.

    I am using a powdered form obtained from a lab and the cost was about $200 for 500 mg. Weighing out the small quantity needed is a bit imprecise but otherwise this source has worked out well.

    The dosage quoted from the UW dog study seems awfully high. I am certainly not doubting your figures but using even the followup study's lower .25 mg/kg would result in a human dose of approx. 20 mg a couple of times per week. Of course we can't assume 1:1 dogs to humans but that's still quite a bit of rapamycin going to those dogs.

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      • Rob8311
      • Rob8311
      • 5 yrs ago
      • Reported - view

      Ozone8 You should doubt my figures!  I'm off by a decimal place - sorry!!  0.025 mg/kg, 0.05 mg/kg, and 0.1 mg/kg (the one my dogs are on) .  Glad you were watching.  So sorry everybody!!  I hope I can revise that post so no one tries those dosages!

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      • Rob8311
      • Rob8311
      • 5 yrs ago
      • Reported - view

      Ozone8 Did you get the age reversal update?  They mention some reasons why some people might not benefit; e.g., you are very fit and into CR.  Also, I think you have to be older.  Dr. Green was in his 70s and suffering when he got great results.  It's possible if you are healthy the benefits might simply be prevention rather than repair, so you won't notice much but you will be less likely to get the diseases of aging that are due to overregulation.  Hard to see how autophagy wouldn't be of benefit, but who knows?  It may be subtle for those who are younger or healthier.

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      • Ozone8
      • Ozone8
      • 5 yrs ago
      • Reported - view

      Rob8311 I haven't yet read that email update but was thinking along the lines you mention. I don't do CR but do practice intermittent fasting (8 hour eating window) several times a week. And at 66 I get a fair amount of exercise and sports. I also take 500 mg Metformin b.i.d. for AMPK activation and other benefits.

      I'm all for the prevention idea and will continue the rapamycin for the time being though a couple of my lab results have slightly worsened. I have also noticed some difficulty in building muscle and a little lower "idle speed" on my internal motor. No mouth sores though.

      Unfortunately the corrected .05/kg (or .025 or .1) dosage for dogs makes it impossible for me to administer to my little Poco as the inexpensive scale I'm using is not accurate enough to measure tiny doses like that. Thanks for making the correction.

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      • Rob8311
      • Rob8311
      • 5 yrs ago
      • Reported - view

      Ozone8 If Poco is 5 kg (say 10 pounds) that would be 0.5 mg at the higher dose of 0.1mg/kg.  If you can get close to that you could try a protocol of MF instead of MWF which might allow for a bit of variance in the dose.  I ran this by Matt Kaeberlein (U of WA).  He thought it was a reasonable protocol since not only low dosages but low trough concentrations may avoid side effects.  The low trough concentrations allow more time for mTOR2 production, which as you probably know you don't want to suppress (only mTOR1).

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      • Rob8311
      • Rob8311
      • 5 yrs ago
      • Reported - view

      Ozone8 Post revised by Maximus (thanks!) to reflect accurate dosages of 0.1 mg/kg, 0.05 mg/kg, and 0.025 mg/kg for the first U of WA study high dose, first U of WA low dose, and U of WA followup study dose, respectively.

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      • Ozone8
      • Ozone8
      • 5 yrs ago
      • Reported - view

      Rob8311 That is an interesting proposal which we will consider. Poco weighs about 7 kg so I would probably want to try a dose of around .3-.4 mg . The scale I've been using for my own rapamycin measurements is accurate to only +/- 1 mg. Seems like it would be a real crap shoot as to how much I'd be giving him each time. Speaking of the little rascal, he's the one on the right.

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      • Rob8311
      • Rob8311
      • 5 yrs ago
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      Ozone8 Wow.  Those two could own your heart!  These two have captured mine.

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      • Ozone8
      • Ozone8
      • 5 yrs ago
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      Rob8311 Yours are very cute as well!

      If I try the rapamycin with Poco I'll have to determine what to mix the powder with. Perhaps put it in a small capsule (as I do with mine) and embed the capsule in some sort of treat he will eat without reservation.

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    • Ozone8 Hi, a little late to the conversation, but I used to be a compounding pharmacist at one point in my career, using meds that needed to be measured in tiny amounts (micrograms) such as estradiol and the thyroid hormones.  We would prepare a jar that was either 1 part to 50 parts or 1 part to 100 parts with lactose.  If you can have the rapamycin powder mailed to your vet, you can take the monthly amount, mix it roughly with the same amount lactose, and then add enough lactose to make the weight 1:100 for the final product, using care when mixing (a face mask and disposable gloves). If your scale can't recognize that, then go up to 1:200 instead. You can buy lactose and empty gelatin capsule on the web.

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    • Dennis
    • Retired USAF pilot, biochemist.
    • Dennis
    • 5 yrs ago
    • Reported - view

    Thanks Rob! Good info! I bought my first 90 pills online (Sirolimus, Rocas) after chatting w/ one of Dr. Greens patients and paid ~$350. Got a second batch of 60 a few weeks ago for less since the price/pill was the same at 60 and 90. Was trying 3mg (age73) w/ 8 oz. grapefruit juice which is risky I know, especially now that I am back to 6mg, but so far no problems but am looking for more info as I go and may stop the grapefruit juice "activation", it slows metabolism of rap!

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