Is rapamycin better than metformin for longevity?

On the scores, yes. Rapamycin's longevity subrating is 8.0 against metformin's 6.2, its healthspan is 7.5 against 6.5, and its autophagy is 8.5 against 6.0. That lead rests on mouse data from Harrison 2009 and Miller 2014, not on human outcomes. Neither drug has a completed human lifespan trial, so the lead is in the biology rather than in proof.

Can I take rapamycin and metformin together?

No trial has tested that combination in humans, so anyone recommending it is extrapolating. The mechanisms are complementary on paper, since rapamycin inhibits mTORC1 directly while metformin activates AMPK, and both converge on autophagy. Combining two off-label drugs with separate monitoring requirements is a decision for a prescriber who is watching both sets of labs.

How long before I know whether it is working?

Very different clocks. Metformin gives a first noticeable change in about a week, reaches full effect at 12 weeks, and its assessment window is 12 weeks. Rapamycin takes around 4 weeks for anything noticeable, reaches full effect near week 48, and its assessment window is 24 weeks. Judging rapamycin at six weeks is judging it too early.

Which one is cheaper?

Metformin, slightly, at an extracted $4 to $30 a month against an estimated $15 to $50 for rapamycin. The rapamycin figure comes from generic sirolimus 1 mg at roughly $33 per 30 tablets with a discount card, at a 3 mg weekly dose. Both are cheap generics, so monitoring and prescriber fees dominate the real budget.

What are the main side effects of each?

Rapamycin's practical problems are mouth ulcers, lipid or glucose changes, impaired wound healing, infection timing, and CYP3A4 interactions including grapefruit, ketoconazole, clarithromycin, ritonavir and rifampin. Metformin's are gastrointestinal at first, with vitamin B12 depletion over the long term per Ballal 2025 and Hussain 2025, and lactic acidosis as the rare high-consequence risk in kidney or liver impairment.

Do I need a prescription for either one?

Yes, both. Rapamycin is approved as sirolimus for renal-transplant rejection prophylaxis and lymphangioleiomyomatosis, so longevity use is off label and usually runs through a longevity telehealth clinic. Metformin is approved for type 2 diabetes, so longevity use is off label there too. Harinath 2025 also found compounded rapamycin gave much lower blood exposure per milligram than commercial sirolimus, so the source of the tablet changes the dose you actually absorb.

Will either one interfere with my training?

Both might. Stanfield 2026 gave weekly 6 mg sirolimus alongside a 13-week home exercise program in adults aged 65 to 85, found no improvement, and reported the drug may have attenuated the gains. Konopka 2019 and Walton 2019 found metformin blunted aerobic and hypertrophy adaptation. If training is your main lever, that lever comes first.

Who should not take rapamycin?

Anyone under 40 without a specific indication, anyone immunocompromised or fighting an active infection, anyone pregnant, trying to conceive without physician clearance, or breastfeeding. Add anyone with surgery coming up or impaired wound healing, a history of interstitial lung disease or pneumonitis, uncontrolled diabetes, severe dyslipidemia, recurrent infections, or unmanaged strong CYP3A4 inhibitors or inducers.

Head-to-Head Comparison

Rapamycin vs Metformin: Which Is Better for Longevity?

Should I ask my doctor about rapamycin or metformin for longevity?

Reviewed 09/07/2026

Metformin scores 6.9 and rapamycin 6.8, which settles nothing. Rapamycin owns the aging-biology rows: longevity 8.0, autophagy 8.5, senescence 7.8, plus replicated mouse lifespan data. Metformin owns everyday medicine and general older-adult use. Neither has a completed human longevity trial, so both remain experiments with a prescriber attached.

Rapamycin 6.8, metformin 6.9. The composite scores are a wash, so pick on which aging story you are buying.
Rapamycin leads every geroscience row: longevity 8.0 against 6.2, autophagy 8.5 against 6.0, cellular senescence 7.8 against 5.8.
Metformin leads the everyday rows: geriatric use 6.5 against 4.9, wound healing 5.0 against 2.8, and pregnancy safety where rapamycin scores 2.1.
No human lifespan trial has finished for either. PEARL missed its primary endpoint and TAME has not read out.
Both can cost you gym progress. Stanfield 2026 found weekly sirolimus may have attenuated exercise gains, and Konopka 2019 and Walton 2019 found the same for metformin.
Rapamycin costs an estimated $15 to $50 a month. Metformin costs $4 to $30 and is extracted from real retail pricing.

At a Glance

Option A

Rapamycin

6.8 / 10 Worth trying

Upside

Efficacy 4.3
Breadth 4.2
Evidence 3.9
Speed 2.4
Durability 3.8
Bioindividuality 3.4

Downside

Safety Risk 2.6
Side Effects 2.4
Cost 2.3
Effort 1.8
Opportunity Cost 1.8
Dependency 1.3
Reversibility 1.5

Best at:

Autophagy 8.5
Longevity 8.0
Cellular Senescence 7.8
Healthspan 7.5

Off-label mTOR inhibitor, prescribed as sirolimus. BioHarmony 6.8, worth trying.

Read full BioHarmony report →

Option B

Metformin

6.9 / 10 Worth trying

Upside

Efficacy 4.3
Breadth 4.0
Evidence 4.8
Speed 3.0
Durability 2.0
Bioindividuality 3.2

Downside

Safety Risk 2.0
Side Effects 2.7
Cost 1.2
Effort 1.2
Opportunity Cost 2.0
Dependency 3.0
Reversibility 1.2

Best at:

Blood Sugar 9.0
Metabolic Health 8.5
Cardiovascular 7.2
Hormonal 7.0

Off-label biguanide, prescribed for type 2 diabetes. BioHarmony 6.9, worth trying.

Read full BioHarmony report →

Head-to-Head Verdict

Use Case	Winner	Rationale
Longevity	Rapamycin	Rapamycin 8.0 against metformin 6.2, and the animal record is the reason. Harrison 2009 extended median and maximal lifespan in genetically heterogeneous mice started late in life, and Miller 2014 replicated it with dose and sex dependence. Metformin's longevity case rests on Barzilai 2016 as a rationale paper and a trial that has not run.
Healthspan	Rapamycin	Rapamycin 7.5 against metformin 6.5, with the honest caveat that the human readout disappointed. Moel 2025 ran PEARL for 48 weeks and found relative safety, no meaningful improvement in the primary visceral-adiposity endpoint, and lean tissue and pain signals in the female subgroup only. That still beats an unrun trial.
Autophagy	Rapamycin	Rapamycin 8.5 against metformin 6.0, the widest gap in the matrix, and it follows straight from the target. Rapamycin binds FKBP12 and inhibits mTORC1 directly, which releases ULK1 and drives autophagy and mitophagy. Metformin reaches mTOR indirectly through AMPK, so it nudges the same process rather than switching it.
Cellular Senescence	Rapamycin	Rapamycin 7.8 against metformin 5.8. Suppressing the senescence-associated secretory phenotype is one of rapamycin's named pathways, and Juricic 2022 showed brief early treatment produced durable geroprotective effects with maintained gut-barrier measures after withdrawal. Metformin has no comparable senescence readout on its report.
Immune Function	Rapamycin	Rapamycin 7.0 against metformin 5.0, with a caveat that matters. Mannick 2018 was a phase 2a trial in 264 older adults that cut reported infections and improved antiviral markers, but it used rapalogs rather than generic rapamycin. Mannick 2021 tempered the picture in larger phase 2b and phase 3 work. Take the row, discount the certainty.
Mitochondrial	Rapamycin	Rapamycin 6.5 against metformin 3.5, and the direction of each drug's effect explains it. Rapamycin drives mitophagy, which clears damaged mitochondria. Metformin partially inhibits Complex I as its whole mechanism, and Konopka 2019 measured attenuated mitochondrial-respiration adaptations in older adults training for 12 weeks.
Geriatric	Metformin	Metformin 6.5 against rapamycin 4.9, and this row is about the whole patient rather than a pathway. Older adults usually arrive with real glycemic dysfunction, and UKPDS 34 plus DPP put hard endpoints behind treating it. Rapamycin's contraindication list starts with immunosuppression and active infection, which is a harder fit at that age.
Wound Healing	Metformin	Metformin 5.0 against rapamycin 2.8, and the gap is a labeled effect rather than an inference. mTOR inhibition impairs wound healing, which is why the rapamycin report carries a pre-surgery hold protocol of one to two weeks either side of an elective procedure. Anyone with surgery scheduled has their answer.
VO2 Max	Tie	Rapamycin 4.1 against metformin 3.5, and both belong at the bottom. Stanfield 2026 gave weekly 6 mg sirolimus alongside a 13-week home exercise program in sedentary 65 to 85 year olds, found no improvement, and reported the drug may have attenuated the gains. Konopka 2019 found the same for metformin. Training beats both.
Prenatal	Metformin	Metformin 6.0 against rapamycin 2.1, and this is a hard stop rather than a preference. Pregnancy or trying to conceive without physician clearance, plus breastfeeding, are listed contraindications on rapamycin. Metformin in pregnancy is still restricted to obstetric direction, so the win here means possible under supervision, not recommended.
Skin Beauty	Rapamycin	Rapamycin 6.3 against metformin 4.5. Lee 2024 reviewed rapamycin in adults and found possible immune, cardiovascular and skin-system effects, with no significant muscular, endocrine or neurological effects. The skin signal is one of the few human-level positives in that review, so this row is real but small.

Cost Comparison

Intervention	Monthly Cost	Notes
Rapamycin	$15 to $50	ESTIMATE, priced 2026-09-07, retail pharmacy channel. Generic sirolimus 1 mg is about $33 per 30 tablets with a discount card, so 3 mg once weekly works out to roughly 13 tablets or about $15 a month, rising to around $50 through a longevity telehealth prescriber. The drug is cheap. The prescriber, the blood work and the follow-up are the real spend.
Metformin	$4 to $30	Extracted from the source report, priced 2026-09-07, retail pharmacy channel. Generic immediate-release runs $4 to $15 a month through pharmacy discount programs and generic extended-release runs $15 to $30. Off-label longevity telehealth sells the same molecule at a large markup, so the channel matters more than the molecule.
The difference	Roughly $10 to $20 a month apart, before monitoring	Both are cheap generics, so the sticker price is not the decision. The rapamycin figure is an estimate built from a discount-card tablet price, while the metformin figure was extracted from the report's own retail pricing.Monitoring is where the budgets separate. Rapamycin needs CBC, lipids, glucose, liver and kidney markers, with optional trough levels. Metformin needs eGFR before starting and annually, plus periodic B12.

When to Switch

These two run on completely different clocks, and that is the first thing to get right. Metformin gives a first noticeable change in about a week and reaches full effect at 12 weeks, with a 12-week assessment window. Rapamycin takes about 4 weeks for anything noticeable, reaches full effect around week 48, and its assessment window is 24 weeks, so judge it at six months rather than at six weeks.

Move from metformin to rapamycin when glucose was never the problem, when your goal is the aging-biology target rather than a lab number, when you are over 50 with measurable immune decline, and when you have a prescriber who will run quarterly blood work. Move from rapamycin to metformin when fasting glucose, HbA1c or lipids drift on treatment, since Lamming 2012 tied chronic mTORC2 disruption to insulin resistance, or when infections, mouth ulcers or a surgery date arrive.

Do not start rapamycin while diabetes is uncontrolled or dyslipidemia is severe, because both are listed contraindications. Running them together is a physician's call and nobody has tested the combination in humans, so anyone selling you that stack is guessing.

Who Should Pick What?

Adult over 50 with measurable age-related immune decline and a longevity prescriber

Rapamycin

Immune subrating 7.0 against 5.0, and Mannick 2018 cut reported infections in 264 older adults. Commit to the blood work: CBC, lipids, glucose, liver and kidney markers. The report's own best-fit profile is exactly this person, treating it as experimental geroscience.

Adult with prediabetes or type 2 diabetes who also wants a longevity angle

Metformin

Treat the disease you actually have. Blood-sugar subrating 9.0, with UKPDS 34 and DPP behind it, and the longevity interest rides along for free. DPP cut diabetes incidence 31% with metformin, though lifestyle cut it 58%, so the drug is the smaller half of that answer.

Serious lifter or endurance athlete of any age

Tie

Neither, while training adaptation is the goal. Stanfield 2026 found weekly sirolimus did not improve a 13-week exercise program and may have attenuated the gains. Konopka 2019 and Walton 2019 found metformin blunted aerobic and hypertrophy adaptation. Both work against the thing you are training for.

Anyone with elective surgery booked in the next two months

Metformin

Rapamycin's wound-healing subrating is 2.8 and its report carries a pre-surgery hold of one to two weeks either side of the procedure. Metformin needs its own hold around iodinated contrast, which is a narrower and more predictable interruption.

Under 40, healthy, normal labs, chasing an edge

Tie

Neither. Age under 40 without a specific indication is a listed contraindication on rapamycin. Metformin's own report calls the tradeoff weak or negative in metabolically healthy athletic users. Hands 2025 concluded human data do not establish either rapalogs or rapamycin as proven anti-aging therapy in healthy adults.

Immunocompromised, recovering from infection, or with a history of pneumonitis

Metformin

Immunosuppression, active infection and a history of interstitial lung disease or pneumonitis are all listed rapamycin contraindications, and the sirolimus labeling carries infection and malignancy warnings. Metformin's exclusions run through the kidney and the liver instead, so check eGFR before you decide.

Woman planning pregnancy, or currently pregnant or breastfeeding

Tie

Neither on your own initiative. Rapamycin is contraindicated in pregnancy, in attempts to conceive without physician clearance, and in breastfeeding. Metformin in pregnancy belongs under obstetric direction. Its prenatal subrating of 6.0 against rapamycin's 2.1 describes a supervised option, not a green light.

On a strong CYP3A4 inhibitor, or unwilling to give up grapefruit

Metformin

Grapefruit, ketoconazole, clarithromycin and ritonavir raise sirolimus exposure and rifampin lowers it, so unmanaged CYP3A4 interaction is a rapamycin contraindication. Metformin's interaction list runs through contrast, alcohol, carbonic anhydrase inhibitors and transporter inhibitors, which is easier to plan around.

Research Highlights

Mechanism Difference
These two are complementary rather than redundant, with one point of overlap. Rapamycin binds FKBP12 and inhibits mTORC1 directly, hitting S6K1, 4E-BP1 and ULK1, which drives autophagy, suppresses senescence-associated inflammatory signaling and modulates immune aging.Metformin comes at the nutrient-sensing network from the other end. It partially inhibits mitochondrial Complex I, raises the AMP to ATP ratio and activates AMPK, which suppresses liver glucose output. Its report lists indirect mTOR modulation as a downstream effect, so the two paths converge on autophagy without duplicating each other.
Safety Comparison
Rapamycin carries the heavier risk profile. Serious infection, impaired wound healing, metabolic disruption, pneumonitis and malignancy warnings all sit on the sirolimus labeling, and Lamming 2012 tied chronic mTORC2 disruption to insulin resistance. Contraindications start at immunosuppression, active infection and age under 40 without an indication.Metformin's worst case is metformin-associated lactic acidosis, rare but high-mortality, concentrated below eGFR 30 and in hypoxia, sepsis, severe liver disease and alcohol abuse. Long-term users need B12 monitoring per Ballal 2025 and Hussain 2025.
Cost Comparison
Both are cheap generics. Rapamycin is an estimated $15 to $50 a month, built from a discount-card price of about $33 per 30 tablets of 1 mg sirolimus at a 3 mg weekly dose, rising toward $50 through a longevity telehealth prescriber. Metformin is an extracted $4 to $30.The monitoring is the real cost. Rapamycin wants CBC, lipids, glucose, liver and kidney markers with optional trough levels. Metformin wants eGFR before starting and annually, plus periodic B12. Both figures were priced 2026-09-07.
Editorial Verdict
Metformin scores 6.9 and rapamycin 6.8, so the composite is a coin flip and the rows decide it. Rapamycin takes every aging-biology row: longevity 8.0, autophagy 8.5, cellular senescence 7.8, immune function 7.0. Metformin takes the practical ones: geriatric use, wound healing, pregnancy safety.Neither has finished a human longevity trial. PEARL missed its primary endpoint, TAME has not read out, and Roark 2025 found no long-term healthy-human evidence of lower mortality. Pick the one whose risk you can monitor, and expect to be wrong about the timeline.
Human Evidence Gap
The strongest longevity data on this page came from mice. Harrison 2009 extended median and maximal lifespan in genetically heterogeneous mice fed rapamycin late in life, and Miller 2014 replicated it with dose and sex dependence. Nothing equivalent exists in humans for either drug.The human readouts are more sober. Moel 2025 ran 48 weeks of low-dose weekly rapamycin and missed its primary visceral-adiposity endpoint. Hands 2025 concluded off-label rapamycin is not established as anti-aging therapy in healthy adults. Metformin's TAME has not started reading out.
No Head To Head Trial
No trial has randomized people to rapamycin against metformin. Every comparison here is indirect, drawn from each drug's own evidence base and from the BioHarmony subratings on the two source reports, so treat the row winners as reasoned calls rather than measured results.The gap will not close soon. TRIAD is a rapamycin geroscience trial with published design and baseline data, and TAME is a metformin trial concept. Neither is built to compare the two, so the honest answer is that nobody knows which does more for a human.

Frequently Asked Questions

Is rapamycin better than metformin for longevity?: On the scores, yes. Rapamycin's longevity subrating is 8.0 against metformin's 6.2, its healthspan is 7.5 against 6.5, and its autophagy is 8.5 against 6.0. That lead rests on mouse data from Harrison 2009 and Miller 2014, not on human outcomes. Neither drug has a completed human lifespan trial, so the lead is in the biology rather than in proof.
Can I take rapamycin and metformin together?: No trial has tested that combination in humans, so anyone recommending it is extrapolating. The mechanisms are complementary on paper, since rapamycin inhibits mTORC1 directly while metformin activates AMPK, and both converge on autophagy. Combining two off-label drugs with separate monitoring requirements is a decision for a prescriber who is watching both sets of labs.
How long before I know whether it is working?: Very different clocks. Metformin gives a first noticeable change in about a week, reaches full effect at 12 weeks, and its assessment window is 12 weeks. Rapamycin takes around 4 weeks for anything noticeable, reaches full effect near week 48, and its assessment window is 24 weeks. Judging rapamycin at six weeks is judging it too early.
Which one is cheaper?: Metformin, slightly, at an extracted $4 to $30 a month against an estimated $15 to $50 for rapamycin. The rapamycin figure comes from generic sirolimus 1 mg at roughly $33 per 30 tablets with a discount card, at a 3 mg weekly dose. Both are cheap generics, so monitoring and prescriber fees dominate the real budget.
What are the main side effects of each?: Rapamycin's practical problems are mouth ulcers, lipid or glucose changes, impaired wound healing, infection timing, and CYP3A4 interactions including grapefruit, ketoconazole, clarithromycin, ritonavir and rifampin.Metformin's are gastrointestinal at first, with vitamin B12 depletion over the long term per Ballal 2025 and Hussain 2025, and lactic acidosis as the rare high-consequence risk in kidney or liver impairment.
Do I need a prescription for either one?: Yes, both. Rapamycin is approved as sirolimus for renal-transplant rejection prophylaxis and lymphangioleiomyomatosis, so longevity use is off label and usually runs through a longevity telehealth clinic. Metformin is approved for type 2 diabetes, so longevity use is off label there too.Harinath 2025 also found compounded rapamycin gave much lower blood exposure per milligram than commercial sirolimus, so the source of the tablet changes the dose you actually absorb.
Will either one interfere with my training?: Both might. Stanfield 2026 gave weekly 6 mg sirolimus alongside a 13-week home exercise program in adults aged 65 to 85, found no improvement, and reported the drug may have attenuated the gains. Konopka 2019 and Walton 2019 found metformin blunted aerobic and hypertrophy adaptation. If training is your main lever, that lever comes first.
Who should not take rapamycin?: Anyone under 40 without a specific indication, anyone immunocompromised or fighting an active infection, anyone pregnant, trying to conceive without physician clearance, or breastfeeding.Add anyone with surgery coming up or impaired wound healing, a history of interstitial lung disease or pneumonitis, uncontrolled diabetes, severe dyslipidemia, recurrent infections, or unmanaged strong CYP3A4 inhibitors or inducers.

Evidence Sources

Animal study Rapamycin fed late in life extends lifespan in genetically heterogeneous mice (2009) NIA Interventions Testing Program anchor. Rapamycin started late in life extended median and maximal lifespan in male and female mice.
Animal study Rapamycin-mediated lifespan increase in mice is dose and sex dependent and metabolically distinct from dietary restriction (2014) ITP follow-up. Dose and sex dependence, with a metabolic profile distinct from dietary restriction.
RCT Influence of rapamycin on safety and healthspan metrics after one year (PEARL trial) (2025) 48-week decentralized double-blind RCT. Relative safety, no meaningful improvement in the primary visceral-adiposity endpoint, female subgroup signals for lean tissue and pain.
RCT TORC1 inhibition enhances immune function and reduces infections in the elderly (2018) Phase 2a RCT in 264 older adults. Low-dose TORC1 inhibition reduced reported infections and improved antiviral markers, using rapalogs rather than generic rapamycin.
RCT Targeting the biology of ageing with mTOR inhibitors to improve immune function in older adults (2021) Larger phase 2b and phase 3 rapalog program. Tempers the immune-aging translation case.
Review What is the clinical evidence to support off-label rapamycin therapy in healthy adults? (2025) Human data do not yet establish rapamycin or rapalogs as proven healthy-adult anti-aging therapies.
RCT RAPA-EX-01: weekly sirolimus plus exercise in older adults (2026) Weekly 6 mg sirolimus did not improve a 13-week home exercise program in sedentary adults aged 65 to 85 and may have attenuated gains.
Mechanistic Rapamycin-induced insulin resistance is mediated by mTORC2 loss and uncoupled from longevity (2012) Chronic mTORC2 disruption linked to insulin resistance. The key metabolic-safety mechanism behind rapamycin's glucose and lipid warnings.
Pharmacokinetic Compounded rapamycin bioavailability versus commercial sirolimus (2025) Compounded rapamycin produced much lower blood exposure per milligram than commercial sirolimus.
Review Long-term healthy-human rapamycin evidence review (2025) No long-term healthy-human randomized trial yet shows lower mortality or durable clinical healthspan extension.
Systematic review Systematic review of rapamycin in adults (2024) Possible immune, cardiovascular and skin-system effects, with no significant muscular, endocrine or neurological effects.
Animal study Long-lasting geroprotection from brief rapamycin treatment in early adulthood (2022) Brief rapamycin produced durable geroprotective effects in Drosophila and maintained gut-barrier measures in mice after withdrawal.
Label DailyMed Rapamune sirolimus prescribing information (2026) Current US labeling covering immunosuppression, infection, malignancy, wound-healing, lipid and drug-interaction warnings.
RCT UKPDS 34: effect of intensive blood-glucose control with metformin in overweight patients with type 2 diabetes (1998) 753 overweight newly diagnosed patients. Lower diabetes-related endpoints, diabetes-related death, all-cause mortality and myocardial infarction.
RCT Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin (DPP) (2002) n=3,234. Metformin cut diabetes incidence 31% and lifestyle cut it 58% versus placebo.
Review Metformin as a Tool to Target Aging (2016) The TAME rationale paper. Supports testing metformin for aging biology rather than proving a healthy-adult longevity benefit.
RCT Metformin inhibits mitochondrial adaptations to aerobic exercise training in older adults (2019) 12-week RCT. Metformin attenuated aerobic-fitness and mitochondrial-respiration adaptations in older adults.
RCT MASTERS trial: metformin blunts muscle hypertrophy with resistance training (2019) 14-week multicenter RCT. Metformin blunted the hypertrophy response to progressive resistance training in older adults.
Observational Can people with type 2 diabetes live longer than those without? (2014) Observational CPRD comparison often cited for metformin longevity. Hypothesis-generating and confounded by treatment selection.
Trial protocol Targeting Rapamycin to Induce Aging Deceleration (TRIAD) trial design (2025) Design and baseline data for the TRIAD rapamycin geroscience trial. Results are not yet available.

Glossary

Quick reference for the medical and technical terms used in this comparison.

mTORC1 Mechanistic Target of Rapamycin Complex 1: The cell's growth switch. Rapamycin inhibits it directly, which is the whole basis of the longevity argument for the drug.
FKBP12 FK506 Binding Protein 12: The protein rapamycin binds first. The rapamycin and FKBP12 pair is what actually blocks mTORC1.
AMPK AMP-Activated Protein Kinase: The cell's low-fuel sensor and metformin's main target. It reaches mTOR indirectly, which is why metformin's autophagy score is lower.
SASP Senescence-Associated Secretory Phenotype: The inflammatory output of worn-out cells that refuse to die. Suppressing it is one of rapamycin's named pathways.
ITP NIA Interventions Testing Program: The multi-site mouse lifespan program that produced rapamycin's flagship results in Harrison 2009 and Miller 2014.
PEARL Participatory Evaluation of Aging with Rapamycin for Longevity: The 48-week decentralized human trial reported in Moel 2025. Relative safety, but the primary visceral-adiposity endpoint was not meaningfully improved.
TAME Targeting Aging with Metformin: The proposed metformin trial for age-related multimorbidity at 1700 mg a day. A trial concept, and it has not read out.
TRIAD Targeting Rapamycin to Induce Aging Deceleration: A rapamycin geroscience trial with published design and baseline data in Coleman 2025. Results are still pending.
CYP3A4 Cytochrome P450 3A4: The enzyme that clears sirolimus. Grapefruit, ketoconazole, clarithromycin and ritonavir raise exposure and rifampin lowers it.

Nick Urban Health Optimization Researcher & CHEK Holistic Lifestyle Coach Level 2

I've spent over a decade testing longevity interventions on myself and screening them for clients and podcast guests

Reviewed Sep 7, 2026 · next review Dec 6, 2026

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