Compound pharmacy rapamycin capsules - bioavailability, concerns, & solutions?

#1

Background

I have a forward thinking MD (Anthony Azar) here in NYC, that prescribed rapamycin for me about 9 months ago.

When I asked him to renew after the 1st 6 months and he learned that a one year supply (at my ask of 12 mg per week) would cost me $3,000+ he called up a compounding pharmacist who prepared 2 mg capsules filled with rapamycin powder at 1/3 the cost. This seemed pretty reasonable for US sourced rapamycin, except…

Concerns

Two threads on this forum now have me concerned:

Bioavailability of Rapamycin From Compounding Pharmacy &

Results of a phase Ib Trial of Encapsulated Rapamycin in Prostate Cancer Patients

Seems like a high probability that the rapamycin in (what I presume as) the gelatin capsules degrades in stomach acid and loses potency as compared to conventionally prepared pills.

I haven’t bothered to test since starting rapamycin, because I had very positive changes and no noticeable side affects, e.g.,

  • Three months after first starting on Siromilus pills at 6 mg per week, I began an effortless weight loss and dropped 15 lbs.

  • I switched to the compound pharmacy’s capsules and upped my dosage to 12 mg per week.

  • Now after several months I gained back about 5 lbs.*. Hmmm…? This seems related to the switch from pills to capsules. I seem on an upward trend.

Questions:

  • Would “acid resistant” capsules solve the problem?

  • Can I request “Enteric” coated capsules from the compound pharmacy or does my physician need to prescribe them?

  • Given (i) I have a 3 month supply and (ii) the small size of the rapamycin capsules, could I just buy empty “Enteric coated” capsules large enough to put the entire capsule (not the contents, the whole capsule) I currently use into? 50+ years of biohacking.

Worst case - (i) go back to the conventional prescription, (ii) consider sourcing from outside the US, and (iii) use the contents of the capsules I have to make skin cream and/or add to minoxidil (I have already significantly recover hair).

re: “Encapsulated Rapamycin” - * Extra credit questions

  • Could a compounding pharmacist prepare liposomal (encapsulated) rapamycin?

  • Wouldn’t liposomal encapsulated rapamycin more easily penetrate cell membranes?

  • I know of DIY biohackers using lecithin to make their own liposomal encapsulated supplements (e,g., a liposomal Myers cocktail). Could one do this with rapamycin powder? Could prove interesting. Any thoughts?

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#2

If you still have any powered rapamycin, you might want to save it and make rapamycin cream. I guess you could try those so-called enteric capsules but do they actually work as stated? I have a problem with compounding pharmacy’s that simply capsule rapamycin. I believe that most if not all of these pharmacy’s know there’s an absorption problem with capsuled powder.
Most all here use prescription rapamycin pills or source from overseas. I get mine from India and know from LabCorp testing that I’m getting what I’m paying for.

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#3

There is another thread on this topic here: New Peter Attia interview w/Matt Kaeberlein, inferior bioavailability of encapsulated rapa

You have good questions - but they are very hard to answer. I think the best way is for you do do some blood tests at a standardized time after you take the different versions/packaging/encapsulated rapamycin and see the results yourself.

Its gotten quite cheap now and easy to get blood sirolimus tests: How to get a Rapamycin (sirolimus) Blood Level Test

Given the low bioavailability of sirolimus in general (only about 14% bioavailability in the best of cases, usually) - and the variations in different types of capsules that you can use (enteric coating or not), its impossible to know whether they work or not with rapamycin unless you try.

Another thread that may be of interest: Rapamycin enteric coating vs powder bioavailability

The liposomal option may work… but I nobody here has reported trying it yet, and doing blood work afterwards to see the effect compared to regular generic rapamycin.

Other thread that may be of interest here: Rapamycin and NanoCrystal Formulations

Where to get Rapamycin enteric coated