Joint replacements and Rapamycin Use

Hi, Community! I’m wondering whether anyone has any info on whether rapa use is safe for people with joint replacements. Or, if you have a reasonably educated opinion, please chime in! I’m asking because sometimes (not always–depends on the orthopedist and his/her opinions on bacterial infections) an ortho will require his/her patients to take a round of antibiotics whenever they receive dental work (in some cases, including simple teeth cleaning), for fear that bacteria will make their way via the bloodstream to the joint replacement. This makes me wonder whether rapa users are temporarily at risk to this potential danger, directly after they’ve dosed, and whether rapa use should be timed with one’s dental visits ( i.e., wait a few days before going to the dentist after you’ve dosed if you have a joint replacement). Thoughts and opinions? Research and reports? Anything? Thanks so much!


Not aware of any studies on Rapa and joint replacement. I’ll say the following;
My wife and I have been taking Rapa for about a year. She had a total knee replacement many years ago. No problems.
Although my wife takes antibiotics before going to dentist, the evidence for this being needed is weak.
I would avoid using Rapa during peri operative period.


Great question! Thanks for asking.

My wife had a hip replacement and she won’t even consider Rapa. She’s worried about exactly that.

Seriously, is your immune system constantly fighting bacterial infection around a metal joint?

I hope we get some good replies.

Hello, KarIT and Bicep! Thanks so much for your participation. I appreciate KarIT’s opinion, and it’s sort of mine, too–although I’m a clinical psychologist and not an MD. I know and work with several orthopedists, and the “jury is out,” so to speak, on whether it’s necessary to prescribe a round of antibiotics prior to a joint replacement patient’s dental visits. Some orthos say yes; others say no. In any case, however, the concern, as I understand it, is real: evidently, since the replacement joint is foreign (i.e., not a natural body part), it’s susceptible to being attacked and overwhelmed by bacteria. And since people do report ear infections, dental infections, etc., on this site, it made me wonder whether joint replacement people are at a unique risk, since an infection in a replacement joint can be gravely dangerous.

I appreciate KarIT’s suggestion about avoiding rapa during the peri-operative period. And his anecdotal report about his wife’s rapa use, post-knee replacement, is encouraging.

It’ll be interesting to see whether anyone else weighs in with info, references to research/studies, or personal stories. It’s what I really appreciate about being a part of our support community!

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I am on my 4th weekly dose since my hip resurfacing device was forcefully (hammered literally) placed into my body. As I have mentioned elsewhere I take a 100mg dose of Doxycycline along side my Rapa dose to make sure I don’t have an infection issue. So far so good.


Hi! So glad that you’re doing great, Danlalane! I experienced the same success, and now, many many months later, I’m doing just fine with my hip and my rapa use. I never experienced any ill effects.

In fact, I’m getting ready to go in for my first blood draw since I started taking rapa, to see how my numbers are doing (hopefully, no red flags, and lots of improvements!).


I had (about 19 months ago now, after a bone cancer - chondrosarcoma - diagnosis) the lower third of my femur replaced with mostly stainless steel, knee totally replaced with a hinge (!) and a rod going into the tibula to support the hinge.

I was given dire warnings about the risk of infection. It’s not that bacteria “attack” the metal, rather if they attach to the metal’s surface the body has great difficulty fighting it off. If this happens - my surgeon said - they might have to redo the surgery to get rid of the infection. This would be Very Bad.

Since I’ve been getting dental work done, I get a few pills of amoxicillin for each appointment.

I haven’t adjusted my rapa intake though. I get no side effects from it (even though I try, with GFJ and other CYP3A4 inhibitors like ginko) and just don’t “feel” like it’s impacting my immunity that much.

I’ll consider the above though, or look for a more definitive test.