Sirolimus on Costplusdrugs

This is a great question. The answer is, it depends. Taking very high single doses, instead of spreading the same dose throughout a week or few, comes with certain risks. While rapamycin is generally very safe, the risk of side effects increase with higher doses. The high peak levels seen when taking a lot in a single dose will increase the risk of certain rare side effects. There are individuals that are susceptible to strange side effects, and for those people, a high single dose could be risky. Note that this is not comon. I’ve seen a ton of anecdotes on rapamycin and know of only one case where an individual got a serious adverse reaction right after taking a single high dose of rapamycin, which required a visit to the ER. That individual supposedly did not have adverse reactions to lower doses, so this is a case where high peak levels might have been causing negative effects. This is why one should always ramp up the doses slowly and start small and increase it a little bit every week or few to see if one tolerates it.

On the other hand, chronic mTORC inhibition by rapamycin does tend to inhibit mTORC2, which causes side effects like impaired insulin sensitivity and elevated blood lipids. This can be largly avoided by intermittent dosing, but taking a large dose every one or two weeks can often prevent this effect almost completely, while the same dose spread out into more frequent smaller doses will inhibit mTORC2 and cause more side effects. In this respect, intermittent doses have less adverse effects, despite higher peak levels.

Overall we have a case where the dose makes the poison and overall for most people the side effects are likely minimized with intermittent doses (every one or two weeks) as opposed to chronic daily or every other day doses. People just need to be careful and ramp up the doses slowly to test their tolerance levels.

Regarding Blagosklonny, the reason he was focusing on higher peak dosing is, if I recall, the idea that higher peak levels are necessary for rapamycin to cross the blood-brain barrier. I think this is one reason he eventually stopped taking rapamycin weekly and started taking double the dose every two weeks instead. I doubt this dosing strategy had anything to do with him getting cancer.


Can you please elaborate on what this means? Do you mean that you were able to get a physician to write you a script for Sirolimus using Push Health, and then said prescription can be sent electronically to CostPlusDrugs?

Yes, I do not use CostPlusDrugs.

The prescription was sent electronically to the pharmacy of my choice.

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Well that’s very good to know. Under what kind of premise did you request Sirolimus if I may? Were you upfront about what you wanted it for?

I had a PharmD, Henry Dunklau, contact me from MidTown Express Pharmacy in Nashville, TN. Their number is 615.320.8410 and website is
He has coated tablets of Rapamycin 2 mg x 30 for $90 or 2 mg x 90 for $240.
Yes, they need an Rx - but he can send them to 43 states - cannot send to CA, OK, Kansas, Arkansas, SC, WV or NH.
Seems like this could be a good U.S. based resource for some folks!


how do you buy from india? Any reputable sources? Or for that matter, any sources. On brazil medications are usually very cheap, 1/5 of US price, yet rapamicyn (60 pills 1mg) cost 600 dollars as generic companies do not produce them (even though the patent expired long ago).

See the information on this page, about importing, and pricing and list of reliable India pharmacies: How to Get Rapamycin, Where to get a Prescription

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Recommend both apple pharmaceuticals and Shivansh trade!
Just create a Indianmart account and then start quoting and you will then get quite a response from the many pharmaceutical companies in India!

Payment is easy via and product quality is good as well! You can negotiate the best possible price as well!

I got some some discounts!

Yeah I don’t love rapamycin becoming more mainstream before there is enough acceptance in the medical community that it can be prescribed freely.

A clampdown on the gray market before the traditional medical world accepts it would make things difficult.

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Have you actually tried to use Mark Cuban’s? I haven’t used it, but I would have thought that they would have a way to upload a scan of a hardcopy script. Unless someone here says they don’t do that, it seems worth a shot …

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I’m just now starting to have patients use this who are in California - my other patients get it through the pharmacy in Nashville that has a very sensible deal and sends to the other states for the most part.
It looks like 30x1 mg is ~$2/mg, and 30 x 2 mg is a bit below that.
I’m putting through my first Rx right now and will let everyone know how it goes once I get feedback from my patient with CostPlusDrugs


Yes, I’ve tried to use my hardcopy Rx with both Mark Cuban’s site and Amazon Pharmacy. Both were no-go. They need to get the Rx from the doctor directly - if the doctor hasn’t worked with them before, the Doc will have to do some paperwork to get into their system, so some Docs (like mine) just aren’t going to do that.


Yes - I’ve done their paperwork. It is a hassle. But it is a one off hassle and then no problems from there.



Okay - have had my first Rx go through - really was a need for patient to sign up. On my side, all I had to do was fax or electronically transmit a prescription. Nothing fancy at all.

They do require that I put the patient’s email in with the Rx. Don’t really see this should be any impediment at all for any prescribing physician with Cost Plus. I put through 30 x 2 mg.

Cost for patient delivered, I think was $112.

Or about $1.80 per mg.


Mark Cuban’s Cost Plus provides a fillable form ( that can be completed and saved by patients, then forwarded to the doctor, saving the doctor some time. Maybe try that.

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Thanks Daph, I appreciate the idea. However my Doc has made it very clear he’s only going to provide hardcopy/paper prescriptions, and not do business with online pharmacies. So I’m not going to push the issue at this time. I can make do with my current situation.

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Don’t underestimate the Indian sources. They may be meds made in India or elsewhere. I’ve researched the manufacturer of what I’ve bought and every time they are quality manufacturers. Shipping time on what we’re looking for is not usually an issue. I’ve bought overseas since 2010 and have never had an issue–those days are gone if it’s written up properly as a prescribed med and is less than 90-days supply. I’ve never seen evidence of a package that was opened and inspected.

The above being said, here is a possible example: Metformin from

Well, that was who made the MDMA contaminated Metformin, See:

“The 2020 metformin tablet recall was a voluntary one from Marksans Pharma Limited, which issues metformin tablets marketed as Time-Cap Labs Inc. Some 178 lots of metformin hydrochloride were recalled in total from various manufacturers.”

Note: “Various manufacturers.” Various manufacturers that sold at pharmacies in America, these were not mail-order shipped from India, so there is risk even if you buy it from CVS. Supposedly “brand” drugs are safer but consider: Virtually all drugs/feedstock come from China, so in reality either the med came from China, or feedstock that went into making the finished med originated in China.

Just something to think about.

MarkCuban was in my ERX module dropdown menu, no paper work for the doctors at all and we have never used them before. As long as they have this NCPDP ID # 3689568, it should appear in any standard ERX module.

Patient do need an account with them though, it’s easy.

It really helped out with our Medicare patients, no need for them to buy from Mexico anymore.


In my view hire another doctor that will do what you want. The doctor work for you not the other way.

A plethora of medical doctors online services to get prescription.

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Yep, I hear ya. I am 100% happy with my Rapa doc (Dr. Alan Green). He’s been responsive to my questions and overall given me all the support I need.

If I ever find myself short of Rapa for any reason, I will be going to one of the tele-medicine sites, e.g.,, and getting what I need there, after comparing prices/services from those sources. When I became interested in Rapamycin, the online sources for Rx’s did not exist. I’m glad there’s options for all of us now.

edit: FYI I am actually using other online sources for other medications I am using for my anti-aging regime, so I’m only a click away from getting rapa from other sources.