Sirolimus on Costplusdrugs

New to rapa community here. Just started taking sirolimus, ordered through CostPlusDrugs (shipped from HealthDyne pharmacy in FL). Titrating weekly up to target of 6 mg weekly. Will post in this thread my blood level ~90 minutes after taking while fasted in morning. Will also post 6 day (trough?) level. Please post your blood Sirolimus results from CostPlus if you are doing the same.

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The manufacturer for CostPlusDrugs sirolimus is Ascend Laboratories, and their website lists the inactive ingredients as “EDETATE DISODIUM, POLOXAMER 188, HYPROMELLOSE 2910 (5 MPA.S), SUCROSE , ALPHA.-TOCOPHEROL, DL, MICROCRYSTALLINE CELLULOSE, CROSCARMELLOSE SODIUM, LACTOSE MONOHYDRATE, GLYCERYL DIBEHENATE, POLYETHYLENE GLYCOL, UNSPECIFIED, POLYVINYL ALCOHOL, UNSPECIFIED, TITANIUM DIOXIDE, GLYCERYL MONOCAPRYLOCAPRATE, SODIUM LAURYL SULFATE, TALC.”

Any biochemist in this community know if these ingredients point to enteric coating or another mechanism of bypassing the stomach?

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If it’s a tablet it must be enteric coated, else it’s pretty much a fake product as it doesn’t increase sirolimus levels. It is unlikely they will have such a product for organ transplants etc.

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How do you test your blood for rapamycin that fast?

I’ve ordered 2 lab requisitions for Labcorp through Life Extension. Will schedule blood draws to time them for peak and then trough blood levels.

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So here it is. Did blood sirolimus test exactly 90 minutes after taking 6mg from CostPlusDrugs (Ascend Laboratories) while fasted in morning (no EVOO or GFJ).

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Seems like it’s a good source of Rapamycin.

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And here is the trough level (7 days after taking 6mg). Is the consensus in this community that 0.6 result is low enough that taking this dosage on a weekly frequency should avoid inhibiting mTOR2?

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@McAlister had several very informative posts about studies that showed that a dosage of 20 mg (20 ng/ml) or below would evade MTOR2 inhibition. The danger zone lies above 20 mg where if you take 40 mg you have about a 50% chance of being someone who gets MTOR2 inhibition. No one knows the chances between 21-40 and above 40. We just have 2 data points. 20 mg and below, no MTOR2 inhibition. 40 mg, 50% chance of MTOR2 inhibition.

If you want to go above 20 mg equivalent, you’re taking your chances. As Clint Eastwood would say, “Do you feel lucky, punk?”

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It is now available. 3/12/24

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The price is good too. Now we just need a doctor to prescribe and we are in business.

In Phoenix, Dr. Toni Harrison 480-418-3678

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Any ideas for virginia?

See this post: Rapamycin Prescription, Doctors that Prescribe It

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FWIW

Have post this several times

I used Push Health, will send the prescription electronically to the pharmacy of your choice.

Paid $65.00 for the prescription.

I have no financial interest in Push Health.

I do use the service
.

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Yes I saw this list but nearly all of them have major disadvantages.

It is a shame we cannot find more doctors that are willing to prescribe in this case, though I get the reasons why.

Back to ordering from India!

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Is there any other fee than the $65 for the prescription? Other than ordering it from a pharmacy?

The fee was/is to the doctor, I was not charged any other fee.

Prescriptions was sent electronically to the pharmacy I chose.

Went/go to the pharmacy picked up and paid for the item.

If you want to know the doctor that was assigned to me and that I use writing me through the message system. As most doctors do not want public attention.

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I did 3 peak tests at Labcorp exactly 2 hours after taking 6 mg of sirolimus made by different manufacturers, to test 2 that were prescribed to me (Ascend and NorthstarRx) and a different one prescribed to my husband (Dr. Reddy’s). I did the tests at the same time of day and took the sirolimus the same way, with a cheese stick, some fresh berries, 1 tbs of fish oil, and green tea.

My 2-hr peak with the NorthstarRx was 28.8 ng/mL, with the Ascend was 28.7 ng/mL, and with the Dr. Reddy’s was 22.2 ng/mL. I’m not convinced the Dr. Reddy’s was less bioavailable - it could have been something else going on with my body that day or that I ate breakfast a little later than usual.

Based on what I’ve read about others’ peak serum levels, I think mine is unusually high and I don’t know why. I do NOT use grapefruit juice. I also did a trough serum test on day 7 the morning before taking another dose, and that was 0.6 ng/mL.

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What a great experiment! Well designed and implemented - thanks for sharing!. I agree - the variation with the Dr. Reddy’s sirolimus seems likely to be random noise due to environmental factors, etc.

How much do you weigh? Any side effects at that dosing? Unfortunately we really don’t have enough information yet to know what an optimal blood level is (peak, AUC, or any other measure)… or know what the optimal dosing schedule (weekly or every two weeks, or low dose daily)…

There is quite a bit of individual variation with rapamycin. If you want to understand more (or see examples in a study in healthy people) see here. You can see how large the standard deviations from the mean are for this sample, so there is obviously a significant amount of personal variation.

Pharmacokenetics and Safety of a Single Dose of Rapamycin (sirolimus) in Healthy Males
10.1097@00007691-200010000-00006-3.pdf (163.8 KB)

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