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Contraindications and Side Effects

Updated

Contraindications of Rapamycin

  1. Pregnancy and Breastfeeding:
    • Rapamycin is not recommended for pregnant or breastfeeding women due to potential risks to the fetus or infant. It is recommended to stop Rapamycin at least 6 months before trying to conceive to focus on nourishing and building.
  2. Severe Liver or Kidney Disease:
    • Patients with severe liver or kidney disease should avoid Rapamycin due to potential toxicity and complications.
  3. Active Infections:
    • Individuals with active infections should not take Rapamycin as it may suppress the immune response. We recommend pausing Rapamycin until an infection, acute sickness, or surgery has healed completely before starting again.
  4. Immunosuppressive Conditions:
    • Patients with conditions requiring immunosuppressive therapy should avoid Rapamycin due to its potential immune-modulating effects.
  5. Hypersensitivity to Rapamycin:
    • Known allergy or hypersensitivity to Rapamycin or any of its components.
  6. Concurrent Use of Certain Medications:
    • Avoid use with medications that strongly interact with the mTOR pathway or those metabolized by CYP3A4, such as certain antifungals, antibiotics, and antiretrovirals. Low doses of these medications may be taken concurrently depending on risk factors.

Potential Side Effects of Rapamycin


Mouth Sores

  • The most common negative side effect for first-time Rapamycin users is a brief bout of canker sores, usually mild and lasting a few days to a couple of weeks.
  • These sores arise due to Rapamycin’s inhibition of the mTOR1 pathway, slowing cellular replication. As a result, minor damages in the mouth that would typically go unnoticed become more apparent.

    Care and Management:

  • Topical Anesthetics: Gels containing benzocaine or lidocaine can numb the area, easing pain during eating.
  • L-lysine: a common amino acid, can be helpful.
  • Hydrogel Dressings: These provide a protective barrier, promoting healing and reducing irritation.
  • Saline Mouthwashes: Regular rinsing with saline helps keep the mouth clean and aids in healing.
  • Systemic Pain Relievers: NSAIDs can help manage pain and inflammation.
  • Antimicrobial Mouthwashes: Use judiciously to reduce bacterial load without causing additional irritation.
  • Adjusting Rapamycin Dose: Consult your healthcare provider about possibly adjusting your dose if sores persist.


Elevated Lipids & Glucose

  • In some patients, an increase in LDL, glucose, and cholesterol may occur.
  • Rapamycin can cause a transient increase in lipids and glucose levels when beginning the protocol. This is because its stimulates autophagy and can cause a release of lipids into the bloodstream. If this is the case, then the values will return back to baseline in the next assessment.
  • Rapamycin can cause an increase in lipids and glucose if the level of Rapamycin in the blood is too high. This can happen if you are not metabolizing the drug quickly enough.

    Care & Management:

  • Dihydroberberine (DHB): DHB is a more bioavailable form of berberine, which has been shown to help manage cholesterol levels. It works by enhancing lipid metabolism, improving insulin sensitivity, and supporting overall cardiovascular health. Incorporating dihydro berberine into your routine, alongside maintaining a healthy diet and regular exercise, may help reduce LDL cholesterol levels more effectively.
  • Dosing Adjustment: another option is to adjust dosing every 2 weeks vs. every 1 week.