Off-Label Drugs as an Anti-aging Medicine: Understand the Risks

The thought of getting older — and facing an age-related decline in your health — can be unsettling. As a result, some individuals try experimental methods in an attempt to prolong youth and extend their lifespan. One such approach is using certain prescription drugs or dietary supplements purported to slow aging.

Key takeaways:
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    Some individuals seek out prescription drugs purported to have anti-aging effects.
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    Off-label prescribing is permitted by licensed healthcare providers — if they feel the benefits of a particular drug outweigh the risks for their patient.
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    The best way to approach aging is to continue to keep your mind and body active.

Common examples among longevity enthusiasts are metformin, rapamycin, rituximab, and various hormonal therapies. If you're wondering about the potential risks and benefits of such drugs, keep reading to learn more about "anti-aging" medicines.

Off-label drug use and anti-aging

Off-label prescribing is when a medication is prescribed for a purpose that differs from the indications listed on the drug’s official labeling, as approved by the FDA. Off-label drug use is a common and completely legal practice. Based on their professional judgment, licensed healthcare providers are permitted to prescribe a drug off-label if they feel it’s the best treatment option for their patient.

To date, the U.S. Food and Drug Administration (FDA) has not approved any treatment to delay the onset of aging or prevent age-related declines in health. Even so, some clinicians offer “off-label” prescribing certain drugs for patients seeking potential anti-aging benefits.

Anti-aging medicine and their risks

One advantage of repurposing an older drug for a new use is that doctors already know a lot about the drug. For example, proper dosing, side effects, contraindications, interactions, and precautions are well-documented.

Next, let’s take a closer look at some of the specific treatments thought to have anti-aging effects and their risks.

Metformin

Metformin is FDA-approved to control blood sugar levels in people with type 2 diabetes. However, recent studies have investigated the potential anti-aging effects of metformin when used off-label. The drug has been shown to have benefits for cardiovascular health, thus possibly improving longevity. Additionally, metformin can aid in weight loss, potentially improving health outcomes in people with pre-diabetes and type 2 diabetes. Studies also suggest that metformin may lower the risk of dementia and stroke.

One study on people with diabetes found that those who took metformin had prolonged survival compared to those who did not. Metformin has also been shown to have potential anti-aging benefits in animal studies.

Common side effects of metformin include stomach upset, diarrhea, and a metallic taste in the mouth. Metformin may not be safe for someone with the following:

  • Heart failure;
  • Metabolic acidosis;
  • Impaired kidney or liver function;
  • Allergy to metformin.

Rapamycin

Rapamycin, also known as sirolimus, is FDA-approved for immunosuppression in people who’ve had an organ transplant.

The decline in organ function is a common complication of aging. As you age, your organs may not work as well as they used to. Rapamycin is thought to slow the process of organ deterioration, thus offering improvements in longevity. In addition, intriguing research suggests a role for rapamycin in potentially delaying organ malfunction. However, clinical studies are needed to verify the effectiveness of rapamycin as an anti-aging agent.

Common side effects of sirolimus include mouth sores, fatigue, high blood pressure, and stomach upset. The drug also suppresses the immune system, thus increasing the risk of frequent or serious infections.

Hormone supplementation

Hormone replacement therapies (HRT) are FDA-approved to treat various disorders of the endocrine system, which affects the body’s hormones and metabolism. When used appropriately, hormone replacement medications can help promote a healthy weight, improve cognitive function, regulate metabolism, and minimize fatigue. However, they should not be used for off-label reasons without considering the risks.

Despite the known problems of hormone therapy abuse among athletes, off-label use of the following drugs has been popularized to combat aging:

  • Testosterone replacement therapy. Testosterone, also called androgen therapy, is often promoted to help treat low sex drive, erectile dysfunction, and other symptoms in men;
  • Growth hormone. In an extensive study of athletes, growth hormone was shown to significantly reduce fat mass, increase lean body mass, and improve sprint capacity, but did not improve strength, endurance, or power. Still, the data on growth hormone in athletes has encouraged some non-athlete individuals to seek its potential benefits on their performance and longevity;
  • Thyroid hormone. Deviations in thyroid function are linked to an increased risk of cardiovascular disease and related death. A 2017 research study found considerable differences in life expectancy with variations in thyroid function. The results showed that people older than 50 with lower thyroid function lived longer overall and without cardiovascular disease than those with higher thyroid function. Some people may opt for thyroid hormone drug therapy to increase thyroid function and, thus, life expectancy. However, having too much thyroid hormone in the body can lead to serious and even life-threatening adverse effects.

Common side effects of hormone therapy can include weight changes, headaches, upset stomach, and reproductive challenges. Androgen use in men often leads to gynecomastia (breast tissue growth in men), small testes, acne, and low sperm density. In women, side effects of androgens may include acne, hirsutism (increased body hair growth), hair loss, and voice deepening.

Rituximab

Rituximab (brand name: Rituxan) is an FDA-approved antibody treatment for non-Hodgkin’s lymphoma, chronic lymphocytic leukemia, and rheumatoid arthritis. The discovery of rituximab in the late 1980s completely revolutionized the treatment of non-Hodgkin’s lymphoma, drastically improving survival and paving the way for other life-extending antibody treatments.

Studies in animals suggest promising anti-aging effects of rituximab. However, some scientists have questioned if rituximab might reduce the risk of developing age-related diseases such as cardiovascular disease and cancer.

Rituximab's side effects include immune system suppression, body aches, bloating, and skin reactions. Rituximab should not be used if you have an active infection, heart problems, are pregnant, or are allergic to the drug.

Can I buy anti-aging medicine online?

Yes, but ordering prescription drugs from certain websites is not advised due to the possibility of receiving counterfeit or contaminated products. Instead, it is best to connect with a licensed healthcare provider and use a licensed pharmacy. If you are interested in obtaining a prescription drug for any purpose, including an off-label one, you should talk with a licensed healthcare professional. Your doctor or pharmacist can determine if taking this medication is safe.

Non-drug strategies for healthy aging

The best way to approach aging is to keep your mind and body active. Maintaining a healthy lifestyle is key in helping to prevent the physical and cognitive effects of aging. Optimize your health at any age by:

  • Exercising regularly;
  • Eating a healthy diet;
  • Avoiding tobacco products;
  • Limiting alcohol intake;
  • Maintaining social relationships;
  • Finding purpose in activities that are deeply meaningful.

Aging is a natural, unpreventable process. While medications to postpone the onset of aging processes are being researched, no “miracle drug” exists for controlling the effects of aging. “Anti-aging” medicines should never be used without the supervision of a healthcare professional. Ultimately, wholesome and active lifestyle choices are the safest way to pursue a longer, healthier life.

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