Anti-aging and longevity
Use of drugs and supplements to slow aging, extend lifespan, improve appearance, and enhance mental performance in adults without a clinical diagnosis. Covers antioxidant supplements and vitamins for longevity and cancer prevention in healthy adults, combined oral contraceptives for anti-aging, glutathione precursors for skin lightening, nootropics for cognitive enhancement, and off-label drugs (metformin, sildenafil, hydroxychloroquine) for biological aging slowdown. Evidence base is limited or absent.
156 drugs
Also known as: anti-aging supplements, sports supplements, performance enhancers, Smart drugs, Nootropics for healthy adults, Longevity
Drugs used for this condition
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DAcetyl-L-carnitineNot recommended · Acetylated ester of L-carnitine; supplement with claimed neurotropic effectBiohackers market acetyl-L-carnitine for anti-ageing and mitochondrial support. The claim rests on early-2000s Bruce Ames rat studies where ALCAR plus alpha-lipoic acid improved mitochondrial function in old animals. Human translation is not confirmed. No human RCTs with lifespan endpoints exist. EFSA rejected the health claim «contribute to the maintenance of cognitive function in elderly». Evidence-based risk reduction for ageing comes from blood pressure, lipid and glucose control, physical activity and not smoking, not from supplements.
- DApigeninNot recommended · Flavonoid from chamomile, parsley and celery; supplement for sleep and «anti-ageing»; not registered as a drug by AEMPS or EMA; EFSA has not approved related health claimsApigenin is a plant flavonoid found in chamomile, parsley, and celery, promoted as a supplement for anti-aging and longevity. Studies in people have not shown a convincing benefit for this use – there is no evidence base to support it. What actually helps healthy aging is straightforward: sleep, regular physical activity, a diet with vegetables and enough protein, not smoking, and protecting skin from the sun.
- DAscorbic acidNot recommended · Vitamins. AntioxidantsAscorbic acid (vitamin C) is a nutrient often promoted in supplements as a way to slow aging and extend lifespan. Convincing benefit for this use hasn't been shown: the evidence doesn't support that taking supplements delays aging or makes people live longer. What actually helps here is sleep, regular physical activity, a varied diet and not smoking, and most vitamin C comes from vegetables and fruit anyway.
- DAstaxanthinNot recommended · Dietary supplements, carotenoids (local classification)Astaxanthin is a carotenoid pigment with antioxidant properties, and supplements containing it are marketed for slowing aging and extending lifespan. The benefit for this use hasn't been shown in people: there's no evidence that it affects aging or how long we live. What actually helps skin and longevity is straightforward – sun protection, not smoking, sleep, physical activity and a balanced diet.
- DAstragalus root (Astragalus membranaceus; Huang Qi in traditional Chinese medicine)Not recommended · Root of the perennial legume Astragalus membranaceus and its extracts. In traditional Chinese medicine, Huang Qi is used to «tonify Qi»; modern marketing sells it as an «immune modulator», a «longevity and telomere supplement», and supportive care in oncology. Neither AEMPS nor EMA registers it as a medicine; the EMA HMPC has not published a dedicated monograph on astragalus. AESAN classifies it as a complemento alimenticio. FDA has issued no approval.Astragalus is a flagship ingredient of the «telomere supplement» market. The concept: chromosome telomeres shorten with age, cells enter replicative senescence, and the cycloastragenol fraction TA-65 «activates telomerase» and «rebuilds telomeres», returning cells to a younger state. Clinical data do not confirm the hypothesis. Published TA-65 studies are small open-label manufacturer-sponsored series reporting immunological changes and modest telomere lengthening in some lymphocyte fractions, but no hard endpoints (lifespan, age-related disease incidence). NCCIH classifies astragalus among supplements with insufficient evidence for anti-ageing claims. Telomerase activation in humans carries an oncological risk – extending the life of cells carrying accumulated mutations – so most oncologists and geriatricians do not recommend TA-65. The real strategy for healthy longevity (data from Okinawa, Sardinia, Nicoya, Ikaria) is physical activity, a Mediterranean diet, calorie restriction without deficit, smoking and alcohol cessation, social ties, blood-pressure, diabetes, and lipid control. Astragalus root does not add anything magical to this picture.
- DAtorvastatin + EzetimibeNot recommended · Fixed-dose combination: statin plus intestinal cholesterol absorption inhibitorAtorvastatin + ezetimibe is sometimes sold as a longevity drug and as cholesterol lowering for healthy young adults with LDL-C <130 mg/dL and ASCVD risk <5%. Per ESC/EAS 2019, ACC/AHA 2018, and SEA 2023, statin therapy is not initiated for ASCVD risk <5% – benefits do not exceed harms (myopathy, transaminitis, hyperglycemia). Ezetimibe + statin has no indication in young patients without diagnosed dyslipidemia or familial hypercholesterolemia. If prescribed for anti-aging without SCORE2 calculation or a familial form, consider getting a second opinion and a formal ASCVD risk estimate.
- DCalcium + CholecalciferolNot recommended · Fixed-dose combination: calcium salt (carbonate) plus vitamin D3Calcium + vitamin D is often marketed to all adults for strong bones, immunity, and longevity. Per NOF 2022, USPSTF 2018, and SEIOMM 2022, in healthy adults without osteoporosis, prior low-energy fractures, or confirmed vitamin D deficiency, daily supplementation does not reduce fracture risk or improve survival. High calcium intake (>1500 mg/day from diet plus supplements) increases kidney-stone risk and, by some meta-analyses, cardiovascular events. If prescribed for prevention without osteoporosis or vitamin D deficiency, consider getting a second opinion and a DXA scan.
- DCholine bitartrateNot recommended · Essential nutrient, dietary supplement. The basic choline form used in supplements. Not registered as a medicine in the EU or USA; sold as a supplement in RussiaCholine bitartrate is a salt form of choline sold as a supplement and marketed for anti-aging and longevity. Studies have not shown a convincing benefit for this use: there is no evidence that taking it extends life or slows age-related changes. What actually affects lifespan is different – not smoking, keeping blood pressure and blood sugar in check, physical activity and sleep, rather than a single supplement
- DDimethyl FumarateNot recommended · Immunomodulator for disease-modifying therapy of multiple sclerosisDimethyl fumarate is sometimes promoted in biohacking circles as an Nrf2 activator for anti-aging and detox. Nrf2 activation is described in vitro and in animal models, but clinical benefit in adults without multiple sclerosis or moderate psoriasis is not confirmed. In healthy adults it causes marked flushing, GI distress (diarrhea, nausea 30–40%), and lymphopenia with risk of progressive multifocal leukoencephalopathy (PML – rare but fatal). If prescribed for longevity without MS or moderate-severe psoriasis, consider getting a second opinion.
- DFisetin (flavonol from strawberries, mangoes and onions)Not recommended · Plant flavonol, supplement. Natural polyphenol from strawberries, mangoes, onions, apples. The biohacking industry positions it as a «senolytic» – an agent that clears senescent cellsFisetin is a flavonol found in plants such as strawberries, mango and onion. It is marketed as an anti-aging and longevity supplement, often as a senolytic that clears senescent cells. In people, no convincing benefit for this use has been shown – there is no solid evidence that it slows aging or extends lifespan. What does help with healthy aging is well established: regular physical activity, sleep, a sensible diet, and keeping blood pressure, glucose and lipids in check, along with not smoking. Fisetin should not be taken instead of measures and treatments with proven benefit, since that can mean missing care that actually works.
- DFluvastatinNot recommended · Statin (HMG-CoA reductase inhibitor)Statins, including fluvastatin, are sometimes marketed as a longevity drug for all adults over 40. Per ESC/EAS 2019, ACC/AHA 2018, and SEA 2023, statin therapy in adults without diagnosed dyslipidemia or familial hypercholesterolemia is not started at SCORE2 ASCVD risk <5%: benefits do not exceed harms (myopathy, transaminitis, raised blood glucose). In the potency race, fluvastatin loses to atorvastatin/rosuvastatin; prescribing it just in case has no rationale. If prescribed without SCORE2 risk calculation or a lipid panel, consider getting a second opinion and a formal risk estimate.
- DFolic acidNot recommended · Vitamins. Haemopoietic stimulantsFolic acid is a B vitamin needed for cell division and blood formation. For anti-aging and longevity it gets marketed as a supplement that supposedly slows aging and extends lifespan. No convincing benefit has been shown for this use: there is no evidence base supporting an anti-aging effect in people without a deficiency. Folic acid makes sense for a confirmed deficiency and when planning a pregnancy; for slowing aging, other approaches help – sleep, diet, physical activity, not smoking, and protecting skin from the sun.
- DGlimepirideNot recommended · Third-generation sulfonylureaGlimepiride is sometimes prescribed in prediabetes (HbA1c 5.7–6.4%) to prevent progression to type 2 diabetes. Per ADA 2024, EASD 2024, and redGDPS 2024, first-line in prediabetes is lifestyle modification, with metformin in high risk (BMI ≥35, prior GDM, age <60). Sulfonylureas at HbA1c <6.5% are not indicated – hypoglycemia and weight gain risks exceed any benefit. Prescribing for longevity or for sugar control in healthy adults is clearly off-label. If prescribed without a type 2 diabetes diagnosis, consider getting a second opinion.
- DGlucosamine + ChondroitinNot recommended · Chondroprotector. Glucosamine sulfate and chondroitin sulfate as monoproducts are registered by AEMPS as medicines for symptomatic treatment of mild-to-moderate knee osteoarthritis (Xicil, Pharma Mar; Condrosulf, Condrosan, Bioiberica). Fixed combinations are more often dietary supplements. In Russia, Dona and Structum are registered as medicinesGlucosamine and chondroitin are cartilage components long sold as joint supplements, and more recently marketed for slowing aging and extending lifespan. The benefit for this use has not been shown: there is no evidence base supporting an anti-aging effect or any impact on longevity. What actually helps with healthy aging is different – movement, sleep, nutrition, and managing risk factors like blood pressure and blood sugar. The substance itself is harmless in this role, but there is no reason to expect a rejuvenating effect.
- DGrape seed extract (Vitis vinifera, oligomeric proanthocyanidins)Not recommended · Plant polyphenol complex, supplement. Source of oligomeric proanthocyanidins (OPC), compositionally similar to pycnogenolGrape seed extract contains oligomeric proanthocyanidins, plant antioxidants marketed to slow aging and extend lifespan. Studies have not shown convincing benefit for this use: there is no solid evidence that the supplement actually affects aging or how long people live. What does help these outcomes is the ordinary stuff – sleep, diet, physical activity and sun protection for the skin.
- DHydrolysed Collagen Peptides (type I and III)Not recommended · Dietary supplement, hydrolysate of animal or marine connective tissue. In Russia and Spain sold as dietary supplement. AEMPS does not register oral collagen as a medicineHydrolyzed collagen is collagen protein cut into peptides for easier absorption. It is sold to slow aging, extend life, and prevent age-related changes in skin, hair, and joints. After ingestion, hydrolyzed collagen is broken down in the gut to amino acids and small peptides; the body uses these amino acids the same way as those from any other protein source (meat, fish, eggs, dairy). Targeted delivery to skin or cartilage does not happen. Clinical studies are small, heterogeneous, and funded by supplement manufacturers; systematic reviews show that the effect on skin condition in healthy adults is either absent or clinically insignificant. The best collagen approach is a complete diet with adequate protein (1–1.5 g/kg body weight), vitamin C, and UV protection. If hydrolyzed collagen is being taken for anti-aging skin, consider seeking a second opinion.
- DHydroxocobalaminNot recommended · Vitamin B12 (European form of choice) and cyanide poisoning antidoteHydroxocobalamin is a form of vitamin B12 used to treat B12 deficiency and the anemia linked to it. Marketers promote it for anti-aging and longevity as a way to "rejuvenate" and slow aging, but no convincing benefit has been shown for that use – there is no solid evidence that taking it for longevity helps people whose B12 levels are normal. When B12 is already adequate, extra doses do not produce an anti-aging effect. What actually affects aging is sleep, diet, physical activity, not smoking, and keeping blood pressure and blood sugar in check; B12 is worth supplementing only when lab tests confirm a deficiency.
- DL-arginineNot recommended · Conditionally essential amino acid, NO precursor. Sport and cardio-biohacking supplement. AEMPS does not register as medicineL-arginine is an amino acid and a nitric oxide precursor that marketing links to a longer life and slower aging. No large clinical trial shows that L-arginine supplements extend human lifespan or reverse aging. EFSA reviewed the proposed L-arginine effects (immune function, blood vessels, physical performance and others) and found no cause-and-effect relationship for any of them, and the EU has authorized no anti-aging claim. Laboratory work shows that prolonged L-arginine exposure accelerates endothelial cell senescence, and in the VINTAGE MI trial high doses raised mortality in patients after a heart attack. In healthy adults at usual doses the supplement is tolerated, but it offers no longevity benefit.
- DL-threonine + pyridoxine (Biotredin)Not recommended · Combined metabolic preparations (local classification). Russian development.Biotredin is a combination of L-threonine and pyridoxine (vitamin B6) sold in Russia as an amino-acid complex for nervous-system support and youth extension. The evidence base is limited to in-house studies by the manufacturer; no independent international clinical studies exist. Biotredin is not included in any international guidelines. The idea of youth extension through amino-acid supplements is not supported by clinical evidence. The supplement is relatively safe, but no anti-aging effect should be expected. If biotredin was recommended for rejuvenation, consider seeking a second opinion.
- DLecithin (soy or sunflower phosphatidylcholine)Not recommended · Phospholipid mixture, dietary supplement. A mass OTC «memory drug» and «hepatoprotector» in Russia. Essentiale (Sanofi, essential phospholipids) is a separate regulated medicine, registered by AEMPS and in Russia for NAFLDLecithin is a source of phosphatidylcholine from soy or sunflower. As a supplement it gets marketed for slowing aging and supporting longevity. No convincing benefit has been shown for this use, and there is no evidence base behind the anti-aging claim. What actually affects how we age is more ordinary: sleep, diet, physical activity, sun protection, and not smoking.
- DMagnesium L-threonate (Magtein)Not recommended · Magnesium chelate with L-threonic acid in a specific stoichiometry; the patented Magtein form, developed as a Stanford / MIT spinout; sold as a «magnesium for the brain» supplementMagnesium L-threonate (brand Magtein) is a magnesium form marketed to slow aging and support longevity, with manufacturers promising brain protection and a longer healthy life. No convincing data show the supplement slows aging or extends lifespan; this use rests on lab work and a few small studies rather than a solid evidence base in people. Healthy aging actually responds to well-established measures: controlling blood pressure, glucose and lipids, staying physically active, not smoking, sleeping well and eating a balanced diet. Do not take magnesium L-threonate in place of these measures, since swapping a proven approach for a supplement with no demonstrated benefit leaves real risks untreated.
- DMedium-chain triglycerides (MCT, coconut oil C8–C10)Not recommended · Medium-chain fatty acids C8 (caprylic) and C10 (capric), extracted from coconut and palm kernel oil. Supplement. In clinical medicine MCT is used in enteral and parenteral nutrition in malabsorption syndrome, cystic fibrosis and ketogenic diet for drug-resistant epilepsy. AEMPS does not register it as a monoproduct medicineMedium-chain triglycerides (MCT) are fats from coconut and palm-kernel oil, the C8–C10 fractions. In the anti-aging niche they get promoted as a quick source of energy and ketones that supposedly slows aging and extends lifespan. No convincing benefit for this use has been shown in people: there is no evidence base for life extension or rejuvenation. Healthy lifespan depends far more on sleep, regular physical activity, a balanced diet, and keeping blood pressure, weight, and blood sugar in check.
- DMelatoninNot recommended · Hypnotics. Melatonin receptor agonistsMelatonin is a hormone that regulates the sleep-wake cycle. For anti-aging and longevity it gets promoted as a supplement that slows aging and extends lifespan. Studies have not shown a convincing benefit for this use in people – there is no solid evidence base for taking melatonin to live longer. What actually supports healthy aging is steady sleep, physical activity, good nutrition, and managing risk factors with a doctor. At usual doses melatonin is safe, but the longevity claim is unproven.
- DMenaquinone (vitamin K2)Not recommended · Vitamins. γ-glutamyl carboxylase cofactorMenaquinone (vitamin K2) is a form of vitamin K often promoted as a supplement for anti-aging and longevity. Clear benefit for this use has not been shown: there is no solid evidence that K2 extends lifespan or slows aging. Lifespan responds far more to managing blood pressure and blood sugar, not smoking, staying physically active, and sleeping well – worth discussing with your doctor. Important: vitamin K reduces the effect of warfarin and other vitamin K antagonists; patients on these anticoagulants, including those with a mechanical heart valve, must not take vitamin K supplements without medical agreement.
- DMenaquinone-7Not recommended · Fat-soluble vitamin K2 (MK-7 form)Menaquinone-7 (MK-7) is a form of vitamin K2 marketed as a supplement to slow aging and extend lifespan. So far no convincing benefit for this use has been shown – there is no evidence base for anti-aging or longevity. Lifespan and age-related changes respond more reliably to sleep, physical activity, diet and not smoking; if you have a vitamin K deficiency, talk to a doctor about supplementation. Important: vitamin K reduces the effect of warfarin and other vitamin K antagonists; patients on these anticoagulants, including those with a mechanical heart valve, must not take vitamin K supplements without medical agreement.
- DMethylsulfonylmethane (MSM)Not recommended · Dietary supplement. Organic sulphur compound, dimethyl sulfone. AEMPS does not register as a medicine; in Russia and Spain – dietary supplementMethylsulfonylmethane (MSM) is a sulfur compound sold as a supplement for slowing aging and extending lifespan. No convincing benefit for this use has been shown: there is no quality evidence base for an effect of MSM on aging or longevity in people. On its own, at usual doses, it is well tolerated. What actually affects a longer healthy life is not smoking, regular physical activity, sleep, and keeping blood pressure, blood sugar, and weight in check with your doctor.
- DNattokinase (serine protease from fermented soybean natto, Bacillus subtilis var. natto)Not recommended · Serine protease isolated from fermented soy natto. Supplements market it as a «natural blood thinner», «protection against stroke and thrombosis», and a «natural warfarin alternative». Neither AEMPS nor EMA register it as a medicine; AESAN classifies it as a complemento alimenticio without therapeutic indication. FDA has issued no approval and warned manufacturers in 2022 about illegal claims of myocardial infarction and stroke prevention.Nattokinase is presented as «healthy-vessel and longevity protection» on TikTok, at anti-ageing conferences, and in preventive-medicine clinics. The hypothesis leans on Japan's low cardiovascular disease rate and traditional natto breakfast consumption. This correlation has been examined repeatedly in epidemiology, but population-level causality between natto and cardiologic longevity has not been established – lower BMI, fish and tea intake, low red-meat consumption, low obesity prevalence, and active lifestyle drive most of the signal. The correlation does not transfer to capsules of purified nattokinase: RCTs with hard endpoints of lifespan or cardiovascular mortality have not been done. Chen 2018 (Biomark Insights) reviewed small series showing 3–5 mm Hg systolic blood-pressure reductions in short-term studies, but methodological quality is low (open-label, small samples, varied doses). AHA and ESC prevention guidelines rely on blood-pressure control (target 120–129 mm Hg for most), statins for dyslipidaemia, metformin and incretins for diabetes, smoking cessation, and a Mediterranean diet. Nattokinase is not in these recommendations.
- DNicotinamide mononucleotide (NMN)Not recommended · Dietary supplements, NAD+ precursors (local classification)Nicotinamide mononucleotide (NMN) is a NAD+ precursor sold as a supplement and promoted for slowing aging and extending lifespan. Human studies have not shown convincing benefit for this use, and there is no evidence base for anti-aging or longevity. The substance itself is well tolerated in this role. What actually affects biological aging is the ordinary stuff: not smoking, regular physical activity, decent sleep, and keeping blood pressure, glucose and lipids in check.
- DNicotinamide riboside (NR)Not recommended · Dietary supplements, NAD+ precursors (local classification)Nicotinamide riboside (NR) is a form of vitamin B3 marketed as an anti-aging and longevity supplement, on the idea that it raises cellular NAD+ levels. In people, a meaningful benefit for this use has not been shown – the supplement does raise blood NAD+, but there is no solid evidence that this slows aging or extends lifespan. For healthy aging, the approaches with real backing are steady sleep, regular physical activity, a balanced diet, and not smoking. NR is well tolerated in this context; the issue is simply the lack of a proven effect.
- DOmega-9 monounsaturated fatty acid (oleic acid)Not recommended · Monounsaturated fatty acidsOmega-9 (oleic acid) is a monounsaturated fatty acid abundant in olive oil. Supplements promote it for slowing aging and extending lifespan. Convincing benefit for this use has not been shown, and there is no solid evidence behind omega-9 as an anti-aging agent. Aging is shaped far more by sleep, a diet rich in vegetables and fish, regular movement, and not smoking.
- DOrlistatNot recommended · Peripherally acting antiobesity drug – intestinal lipase inhibitorOrlistat is heavily marketed to non-obese people for quick weight loss, summer weight loss, and healthy weight loss at BMI 25-27. Per EASO 2024 and SEEN 2023, neither weight above ideal at BMI <27 nor cosmetic weight loss is an indication. Without concurrent dietary fat restriction the drug does not work; with more than 30 g of fat per meal it causes marked steatorrhea, fecal incontinence, and flatulence. Long-term use without monitoring risks deficiency of fat-soluble vitamins A, D, E, K and reduced bone mineral density. If prescribed at BMI <27 without mandatory dietary changes, consider getting a second opinion and reconsider whether you need this drug at all.
- DPropolis (bee product)Not recommended · Bee product, supplement. Not registered as monomedicine in EU or AEMPS; OTC segment in Italy and GermanyPropolis is a bee product often marketed as a way to slow aging and extend lifespan. There's no convincing evidence for this use: studies don't show an anti-aging effect or any impact on longevity. The substance itself is harmless in this role, but it won't deliver a rejuvenating result. What actually shapes aging is sleep, nutrition, physical activity, sun protection, and keeping chronic conditions under control.
- DPumpkin seed oil (Cucurbita pepo, Cucurbita maxima)Not recommended · Plant product, supplement. In EU – traditional herbal medicinal product per EMA HMPC monograph; AEMPS does not register as monomedicinePumpkin seed oil (Cucurbita pepo, Cucurbita maxima) is a plant oil rich in fatty acids and tocopherols, marketed as a way to slow aging and support longevity. No convincing benefit for this use has been shown: there is no evidence that it affects lifespan or the aging process. What actually moves the needle on aging are everyday habits you control – sleep, diet, physical activity, not smoking, and protecting skin from the sun. The oil is harmless at usual amounts, but do not use it in place of measures and treatments with proven benefit, or you may miss what really works.
- DPycnogenol (French maritime pine bark extract, Pinus pinaster)Not recommended · Plant polyphenol complex, supplement. Standardised maritime pine bark extract with 65–75% oligomeric proanthocyanidinsPycnogenol is a patented extract of maritime pine bark (Pinus pinaster), rich in proanthocyanidins. It is marketed as a supplement to slow aging and extend lifespan, usually through the idea of fighting free radicals. No convincing benefit has been shown for this use: the data come from small, short studies, and there is no evidence base for anti-aging or longevity. What actually affects skin aging is sun protection, not smoking, and enough sleep; among topical agents, retinoids.
- DPyrroloquinoline quinone (PQQ)Not recommended · Dietary supplements, redox cofactors (local classification)Pyrroloquinoline quinone (PQQ) is sold as a supplement to slow aging and extend lifespan, with promises of mitochondrial support and more cellular energy. No convincing benefit for this use has been shown in people, and there is no evidence base for anti-aging or longevity. What actually affects aging and lifespan is sleep, diet, physical activity and not smoking.
- DQuercetinNot recommended · Dietary supplements, flavonoids (local classification). Also registered in Russia as an angioprotective agent.Quercetin is a plant flavonoid found in onions, apples and capers, marketed in supplements as an anti-aging and longevity aid, sometimes paired with other so-called senolytics. There is no convincing human evidence that it slows aging, rejuvenates skin or extends lifespan. The compound itself is well tolerated at usual supplement doses. For healthy aging, the approaches that hold up are the proven ones: sleep, physical activity, diet, not smoking and sun protection.
- DReishi (Ganoderma lucidum, lingzhi)Not recommended · Medicinal mushroom of traditional Chinese medicine, supplement. AEMPS does not register as medicineReishi (Ganoderma lucidum, lingzhi) is a medicinal mushroom marketed in supplements for slowing ageing and longevity. There is no convincing benefit for this use: the evidence base showing any effect on lifespan or age-related changes is missing. What actually supports healthy ageing is different – regular physical activity, sleep, a diet with vegetables and enough protein, not smoking, and keeping blood pressure, blood sugar, and cholesterol in check.
- DSilicon (organic silicon, silica from horsetail or bamboo)Not recommended · Mineral in supplement form. Not registered as medicine in EU or AEMPSSilicon as organic silicon (horsetail or bamboo extract) is sold as a supplement to slow aging and support longevity, usually for skin, hair, and nails. The benefit for this use has not been shown: there is no solid evidence that it affects aging or lifespan. For skin and overall health, other approaches help – sun protection, not smoking, sleep, and a reasonable diet; for brittle hair or nails it makes sense to look for the specific cause with a doctor.
- DSomatropinNot recommended · Recombinant human growth hormoneSomatropin is heavily marketed in anti-aging clinics and the fitness industry as a rejuvenation, muscle-building, and fat-burning drug. In the US, EU, and Russia, prescribing it outside pediatrics and confirmed adult deficiency is prohibited. The Endocrine Society 2019, AACE 2019, and SEEN 2022 explicitly state: in people with normal GH secretion the drug does not work as a rejuvenator – the Rudman 1990 study cited by sellers showed transient lean-mass gain alongside edema, insulin resistance, and tumor risk. In athletes somatropin is on the WADA prohibited list. If prescribed for rejuvenation or quality of life without confirmed deficiency by two stimulation tests, consider getting a second opinion from an independent endocrinologist.
- DSpermidineNot recommended · Dietary supplements, polyamines (local classification)Spermidine is a polyamine found in foods such as wheat germ, soy, mushrooms and aged cheese, and as a supplement it gets promoted for slowing aging and extending lifespan. The interest comes from cell and animal studies where spermidine triggered autophagy, but convincing benefit for this use has not been shown in people: there are no high-quality long-term trials with hard outcomes. Healthy aging rests on well-established habits – a balanced diet, regular physical activity, enough sleep, not smoking and keeping cardiovascular risk factors in check.
- DStinging nettle root (Urtica dioica, radix)Not recommended · Plant extract, supplement. In EU – traditional herbal medicinal product per EMA HMPC monograph 2010 for BPH symptoms; AEMPS does not register as monomedicineNettle root (Urtica dioica, radix) is a herbal material promoted for anti-aging and longevity. No convincing benefit has been shown for this use: there is no evidence base supporting an effect on lifespan or aging. The substance is harmless in this role, but an anti-aging effect should not be expected. For healthy aging, the approaches that actually work are well known: sun protection, sleep, physical activity, a sensible diet, and managing risk factors with a doctor.
- DSulforaphane (isothiocyanate from broccoli sprouts)Not recommended · Plant isothiocyanate, supplement. Formed from glucoraphanin (Brassica oleracea) by myrosinase. Activator of the Nrf2-Keap1 pathwaySulforaphane is an isothiocyanate from broccoli sprouts, promoted as an antioxidant and Nrf2 activator to slow aging and extend lifespan. No convincing benefit for this use has been shown: the evidence is limited to lab models, animal experiments, and small short-term studies on biomarkers, with no confirmed effect on human lifespan or aging. Healthy aging rests on proven measures: not smoking, regular physical activity, a balanced diet, enough sleep, and keeping blood pressure and metabolic markers in check. In this role the compound is harmless.
- DTaurineNot recommended · Sulfur-containing amino acid, supplement and energy-drink ingredient. In Russia registered as a medicine (Dibicor) for T2DM and CHFIn 2023, Science published Singh et al. on taurine as a «driver of aging»: lifelong taurine intake in mice and monkeys extended lifespan by 10–12% and improved metabolic markers. The paper triggered a marketing wave: supplement makers sell taurine as an «anti-aging drug». But: no human RCT data with hard endpoints (mortality, morbidity). Correlation between taurine level and biological age does not prove causation. EFSA 2009 did not approve a longevity claim. Anti-aging taurine use in humans today is purely experimental and not supported by clinical guidelines. If it was recommended «to slow aging», consider seeking a second opinion.
- DTauroursodeoxycholic acid (TUDCA)Not recommended · Bile acid, conjugate of ursodeoxycholic acid with taurine. RX medicine in Japan; in EU/US sold as supplement. AEMPS does not register it as a medicine. Not registered in Russia via GRLSTauroursodeoxycholic acid (TUDCA) is a bile acid. Researchers study it in liver and bile-duct conditions, and the biohacking scene promotes it as a supplement to slow aging and extend lifespan. Convincing benefit for that specific purpose has not been shown in people: there are no quality clinical trials on TUDCA taken for longevity. What actually affects how long and how well people live are well-established habits, namely enough sleep, regular physical activity, a diet low in ultra-processed food, not smoking, and keeping blood pressure, glucose, and weight in check.
- DTocotrienolsNot recommended · Natural vitamin E forms (4 isomers α, β, γ, δ)Tocotrienols are a form of vitamin E, marketed as an antioxidant that slows ageing and extends lifespan. No convincing benefit has been shown for anti-ageing or longevity in this role, and the evidence for such use is lacking. What actually affects ageing: sun protection, not smoking, sleep, physical activity and diet; for the skin, proven ingredients such as retinoids do the work.
- DUbidecarenone (coenzyme Q10)Not recommended · Other cardiac preparations. Coenzyme Q10Ubidecarenone, better known as coenzyme Q10 (CoQ10), is a compound the body makes on its own. It is sold as a supplement to slow aging and extend lifespan. For anti-aging and longevity, the supplement has not shown convincing benefit, and there is no solid evidence base for this use. For the skin, sun protection and retinoids do the work; for lifespan, sleep, not smoking, and physical activity matter most.
- DUrolithin A (ellagitannin metabolite, mitophagy activator)Not recommended · Ellagitannin metabolite, supplement. Formed by gut microbiota from ellagitannins in pomegranates, walnuts and raspberries. Synthetic form Mitopure (Amazentis) is patented and sold in EU and USUrolithin A is a metabolite of ellagitannins (found in pomegranate and walnuts) that gut bacteria produce only in some people. Supplements promote it as a mitophagy activator for anti-aging and longevity. Convincing benefit for this use has not been shown in people, and there is no solid evidence that it slows aging or extends lifespan. What actually supports healthy aging is straightforward: regular physical activity, enough sleep, a balanced diet and not smoking.
- DVildagliptin + MetforminNot recommended · Fixed-dose combination: DPP-4 inhibitor plus biguanideMetformin in fixed-dose combinations is marketed as an anti-aging drug that extends lifespan in healthy adults. In 2026 the principal TAME trial is still ongoing with no results yet. In people without diabetes or prediabetes, metformin is not approved by AEMPS, EMA, or FDA. Additional risks include B12 deficiency (6–30% on long-term use), lactic acidosis during dehydration, and GI side effects. If prescribed for longevity without a diagnosis of type 2 diabetes or prediabetes (HbA1c <5.7%), consider getting a second opinion.
- DVitamin B12 (cobalamin)Not recommended · Water-soluble B-vitamin; cofactor of methionine synthase and methylmalonyl-CoA mutaseVitamin B12 (cobalamin) is a water-soluble vitamin needed for blood formation and nerve function. For anti-aging and longevity it gets marketed as a supplement that supposedly slows aging and extends lifespan. In people without a B12 deficiency, this use has no convincing evidence behind it: when blood levels are normal, extra B12 does not extend life or reverse aging. The vitamin itself is harmless at usual doses, but it does not act on aging this way. What actually supports healthy aging are sleep, diet, physical activity, not smoking, and managing chronic conditions. Do not take B12 in place of a treatment with proven benefit, since swapping out real care means losing valuable time.
- FAceclofenacNot recommended · NSAID, acetic acid derivative, COX-1/COX-2 inhibitorAceclofenac is a nonsteroidal anti-inflammatory drug (NSAID). It is prescribed in short courses for osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis (AEMPS Ficha Técnica). In anti-aging regimens, aceclofenac is positioned as a safer diclofenac for long-term use in age-related joint pain. Long-term NSAID use in people without a confirmed inflammatory disease is not justified: ACR 2020 and EULAR 2023 recommend non-pharmacological approaches (weight loss, exercise, physiotherapy) as the basis of osteoarthritis care, with NSAIDs reserved for short flare courses. The drug carries serious risks on chronic use: gastrointestinal bleeding, blood-pressure elevation, acute kidney injury, and cardiovascular events. If aceclofenac was prescribed for age-related pain as long-term therapy, consider seeking a second opinion.
- FAcetylcysteineNot recommended · Mucolytic; paracetamol overdose antidote; glutathione precursorBiohacker community frames NAC as an «anti-aging drug», «universal antioxidant» and «mitochondrial protector». There are no long-term randomised trials in healthy people with mortality or age-related disease endpoints. NIH ODS 2024 notes that benefit in healthy adults is unproven; in animal models antioxidant excess even accelerated tumour growth. AEMPS and EMA have not registered the drug as a geroprotector. For evidence-based prevention of ageing, lifestyle, sleep, physical activity and diet – confirmed in large cohorts – are appropriate topics to discuss with a clinician.
- FAcetylsalicylic acidNot recommended · Antiplatelet agents (low dose) / NSAIDs (analgesic dose)Low-dose aspirin (75–100 mg) is taken in anti-aging and longevity communities to suppress chronic inflammation of aging and to extend life. Primary-prevention trials ASCEND 2018 (patients with diabetes) and ASPREE 2018 (older adults over 70) showed: in healthy adults, aspirin for primary CV prevention is not justified – the small reduction in heart attack risk is offset by an increase in major bleeding, and in older adults ASPREE even showed increased all-cause mortality on aspirin. ACC/AHA 2019 and ESC 2021 do not recommend aspirin for primary CV prevention in people without confirmed coronary disease, stroke, or other high CV risk. The drug raises the risk of gastrointestinal bleeding, hemorrhagic stroke, and hypersensitivity reactions. If aspirin is being taken for longevity without confirmed high CV risk, consider seeking a second opinion.
- FAdalimumabNot recommended · Biologic – tumor necrosis factor alpha (TNFα) inhibitorAdalimumab is a monoclonal antibody against tumor necrosis factor alpha (TNF-α). It is prescribed for rheumatoid arthritis, ankylosing spondylitis, Crohn's disease, ulcerative colitis, psoriasis, psoriatic arthritis, and hidradenitis (approved indications per AEMPS and EMA). In premium anti-aging circles, adalimumab is promoted as a biological for suppressing chronic inflammation of aging in healthy people. In healthy adults, no clinical studies of prophylactic use exist; international anti-aging guidelines do not include adalimumab. The drug has serious risks: severe infections (bacterial, fungal, opportunistic), reactivation of tuberculosis and hepatitis B (requires screening before start), lymphomas and other malignancies (FDA boxed warning), injection site reactions, and demyelinating diseases. If adalimumab was recommended to suppress aging-related inflammation in a healthy person, seek a second opinion immediately.
- FAdemetionineNot recommended · Amino acids and derivatives. Hepatoprotective agentSAMe in the biohacking segment is sold as an «epigenetic reverser» promising slower aging via DNA methylation support. No evidence base: no human RCTs with aging biomarker endpoints (telomeres, Horvath epigenetic clocks), all-cause or cardiovascular mortality. EFSA 2010 approved no «anti-aging» claim for SAMe. Proven mortality reduction paths are BP, glycaemic and lipid control, smoking cessation, Mediterranean diet and physical activity. If SAMe was recommended as a «longevity supplement» without diagnosed depression or cholestasis, consider seeking a second opinion.
- FAlendronic acidNot recommended · Nitrogen-containing bisphosphonateAlendronic acid is a bisphosphonate. It is prescribed for osteoporosis with confirmed reduced bone mineral density (T-score below -2.5 or with fragility fractures) and for Paget's disease (NOGG 2021, AACE 2020 guidelines). In anti-aging communities, alendronate is prescribed for bone rejuvenation with normal bone density. No clinical studies of prophylactic use outside osteoporosis exist; with normal bone density, the benefit does not outweigh the risks. The drug has serious adverse effects: esophageal erosions and ulcers (requires intake with plenty of water in an upright position), osteonecrosis of the jaw (especially after dental procedures), and atypical femoral fractures on long-term use (over 5 years). If alendronate was prescribed outside confirmed osteoporosis, consider seeking a second opinion.
- FAlpha-lipoic acid (thioctic acid, ALA)Not recommended · Antioxidant; cofactor of pyruvate and α-ketoglutarate dehydrogenaseBiohacker blogs place ALA alongside metformin and NMN in the «longevity stack». No trials in healthy adults with mortality or age-related disease endpoints exist. AEMPS and EMA have not registered the drug as a geroprotector. Harm is documented: ALA has been linked to insulin autoimmune syndrome (Hirata disease) with severe spontaneous hypoglycaemia, notably in carriers of HLA-DRB1*04:06 – with no longevity benefit this is a net negative. Taking ALA «for ageing» sells hope, not treatment. Evidence-based ageing-slowing factors are physical activity, blood-pressure control, smoking cessation and adequate sleep.
- FAlpha-tocopherolNot recommended · Fat-soluble vitamin EVitamin E is sold for rejuvenation, immunity and longevity. There is no evidence base. The 2012 Cochrane review of antioxidants and the 2005 Miller meta-analysis showed that high-dose alpha-tocopherol does not extend life and raises all-cause mortality with long-term use. The only evidence-based use of vitamin E, biopsy-confirmed non-alcoholic steatohepatitis, is covered in a separate card and has nothing to do with anti-aging. If vitamin E was recommended for rejuvenation, consider seeking a second opinion.
- FAmiodaroneNot recommended · Class III antiarrhythmics (Vaughan Williams)Amiodarone is a class III antiarrhythmic drug. It is prescribed for dangerous ventricular arrhythmias and for rhythm control in atrial fibrillation when other drugs are ineffective or contraindicated (ESC 2024). In anti-aging practices, amiodarone is prescribed to healthy adults as a universal antiarrhythmic. In people without arrhythmias, no clinical studies of prophylactic use exist, and such prescription is extremely dangerous. Amiodarone has a severe adverse-effect profile: pulmonary fibrosis (irreversible), thyrotoxicosis and hypothyroidism (amiodarone contains 37% iodine by mass), hepatotoxicity up to acute liver failure, corneal deposits with visual impairment, photosensitization (bluish skin discoloration in sunlight), and QT prolongation. If amiodarone was prescribed to a person without a dangerous arrhythmia, seek a second opinion immediately.
- FAzathioprineNot recommended · Immunosuppressants, thiopurinesAzathioprine is an antimetabolite immunosuppressant, a purine analogue. It is prescribed to prevent organ transplant rejection and for severe autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease) when other drugs are ineffective. In anti-aging circles, azathioprine is occasionally promoted as a means of resetting or renewing the immune system in healthy adults. In healthy adults, no clinical studies of such use exist. The drug has serious risks: myelosuppression with risk of severe neutropenia, increased risk of lymphoma and other malignancies (especially non-Hodgkin lymphoma and skin cancer), severe hepatotoxicity, and requires thiopurine methyltransferase testing before start to prevent severe toxicity in carriers of the defective variant. If azathioprine was recommended to a healthy person for the immune system, seek a second opinion immediately.
- FBerberineNot recommended · Dietary supplements, plant alkaloids (local classification)Berberine is an alkaloid found in barberry bark, goldenseal, and coptis. In biohacker protocols, berberine is positioned as a geroprotector via AMPK activation and calorie-restriction mimicry. Clinical studies in humans are few: meta-analyses in type 2 diabetes show modest HbA1c reduction (0.5–1%) and weight reduction comparable to metformin in small samples. For healthy adults or life extension, no compelling evidence base exists; international anti-aging guidelines do not include berberine. The supplement causes GI disturbances (nausea, diarrhea, cramps), potential hepatotoxicity in susceptible people, and drug interactions (a strong CYP3A4 and P-gp inhibitor, raising blood levels of many drugs). If berberine was recommended for longevity, consider seeking a second opinion.
- FBisoprololNot recommended · Selective beta-adrenergic blockersBisoprolol is a selective β1-adrenergic blocker. It is prescribed for hypertension, heart failure, ischemic heart disease, and arrhythmias (ESC/ESH 2023, SEH-LELHA). In anti-aging regimens, bisoprolol is given for anti-aging of the heart and for stress-related tachycardia in healthy adults. In people with normal blood pressure and no confirmed pathology, no clinical studies of prophylactic use exist. The drug causes bradycardia (pronounced in predisposed people), hypotension, fatigue, bronchospasm in COPD or asthma, and a withdrawal syndrome on abrupt discontinuation. If bisoprolol was prescribed to a healthy person, consider seeking a second opinion.
- FCalcifediol (25-hydroxyvitamin D)Not recommended · Vitamin D analogue (25-hydroxy metabolite)Calcifediol (25-hydroxyvitamin D) is an intermediate metabolite of vitamin D that raises blood 25(OH)D faster than cholecalciferol. It is prescribed for vitamin D deficiency, especially with malabsorption (AEMPS Ficha Técnica). Healthy adults take calcifediol in drops and capsules for an anti-aging level of vitamin D. With normal 25(OH)D (above 20 ng/mL per most international guidelines), no clinical studies of prophylactic use exist. Vitamin D overdose causes hypercalcemia (nausea, vomiting, weakness, kidney dysfunction, arrhythmias). If calcifediol is being taken without confirmed 25(OH)D deficiency on blood test, consider seeking a second opinion and getting tested.
- FCandesartanNot recommended · Angiotensin II receptor blockerCandesartan is an angiotensin II receptor blocker (ARB). It is prescribed for hypertension and heart failure (ESC/ESH 2023, SEH-LELHA, ACC/AHA 2017). In anti-aging regimens, candesartan is given to healthy normotensives as a mild protector of the heart and vessels. In people with normal blood pressure, no clinical studies of prophylactic use exist. ARBs do not cause cough as ACE inhibitors do, but other risks remain: hyperkalemia, dizziness, acute kidney injury in renal artery stenosis, and teratogenicity (contraindicated in pregnancy). If candesartan was prescribed to a healthy person, consider seeking a second opinion.
- FCaptoprilNot recommended · ACE inhibitorCaptopril is a short-acting angiotensin-converting enzyme (ACE) inhibitor. It is prescribed for hypertension and heart failure (ESC/ESH 2023, SEH-LELHA, ACC/AHA 2017). In anti-aging regimens, captopril is used in healthy normotensives as a quick vasodilator to protect vessels from aging. In people with normal blood pressure, captopril does not work: no clinical studies of such use exist, and a vessel-rejuvenating effect has not been demonstrated. The drug causes a dry cough (10–20% of patients), elevated blood potassium, angioedema in predisposed people (life-threatening), and acute kidney injury in renal artery stenosis. If captopril was prescribed to a person with normal blood pressure, consider seeking a second opinion.
- FCarvedilolNot recommended · Alpha and beta blocker (non-selective β + α1)Carvedilol is a nonselective β-adrenergic blocker with additional α1-blocking activity. It is prescribed for heart failure, after myocardial infarction, and for hypertension (ESC/ESH 2023, SEH-LELHA, ACC/AHA 2017). In anti-aging regimens, carvedilol is positioned as a combined α/β-blocker for anti-aging of the vascular system in healthy normotensives. In people with normal blood pressure and no heart failure, no clinical studies of prophylactic use exist. The drug causes pronounced orthostatic hypotension (especially at start of treatment, with fall risk in older adults), bradycardia, fatigue, and hypoglycemia in patients with diabetes. If carvedilol was prescribed to a healthy person, consider seeking a second opinion.
- FCelecoxibNot recommended · Selective COX-2 inhibitor (coxib)Celecoxib is a selective cyclooxygenase-2 inhibitor (coxib). It is prescribed for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute pain control (AEMPS Ficha Técnica). In anti-aging regimens, celecoxib is positioned as a coxib for suppressing aging-related inflammation and a GI-safe NSAID for chronic use. Long-term use in people without a confirmed inflammatory disease is not justified: ACR 2020, EULAR 2023, and the Cochrane review by Curtis 2017 do not support NSAIDs as prophylaxis against aging-related inflammation. COX-2 selectivity reduces GI bleeding risk but does not eliminate cardiovascular risk: the PRECISION 2016 trial showed comparable myocardial infarction and stroke risk to other NSAIDs. If celecoxib was prescribed for chronic anti-inflammatory use, consider seeking a second opinion.
- FChaga (Inonotus obliquus)Not recommended · Medicinal mushroom parasitising birch. In Russia OTC «Befungin» registered, in the West – supplement. AEMPS does not register as medicineChaga is sold as a «natural antioxidant» and longevity supplement on the high polyphenol and melanin content, promising oxidative stress protection and aging slowdown. Cochrane 2012 on antioxidant supplements recorded no all-cause mortality reduction in healthy people; for some components (beta-carotene) – increased mortality. No quality human RCTs with aging biomarker, telomere or all-cause/cardiovascular mortality endpoints. If chaga was recommended for «life extension» or «anti-age», consider seeking a second opinion. Important: chaga oxalates raise nephrolithiasis and oxalate nephropathy risk with prolonged intake.
- FCholecalciferolNot recommended · Vitamins. Regulator of calcium-phosphorus metabolismCholecalciferol (vitamin D3) is a fat-soluble vitamin. It is prescribed for prevention and treatment of vitamin D deficiency and for osteoporosis in combination with calcium (AEMPS Ficha Técnica). In anti-aging communities, vitamin D3 is taken in high doses to slow aging and extend life. The large VITAL trial (NEJM 2019, over 25,000 participants) showed no reduction in cardiovascular events or all-cause mortality on 2000 IU/day vitamin D3 versus placebo. In people with normal 25(OH)D, no clinical studies of prophylactic anti-aging use exist. Overdose causes hypercalcemia with risk of kidney dysfunction and arrhythmias. If cholecalciferol is being taken in high doses without confirmed deficiency, consider seeking a second opinion.
- FCholecalciferol + menaquinone-7 (D3+K2 combo)Not recommended · Combined supplement: fat-soluble vitamins D3 and K2D3+K2 combo is marketed as a «longevity formula» on the hypothesis of vitamin D effects on immunity, telomeres, methylation, plus K2 on vessels. Cochrane 2014 on vitamin D and mortality: no reduction in all-cause mortality in non-deficient people; in deficient patients the small positive effect is limited. VITAL 2019 found no mortality reduction from vitamin D in the general US population (unselected by deficiency). No large longevity RCTs exist for K2. If the combo was recommended «for slowing aging», consider seeking a second opinion. Important: vitamin K reduces the effect of warfarin and other vitamin K antagonists; patients on these anticoagulants, including those with a mechanical heart valve, must not take vitamin K supplements without medical agreement.
- FCholine (umbrella: bitartrate, phosphatidylcholine, lecithin)Not recommended · Essential nutrient-like substance; precursor of acetylcholine and phosphatidylcholineBiohacker blogs include choline in the «longevity stack» alongside NAD+, CDP-choline and resveratrol. No long-term randomised trials in healthy people with mortality or age-related disease endpoints exist. NIH ODS 2024 reports no anti-ageing data. Wallace 2018 notes that nutrigenomic data are interesting for specific populations (pregnancy, PEMT variants) but do not justify routine «longevity» use. AEMPS and EMA have not registered lecithin or phosphatidylcholine as geroprotectors. Evidence-based options are physical activity, the Mediterranean diet, smoking cessation and blood-pressure control.
- FCholine alfoscerateNot recommended · Other nervous system drugs. ParasympathomimeticsAlpha-GPC is sold in the anti-aging segment as «natural slowing of brain aging». No evidence base: there are no RCTs with lifespan, dementia incidence or aging biomarker endpoints for alpha-GPC. EFSA has not approved any «anti-aging» health claim for choline compounds. Concerns: a post-hoc ARIC 2021 analysis (population cohort) recorded an association between long-term choline supplement use and increased ischemic stroke and atherosclerosis risk via the TMAO metabolite; the link needs RCT confirmation. If alpha-GPC is taken as part of an «anti-aging protocol» without a confirmed diagnosis and physician supervision, there is neither evidence of benefit nor long-term safety data.
- FCiclosporinNot recommended · Immunosuppressants. Calcineurin inhibitorsCyclosporine is a calcineurin inhibitor immunosuppressant. It is prescribed to prevent organ transplant rejection and for severe psoriasis, atopic dermatitis, rheumatoid arthritis, and nephrotic syndrome (AEMPS Ficha Técnica). In alt-anti-aging circles, cyclosporine is promoted for suppressing immune aging. In healthy adults, no clinical studies of such use exist. The drug has serious risks: nephrotoxicity (irreversible on long-term use), hypertension, increased malignancy risk (lymphomas, skin cancer), opportunistic infections, hyperlipidemia, hypertrichosis, gingival hyperplasia, tremor, and neurotoxicity. Cyclosporine is a strong CYP3A4 inhibitor with multiple drug interactions. If cyclosporine was recommended to a healthy person, seek a second opinion immediately.
- FConjugated linoleic acid (CLA)Not recommended · Mixture of positional and geometric linoleic acid isomers; supplement for «fat burning» and sports nutrition; not registered as a medicine by AEMPSSports blogs include CLA in stacks for «lean mass», «anti-ageing» and «metabolism boost». No long-term RCTs in healthy adults with mortality or age-related disease endpoints exist. EFSA and AEMPS have not registered the substance as a geroprotector. Known risks of prolonged use are raised HOMA-IR and insulin resistance, hepatotoxicity in predisposed individuals and increased systemic inflammation markers. Evidence-based ageing-slowing options are regular aerobic and resistance training, Mediterranean diet, smoking cessation, BP and glucose control.
- FCopperNot recommended · Trace cofactor mineral, used in parenteral nutrition and supplementsCopper is marketed in supplements as a «grey-hair» remedy, «skin firmness» booster, «hair growth» aid and «longevity» tool. The pitch leans on copper's role in melanin synthesis and collagen cross-linking. Clinical trials in healthy adults showing that oral copper reverses greying, smooths wrinkles or extends life do not exist. NIH ODS and EFSA systematic reviews found no benefit of copper supplements in people without confirmed deficiency. Chronic excess is risky: it raises oxidative stress in hepatocytes and may mask Wilson disease. Most adults on a balanced diet have adequate copper. If copper was bought for anti-ageing, consider seeking a second opinion before continuing.
- FCurcumin (Curcuma longa extract)Not recommended · Herbal anti-inflammatory agentsCurcumin is a polyphenol from turmeric. In anti-aging and longevity communities, curcumin is sold to slow aging, extend life, and support cognitive function. Curcumin's bioavailability is very low (under 1% after oral intake), limiting real clinical activity; even with piperine or liposomal formulations, no significant anti-aging clinical effects have been shown. International anti-aging guidelines do not include curcumin. Curcumin is relatively safe but can cause GI disturbances, thin the blood (bleeding risk with anticoagulants), and trigger allergic reactions in susceptible people. If curcumin was recommended for longevity, consider seeking a second opinion.
- FCyproterone acetateNot recommended · Antiandrogen with progestogenic activityCyproterone acetate is an antiandrogen and progestogen. It is prescribed for men with prostate cancer on androgen deprivation therapy and severe hypersexuality; in women, for severe androgen-dependent acne or hirsutism when other drugs are ineffective (AEMPS Ficha Técnica). In men, cyproterone acetate is used off-label to suppress libido in anti-aging practice. In women with mild acne or hirsutism not meeting all AEMPS criteria, cyproterone acetate is not indicated. The drug has serious risks: meningiomas (dose-dependent risk; EMA imposed strict dose and duration limits in 2020), hepatotoxicity, thromboembolic events, depression, and erectile dysfunction with reduced libido in men. If cyproterone acetate was prescribed for anti-aging or for mild acne, consider seeking a second opinion.
- FDapagliflozinNot recommended · Sodium-glucose cotransporter-2 (SGLT2) inhibitorDapagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It is prescribed for type 2 diabetes, heart failure (regardless of diabetes), and chronic kidney disease (ESC 2024, ADA 2024, KDIGO 2024). In anti-aging and longevity communities, dapagliflozin is promoted as an mTOR-sparing metabolic modulator in non-diabetics for life extension. In people without diabetes, heart failure, or CKD, no clinical studies of prophylactic use for anti-aging exist. The drug causes urogenital infections (5–10% of cases), euglycemic diabetic ketoacidosis (rare but dangerous), and volume disturbance with fall risk in older adults. If dapagliflozin was prescribed to a person without diabetes or heart failure, consider seeking a second opinion.
- FDehydroepiandrosterone (DHEA, prasterone)Not recommended · Endogenous C19 steroid precursor; an EU prescription drug for adrenal insufficiency and a vaginal form (Intrarosa); a freely available supplement in the United StatesDHEA is the flagship of biohacker «youth hormone» protocols. The two-year Mayo Clinic DHEA Aging Trial (NEJM 2006) in men and women aged 60–88: DHEA 75 mg/day did not improve body composition, muscle strength, bone density, insulin sensitivity or quality of life vs placebo. Cochrane 2003 on DHEA for cognition in older adults found no effect. The Endocrine Society 2014 states that routine DHEA use «for ageing» in people without adrenal insufficiency is not justified. AEMPS and EMA have not registered the drug as a geroprotector. Adverse effects in women include acne, scalp hair loss and hirsutism; in men – gynecomastia and accelerated BPH growth.
- FDenosumabNot recommended · Biologic – RANKL inhibitorDenosumab is a monoclonal antibody against RANKL. It is prescribed for osteoporosis with high fracture risk (especially in postmenopausal women and men with prostate cancer on androgen deprivation therapy) and for prevention of skeletal events in bone metastases (NOGG 2021, AACE 2020). In anti-aging circles, denosumab is promoted as a biological for anti-aging of bones in healthy postmenopausal women without confirmed osteoporosis. In people without confirmed osteoporosis, no clinical studies of prophylactic use exist. The drug has serious risks: osteonecrosis of the jaw (especially after dental procedures), atypical femoral fractures, hypocalcemia, severe infections, and on discontinuation a risk of multiple vertebral fractures (requires immediate transition to a bisphosphonate). If denosumab was prescribed without confirmed osteoporosis, consider seeking a second opinion.
- FDiclofenacNot recommended · Non-steroidal anti-inflammatory drugs (NSAIDs)Diclofenac is a nonsteroidal anti-inflammatory drug (NSAID). It is prescribed for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and acute pain (AEMPS Ficha Técnica). In anti-aging circles, diclofenac is promoted as an anti-aging drug to suppress low-grade inflammation in healthy adults, citing older work on inflammation and aging. Regular diclofenac use in people without a confirmed inflammatory disease is not justified: the Bhala 2013 meta-analysis (CNT collaboration, over 350,000 patients) showed that diclofenac increases cardiovascular events by 40% versus placebo, more than most other NSAIDs. Regular use also elevates the risk of gastrointestinal bleeding and acute kidney injury. If diclofenac was prescribed for chronic use against aging-related inflammation, consider seeking a second opinion.
- FDigoxinNot recommended · Cardiac glycosides (digitalis)Digoxin is a cardiac glycoside. It is prescribed for heart failure with reduced ejection fraction (when standard therapy is ineffective) and for rate control in atrial fibrillation (ESC 2024). In alt-cardiology, digoxin is sometimes promoted as a mild cardiotonic for older adults to support the heart. No clinical studies of prophylactic use outside HF or AF exist, and such prescription is dangerous. Digoxin has a narrow therapeutic index – the gap between therapeutic and toxic doses is small. Signs of toxicity: nausea, visual disturbances (yellow-tinted vision), arrhythmias (especially with hypokalemia). Risk is higher in older adults and with renal impairment. If digoxin was prescribed outside heart failure or AF, consider seeking a second opinion.
- FDiltiazemNot recommended · Calcium channel blocker, non-DHP (benzothiazepine derivative)Diltiazem is a non-dihydropyridine calcium channel blocker. It is prescribed for hypertension, stable angina, and rate control in atrial fibrillation (ESC/ESH 2023, SEH-LELHA, ACC/AHA 2017). In healthy normotensives, diltiazem is used for vascular protection from aging. In people with normal blood pressure, no clinical studies of prophylactic use exist. The drug causes bradycardia, PR-interval prolongation with risk of atrioventricular block (especially combined with β-blockers), ankle edema, and constipation. Diltiazem is a CYP3A4 inhibitor causing multiple drug interactions. If diltiazem was prescribed to a person with normal blood pressure, consider seeking a second opinion.
- FDrospirenone + ethinylestradiolNot recommended · Combined oral contraceptives — antimineralocorticoid progestinDrospirenone + ethinylestradiol is a combined oral contraceptive. It is prescribed for contraception, severe acne, and premenstrual dysphoric disorder (AEMPS Ficha Técnica). In anti-aging communities, combined oral contraceptives are promoted as anti-aging and appearance enhancement in healthy women. Combined oral contraceptive use without need for contraception or confirmed dermatologic/gynecologic indications is not justified: increased risk of venous thromboembolism (especially in smokers, obesity, age over 35), arterial thrombosis, breast cancer on long-term use, and gallbladder disease. If combined oral contraceptive was prescribed for anti-aging or appearance improvement without other indications, consider seeking a second opinion.
- FDutasterideNot recommended · Testosterone 5α-reductase types 1 and 2 inhibitorsDutasteride is a 5α-reductase type I and II inhibitor, more potent than finasteride. It is prescribed for men with benign prostatic hyperplasia (AEMPS Ficha Técnica). Dutasteride is used in women with hair loss and in anti-aging protocols as a more potent 5α-reductase inhibitor. In women, clinical evidence is insufficient and the drug is teratogenic (FDA category X, risk of male fetal development disruption). Risks of reduced libido, erectile dysfunction, depression, and gynecomastia in men are also described, as is a post-dutasteride syndrome with prolonged adverse effects after discontinuation. If dutasteride was prescribed to a woman or to a man without confirmed BPH diagnosis, consider seeking a second opinion.
- FEltrombopagNot recommended · Thrombopoietin receptor agonist (TPO-R)Eltrombopag is a thrombopoietin receptor agonist. It is prescribed for chronic immune thrombocytopenia, aplastic anemia, and thrombocytopenia associated with chronic hepatitis C (AEMPS Ficha Técnica). In alt-anti-aging circles, eltrombopag is occasionally promoted for general platelet boost and immunity in healthy people. In healthy adults, no clinical studies of such use exist. The drug has serious risks: hepatotoxicity (requires regular liver enzyme monitoring), thromboembolic events (paradoxically, with excessive platelet elevation), cataract, and myelodysplastic changes in some patients. If eltrombopag was recommended to a healthy person, seek a second opinion immediately.
- FEnalaprilNot recommended · Angiotensin-converting enzyme inhibitors (ACEi)Enalapril is a long-acting ACE inhibitor. It is prescribed for hypertension, heart failure, after myocardial infarction, and for diabetic nephropathy (ESC/ESH 2023, SEH-LELHA). In anti-aging regimens, enalapril is given to healthy normotensives for general cardioprotection and to slow vascular aging. In people with normal blood pressure and no confirmed pathology, no clinical studies of prophylactic use exist. The drug causes a dry cough (10–20% of patients), hyperkalemia, dizziness, angioedema in predisposed people, and teratogenicity (contraindicated in pregnancy). If enalapril was prescribed to a healthy person, consider seeking a second opinion.
- FEnoxaparin sodiumNot recommended · Low-molecular-weight heparin (LMWH)Enoxaparin is a low-molecular-weight heparin. It is used for prevention and treatment of venous thromboembolism, for acute coronary syndrome, and during surgery with high thrombotic risk (ACCP 2024, ESC 2023). In anti-aging regimens, enoxaparin is used for blood thinning in people without confirmed thrombotic risk. In healthy adults, no clinical studies of prophylactic use exist. The drug raises the risk of major bleeding and heparin-induced thrombocytopenia (HIT, which can cause paradoxical thrombosis) and requires subcutaneous injection. If enoxaparin was prescribed for blood thinning in a healthy person, consider seeking a second opinion.
- FEpigallocatechin-3-gallate (EGCG, main green tea polyphenol)Not recommended · Catechin polyphenol from green tea (Camellia sinensis), supplement. EFSA 2018 limited safe dose from supplements to 800 mg/day due to hepatotoxicityEGCG is actively sold in the longevity segment via oxidative ageing theory and translation from mouse data. No RCTs with lifespan, biological ageing slowing or all-cause mortality endpoints in humans. Most important – EFSA 2018 and LiverTox NIH describe a series of drug-induced liver injury (DILI) cases with high-dose EGCG supplements: hepatocellular pattern, 1–5 months latency, sometimes requiring discontinuation and rarely transplantation. AASLD 2023 DILI practice guidance specifically flags green tea extract as a frequent cause of herb-induced liver injury in the US and EU. If EGCG was recommended as «natural anti-aging» in long-term protocols, consider seeking a second opinion from a general practitioner and monitor ALT, AST, bilirubin.
- FEplerenoneNot recommended · Selective mineralocorticoid receptor antagonistEplerenone is a selective mineralocorticoid receptor antagonist. It is prescribed for heart failure after myocardial infarction and for resistant hypertension (ESC 2024). In anti-aging regimens, eplerenone is used as a selective anti-aldosterone heart protector. No clinical studies of prophylactic use outside these indications exist. The drug causes hyperkalemia (dangerous, can trigger arrhythmias), dizziness, and fatigue. If eplerenone was prescribed without heart failure or resistant hypertension, consider seeking a second opinion.
- FEstradiolNot recommended · Estrogens — natural and semisyntheticEstradiol is the natural female sex hormone. Systemic forms (patches, gels, tablets) are prescribed for menopausal hormone therapy in women with marked vasomotor symptoms or for osteoporosis prevention in early perimenopause (NAMS 2022, NICE NG23). In anti-aging communities, estradiol is promoted as an anti-aging agent for skin, libido, and general rejuvenation. The Women's Health Initiative (JAMA 2002) showed that hormone replacement therapy in healthy postmenopausal women increases risk of breast cancer, ischemic stroke, and thromboembolism, not justifying anti-aging use. The drug has serious risks: increased venous thromboembolism (especially in smokers and obesity), breast cancer on long-term use (over 5 years), gallbladder disease, and endometrial cancer when used without a progestogen in women with a uterus. If estradiol was prescribed for anti-aging without confirmed indications, consider seeking a second opinion.
- FEtoricoxibNot recommended · Selective COX-2 inhibitor (coxib)Etoricoxib is a selective cyclooxygenase-2 inhibitor (coxib). It is prescribed for osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and gout (AEMPS Ficha Técnica). In anti-aging regimens, etoricoxib is positioned as a selective coxib without ulcer risks for long-term suppression of low-grade aging-related inflammation. Long-term use in people without a confirmed inflammatory disease is not justified: ACR 2020 and EULAR 2023 do not include NSAIDs in age-related prevention. COX-2 selectivity reduces GI bleeding risk but raises cardiovascular risk: the MEDAL 2007 meta-analysis showed that etoricoxib is associated with greater blood-pressure elevation and heart-failure risk than nonselective NSAIDs. If etoricoxib was prescribed for chronic anti-inflammatory use, consider seeking a second opinion.
- FEverolimusNot recommended · mTOR kinase inhibitor – immunosuppressant and antineoplasticEverolimus is an mTOR inhibitor. It is prescribed to prevent organ transplant rejection and for certain malignancies (renal cell carcinoma, pancreatic neuroendocrine tumors, HR+ HER2- metastatic breast cancer), and for tuberous sclerosis (AEMPS Ficha Técnica). In longevity communities, everolimus is actively promoted as an mTOR inhibitor for life extension, by analogy with rapamycin. The RESILIENT 2014 study in older adults showed transient improvement in vaccination response, but no randomized clinical trials with endpoints on lifespan extension in healthy adults exist. The drug has serious risks: immunosuppression with infections (including opportunistic), stomatitis (common), interstitial lung disease (life-threatening), hyperlipidemia, hyperglycemia, impaired wound healing, and thromboembolic events. If everolimus was recommended to a healthy person for longevity, seek a second opinion immediately.
- FEzetimibeNot recommended · Selective intestinal cholesterol absorption inhibitorEzetimibe is an intestinal cholesterol absorption inhibitor. It is prescribed in addition to a statin for hyperlipidemia and for secondary CV prevention (ESC/EAS 2019; IMPROVE-IT 2015 showed benefit when added to simvastatin after acute coronary syndrome). In healthy adults with normal lipid profile, ezetimibe is used for anti-aging protection against atherosclerosis. In people without confirmed hyperlipidemia or high CV risk, no clinical studies of prophylactic use exist. The drug is relatively safe but can cause myalgia, elevated liver enzymes, and diarrhea. If ezetimibe was prescribed at a normal lipid profile, consider seeking a second opinion.
- FFinasterideNot recommended · Testosterone 5α-reductase type 2 inhibitorsFinasteride is a type II 5α-reductase inhibitor. It is prescribed for men with benign prostatic hyperplasia and androgenic alopecia; it is not indicated in women (AEMPS Ficha Técnica). Finasteride is prescribed to women of reproductive age for hair loss off-label and in anti-aging protocols. In women, clinical evidence for hair loss is insufficient, and the drug is teratogenic (FDA category X, risk of male fetal external genitalia development disruption – contact even through skin is contraindicated with broken tablets). In men, finasteride can cause reduced libido, erectile dysfunction, depression, and gynecomastia; a post-finasteride syndrome with prolonged adverse effects after discontinuation has been described. If finasteride was prescribed to a woman of reproductive age or to a man without confirmed indications, consider seeking a second opinion.
- FGlutathioneNot recommended · Tripeptide antioxidant (γ-glutamyl-cysteinyl-glycine); cofactor of glutathione S-transferaseThe biohacker community frames glutathione as the «main longevity antioxidant» and a «super-stack with NAC, ALA and vitamin C». No long-term randomised trials in healthy people with mortality or age-related disease endpoints exist. NIH ODS 2023: anti-ageing data are insufficient. AEMPS and EMA have not registered the drug as a geroprotector. Evidence-based slowing of ageing rests on physical activity, smoking cessation, blood-pressure control, the Mediterranean diet and adequate sleep.
- FHuperzine A (Huperzia serrata)Not recommended · Alkaloid of Chinese club moss (Huperzia serrata, Lycopodium serratum), a selective reversible acetylcholinesterase inhibitor. Registered as a prescription medicine Shuangyiping for Alzheimer disease in China. No marketing authorisation in the EU or USA; sold as a dietary supplementHuperzine A is sold in the anti-aging segment as «natural Alzheimer prevention» in healthy adults. No evidence base: RCTs of huperzine A in cognitively healthy people with dementia incidence as an endpoint have not been published. Alzheimer prevention in healthy people via AChE inhibition has no rational basis: donepezil, rivastigmine and galantamine are approved only for confirmed dementia, not primary prevention. EMA has no marketing authorisation for huperzine A; FDA has not approved the product. Long-term safety of AChE inhibitor intake by healthy adults has not been studied. If huperzine A is taken «to prevent dementia», there is no evidence nor safety data.
- FHydroxychloroquineNot recommended · Antimalarials, aminoquinolinesHydroxychloroquine is an antimalarial and disease-modifying antirheumatic drug. It is prescribed for systemic lupus erythematosus, rheumatoid arthritis, discoid lupus erythematosus, and for malaria prevention and treatment (EULAR 2023, ACR 2020 guidelines). In anti-aging communities, low-dose hydroxychloroquine is positioned as an anti-aging and life-extension agent. In healthy adults, no clinical studies of such use exist; international anti-aging guidelines do not include hydroxychloroquine. The drug has serious risks on long-term use: irreversible retinopathy (with vision loss risk, requires ophthalmologic screening every 6–12 months), cardiomyopathy, myopathy, neuropathy, and QT prolongation. If hydroxychloroquine was recommended to a healthy person for anti-aging, consider seeking a second opinion.
- FIbuprofenNot recommended · Non-steroidal anti-inflammatory drugs (NSAIDs)Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It is taken short-term for acute pain, fever, headache, and menstrual pain. In anti-aging regimens and sports, ibuprofen is widely taken as a universal prophylactic against low-grade aging-related inflammation and for post-exercise recovery. Regular use in healthy adults is not justified: systematic reviews (Trappe 2011, Schoenfeld 2012) show that regular NSAID use after exercise reduces muscle hypertrophy and training adaptation. Chronic NSAID use in healthy adults raises the risk of gastrointestinal bleeding, hypertension, myocardial infarction, stroke, and acute kidney injury. If ibuprofen is being taken daily for inflammation prophylaxis or recovery, consider seeking a second opinion.
- FIrbesartanNot recommended · Angiotensin II receptor blocker (ARB, sartan)Irbesartan is an angiotensin II receptor blocker. It is prescribed for hypertension and diabetic nephropathy in type 2 diabetes (ESC/ESH 2023, KDIGO 2024, SEH-LELHA). In anti-aging regimens, irbesartan is given to healthy normotensives to protect vessels and rejuvenate them. In people with normal blood pressure and no diabetic nephropathy, no clinical studies of prophylactic use exist. The drug can cause dizziness, hyperkalemia, acute kidney injury, and teratogenicity (contraindicated in pregnancy). If irbesartan was prescribed to a healthy person, consider seeking a second opinion.
- FIsotretinoinNot recommended · Systemic retinoid (vitamin A derivative)Isotretinoin is an oral retinoid. It is prescribed for severe nodular acne vulgaris and for moderate acne unresponsive to other treatments (AAD 2020, EADV 2023, AEMPS Ficha Técnica). In anti-aging practice, isotretinoin is prescribed for anti-aging of the skin and for occasional inflammatory acne lesions without confirmed moderate-to-severe disease. In people with mild acne, the risk profile is not justified. The drug has serious risks: severe teratogenicity (FDA boxed warning, mandatory iPLEDGE program with dual contraception for women of reproductive age), hepatotoxicity, hyperlipidemia, skin and mucosal xerosis, cheilitis, depression and described suicidal-ideation risk, and impaired night vision. If isotretinoin was prescribed for mild eruptions or anti-aging, consider seeking a second opinion.
- FLatanoprostNot recommended · Prostaglandin analogues, antiglaucoma agentsLatanoprost is a prostaglandin F2α analogue. It is prescribed for primary open-angle glaucoma and ocular hypertension to reduce intraocular pressure (NICE NG81, AAO 2020). Latanoprost is used cosmetically for eyelash lengthening outside any ophthalmic indication. The drug carries specific risks in this use: irreversible iris pigmentation (especially in mixed-color eyes – green/hazel may turn dark brown), eyelash lengthening and darkening (the claimed cosmetic effect, but may be asymmetric), periorbital skin pigmentation, eye sinking, and reactivation of ocular herpes. If latanoprost was prescribed for eyelashes, consider seeking a second opinion; bimatoprost (Latisse) is approved for cosmetic eyelash lengthening with a better-characterized profile.
- FLeflunomideNot recommended · Selective immunosuppressantsLeflunomide is a disease-modifying antirheumatic drug (DMARD), a pyrimidine synthesis inhibitor. It is prescribed for active rheumatoid arthritis and psoriatic arthritis (EULAR 2023 guidelines, AEMPS Ficha Técnica). In alt-anti-aging circles, leflunomide is sometimes promoted as a universal modulator of the autoimmune background in healthy people. In healthy adults, no clinical studies of such use exist. The drug has serious risks: hepatotoxicity up to acute liver failure, severe skin reactions (Stevens-Johnson syndrome), peripheral neuropathy, myelosuppression, and significant teratogenicity (the M1 metabolite persists in the body for up to 2 years, requiring a cholestyramine washout protocol before pregnancy planning). If leflunomide was recommended to a healthy person, seek a second opinion immediately.
- FLenalidomideNot recommended · Immunomodulatory drug (IMiD), thalidomide derivativeLenalidomide is an immunomodulatory drug, a thalidomide derivative. It is prescribed for multiple myeloma, myelodysplastic syndrome, mantle cell lymphoma, and follicular lymphoma (AEMPS Ficha Técnica, US REMS program). In alt-anti-aging circles, lenalidomide is occasionally promoted as an immune modulator for anti-aging. In healthy adults, no clinical studies of such use exist, and such prescription is extremely dangerous. The drug has a catastrophic risk profile: teratogenicity (thalidomide derivative, severe birth defects, FDA boxed warning, mandatory REMS program with dual contraception), severe myelosuppression (neutropenia, thrombocytopenia), thromboembolic events (deep vein thrombosis, pulmonary embolism), and secondary malignancies. If lenalidomide was recommended to a healthy person, seek a second opinion immediately; this prescription is life-threatening.
- FLercanidipineNot recommended · Third-generation dihydropyridine calcium channel blockerLercanidipine is a third-generation dihydropyridine CCB with slow onset and prolonged action. It is prescribed for hypertension (ESC/ESH 2023, AEMPS Ficha Técnica, SEH-LELHA). In anti-aging regimens, lercanidipine is positioned in older normotensives as a means to improve microcirculation and as anti-aging. In people with normal blood pressure, no clinical studies of prophylactic use exist. The drug can cause ankle edema (less often than amlodipine), dizziness, headache, and flushing. If lercanidipine was prescribed to a person with normal blood pressure, consider seeking a second opinion.
- FLisinoprilNot recommended · ACE inhibitorsLisinopril is a long-acting once-daily ACE inhibitor. It is prescribed for hypertension, heart failure, and after myocardial infarction (ESC/ESH 2023, SEH-LELHA). In anti-aging regimens, lisinopril is given to healthy normotensives with promises of vessel protection and rejuvenation. In people with normal blood pressure, no clinical studies of prophylactic use exist. The drug causes a dry cough (10–20% of patients), hyperkalemia, angioedema in predisposed people, and teratogenicity. If lisinopril was prescribed to a person with normal blood pressure, consider seeking a second opinion.
- FLosartanNot recommended · Angiotensin II receptor blockers (sartans)Losartan is an angiotensin II receptor blocker, the first ARB to be registered. It is prescribed for hypertension, heart failure, and diabetic nephropathy in type 2 diabetes (ESC/ESH 2023, KDIGO 2024, SEH-LELHA). In anti-aging regimens, losartan is positioned as an anti-aging drug acting on the renin-angiotensin system. In people with normal blood pressure, no clinical studies of prophylactic use exist, and a rejuvenating effect has not been demonstrated. The drug can cause dizziness, hyperkalemia, angioedema in predisposed people, and teratogenicity. If losartan was prescribed to a healthy person, consider seeking a second opinion.
- FManidipineNot recommended · Calcium channel blockers, dihydropyridineManidipine is a dihydropyridine calcium channel blocker. It is prescribed for hypertension (AEMPS Ficha Técnica, SEH-LELHA). In anti-aging regimens, manidipine is marketed as a mild long-acting CCB for healthy normotensives with promises of vessel protection from aging. In people with normal blood pressure, no clinical studies of prophylactic use exist. The drug can cause ankle edema, dizziness, tachycardia, and flushing. Manidipine is not approved by the FDA. If manidipine was prescribed to a person with normal blood pressure, consider seeking a second opinion.
- FMeloxicamNot recommended · NSAID, COX-2 preferential, oxicam derivativeMeloxicam is an NSAID with preferential COX-2 selectivity. It is prescribed for osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis (AEMPS Ficha Técnica). In anti-aging regimens, meloxicam is used as a mild NSAID for long-term use in age-related joint pain. Regular use in people without confirmed osteoarthritis or other inflammatory pathology is not justified: ACR 2020 and EULAR 2023 recommend non-pharmacological approaches (weight loss, exercise, physiotherapy) as the basis for joint complaints, with NSAIDs reserved for short flare courses. Meloxicam's COX-2 selectivity is incomplete and decreases at higher doses. The drug carries specific risks: gastrointestinal bleeding, blood-pressure elevation, acute kidney injury, and cardiovascular events. If meloxicam was prescribed for chronic use in age-related joint pain, consider seeking a second opinion.
- FMetforminNot recommended · Biguanides. Oral antihyperglycemic agentsMetformin is a biguanide, the first-line drug for type 2 diabetes (ADA 2024, EASD 2024 guidelines). In longevity communities, metformin is actively promoted to slow aging and extend life in people without diabetes, citing epidemiological data on reduced mortality in diabetic patients. The large TAME trial (Targeting Aging with Metformin) is ongoing; no randomized results on lifespan extension in healthy adults exist as of 2026. International anti-aging guidelines do not include metformin. The drug has specific risks: GI disturbances (nausea, diarrhea, in 20–30% at initiation), vitamin B12 deficiency on long-term use (risk of megaloblastic anemia and neuropathy), and rarely lactic acidosis (life-threatening, especially in renal impairment and with contrast procedures). If metformin is being taken for longevity without diabetes, consider seeking a second opinion.
- FMetoprololNot recommended · Selective β1-adrenoceptor blockersMetoprolol is a selective β1-adrenergic blocker. It is prescribed for hypertension, ischemic heart disease, heart failure, arrhythmias, and after myocardial infarction (ESC/ESH 2023, SEH-LELHA, ACC/AHA 2017). In anti-aging regimens, metoprolol is taken to relax and lower heart rate in healthy normotensives. In people with normal blood pressure and no ischemic heart disease, no clinical studies of prophylactic use exist. The drug causes bradycardia, hypotension, fatigue, bronchospasm, and a withdrawal syndrome on abrupt discontinuation. If metoprolol was prescribed to a healthy person, consider seeking a second opinion.
- FMinoxidilNot recommended · Other dermatologicals (topical); peripheral vasodilators (systemic)Minoxidil is a vasodilator (originally a systemic antihypertensive). Topical forms (solution, foam) are approved for androgenic alopecia in men and women (AEMPS Ficha Técnica). Low-dose oral minoxidil (0.25–5 mg) is widely used off-label for anti-aging of hair. Clinical studies of oral minoxidil for hair loss are limited; the FDA has not approved the drug for this indication. Oral minoxidil carries serious risks: hypertrichosis (excessive hair growth on face, back), orthostatic hypotension, tachycardia, peripheral edema, and pericardial effusion (FDA boxed warning for systemic minoxidil). If oral minoxidil was prescribed for anti-aging of hair, consider seeking a second opinion.
- FMirabegronNot recommended · Selective β3-adrenoceptor agonist for overactive bladderMirabegron is a selective β3-adrenergic agonist. It is prescribed for overactive bladder (AEMPS Ficha Técnica). Mirabegron is positioned as a modern β3-agonist for anti-aging of the urinary system. No clinical studies of prophylactic use outside overactive bladder exist. The drug can cause hypertension (requires monitoring before and during treatment), urinary retention, tachycardia, headache, and urinary tract infections. If mirabegron was prescribed outside confirmed overactive bladder, consider seeking a second opinion.
- FMycophenolate mofetilNot recommended · Immunosuppressant, selective inosine monophosphate dehydrogenase inhibitorMycophenolate mofetil is an antimetabolite immunosuppressant. It is prescribed to prevent organ transplant rejection and for severe autoimmune diseases (systemic lupus erythematosus, vasculitis) when other drugs are ineffective (AEMPS Ficha Técnica). In alt-anti-aging circles, mycophenolate mofetil is occasionally promoted as a selective immunosuppressant to slow immune aging. In healthy adults, no clinical studies of such use exist. The drug has serious risks: myelosuppression (neutropenia, lymphopenia, anemia), GI disturbances (severe diarrhea in 30% of patients), opportunistic infections, increased lymphoma and other malignancy risk, and significant teratogenicity (FDA boxed warning, mandatory contraception). If mycophenolate mofetil was recommended to a healthy person, seek a second opinion immediately.
- FNaproxenNot recommended · NSAID, propionic acid derivativeNaproxen is a nonsteroidal anti-inflammatory drug (NSAID). It is taken short-term for acute pain, osteoarthritis, rheumatoid arthritis, migraine, and dysmenorrhea (AEMPS Ficha Técnica). In anti-aging regimens, naproxen is taken as a universal anti-inflammatory for age-related joint pain. Regular use in healthy adults without an inflammatory disease is not justified: the Bhala 2013 meta-analysis (CNT collaboration) showed naproxen has the lowest cardiovascular risk among NSAIDs, but gastrointestinal risks (bleeding, perforation) persist and rise with duration of use. Regular use also raises the risk of hypertension and acute kidney injury. If naproxen is being taken daily for inflammation prophylaxis, consider seeking a second opinion; the basis of age-related joint pain management is weight control, exercise, and physiotherapy.
- FNebivololNot recommended · Highly selective β1-blocker with endothelial nitric oxide releaseNebivolol is a selective β1-adrenergic blocker with additional NO-mediated vasodilating activity. It is prescribed for hypertension and heart failure in older adults (ESC/ESH 2023, SEH-LELHA). In anti-aging regimens, nebivolol is promoted as a modern selective β1-blocker with NO effects for healthy normotensives. In people with normal blood pressure, no clinical studies of prophylactic use exist. The drug causes bradycardia, hypotension, fatigue, and headache. If nebivolol was prescribed to a healthy person, consider seeking a second opinion.
- FNicotinamideNot recommended · Water-soluble vitamin B3 (amide form)Nicotinamide is a NAD+ precursor, and the age-related decline of NAD+ has become the marketing basis for «longevity». Supplement makers sell nicotinamide, NMN and nicotinamide riboside as «anti-aging molecules». No large human RCT has shown extended lifespan or slowed aging. Short-term human studies (8–12 weeks, n<100) show elevated blood NAD+, but translation to clinically meaningful endpoints – reduced sarcopenia, improved cognition, fewer cardiovascular events – is absent. At high doses (>3 g/day) hepatotoxicity has been described. If the product was suggested «for longevity», consider seeking a second opinion.
- FNintedanibNot recommended · Tyrosine kinase inhibitorsNintedanib is a tyrosine kinase inhibitor. It is prescribed for idiopathic pulmonary fibrosis and other interstitial lung diseases with progressive fibrosis (AEMPS Ficha Técnica, INPULSIS 2014). In alt-anti-aging circles, nintedanib is occasionally promoted to suppress fibrosis of aging in healthy people. In healthy adults, no clinical studies of such use exist. The drug has serious risks: hepatotoxicity up to severe liver injury, GI disturbances (severe diarrhea in 60% of patients), elevated bleeding risk (especially on anticoagulants), hypertension, and thromboembolic events. If nintedanib was recommended to a healthy person, seek a second opinion immediately.
- FOlmesartan medoxomilNot recommended · Angiotensin II receptor blocker (ARB, sartan)Olmesartan medoxomil is an ARB with a prolonged antihypertensive effect. It is prescribed for hypertension (ESC/ESH 2023, SEH-LELHA). In anti-aging regimens, olmesartan is promoted to healthy normotensives as a vessel protector and a means to slow vascular aging. In people with normal blood pressure, no clinical studies of prophylactic use exist. Olmesartan has a specific risk of severe sprue-like enteropathy (chronic diarrhea, weight loss, and intestinal villous atrophy; described by Marthey 2014, FDA Drug Safety Communication 2013). Other risks: hyperkalemia, dizziness, teratogenicity. If olmesartan was prescribed to a healthy person, consider seeking a second opinion.
- FOmega-3 triglycerides (EPA and DHA)Not recommended · Lipid-modifying agents. Omega-3 polyunsaturated fatty acidsFor slowing aging or extending life, omega-3 (EPA/DHA) has no proven benefit; large RCTs (VITAL, ASCEND) showed no such effect in people without an indication. At high doses (around 4 g/day, as in REDUCE-IT and STRENGTH) omega-3 raises the risk of atrial fibrillation, which the FDA labeling also notes. At usual dietary doses (roughly up to 1–2 g/day, from fish or ordinary supplements) this risk has not been shown and tolerability is good. Bottom line: taking high doses for anti-aging is unjustified; dietary omega-3 intake is safe but is not a longevity intervention.
- FParacetamolNot recommended · Anilides. Analgesics and antipyreticsParacetamol (acetaminophen) is a non-opioid analgesic and antipyretic. It is taken for acute pain (headache, dental, muscular), fever, and dysmenorrhea (AEMPS Ficha Técnica). Paracetamol is often taken for any discomfort or prophylactically before exercise as a universal analgesic. Prophylactic use is not justified: ACR 2020 guidelines for osteoarthritis rank paracetamol lower than previously thought; the Cochrane review by Leopoldino 2019 showed a clinically insignificant effect in knee and hip osteoarthritis versus placebo. Regular paracetamol use raises the risk of hepatotoxicity (especially with alcohol), and at high doses (over 4 g/day or less with liver disease) can cause acute liver failure. If paracetamol is being taken daily as discomfort prophylaxis, consider seeking a second opinion.
- FPhenibutNot recommended · Other anxiolytics (local classification)Phenibut (β-phenyl-γ-aminobutyric acid) is a Soviet anxiolytic with GABA-B agonist activity. In Russia it is prescribed for anxiety, sleep disturbances, and asthenia. In biohacker communities, phenibut is promoted as a nootropic for cognitive enhancement in healthy adults. The drug is not approved by the FDA, EMA, or AEMPS and is not included in any international clinical guidelines. In 2019 the US FDA issued warning letters stating that phenibut does not meet the definition of a dietary ingredient and that products containing it are misbranded; US poison-center calls rose over the same period. The drug has serious risks: rapid development of dependence (even after several weeks of regular use), severe withdrawal syndrome (anxiety, insomnia, tachycardia, psychosis, sometimes seizures, may require hospital treatment), coordination disturbances, and sedation. If phenibut is being taken for anti-aging, concentration, or anxiety, consider seeking a second opinion; safer evidence-based alternatives exist.
- FPhytomenadioneNot recommended · Vitamin K1, haemostatic, antidote for coumarin anticoagulant overdoseVitamin K1 (phytomenadione) is a fat-soluble vitamin found in green leafy vegetables. Its clinical indications are prevention and treatment of hemorrhagic disease of the newborn, bleeding on vitamin K antagonists, and hypoprothrombinemia. In anti-aging supplement marketing, vitamin K1 is sold as an anti-aging agent (often with vitamin D3 and calcium). International guidelines do not mention vitamin K1 as an anti-aging agent. Vitamin K1 is dangerous in people on warfarin or other vitamin K antagonists – it sharply reduces their effect with thrombosis risk. If vitamin K1 is being taken for anti-aging, consider seeking a second opinion, especially if you take anticoagulants.
- FPioglitazoneNot recommended · Thiazolidinedione (PPAR-γ agonist), oral antidiabeticPioglitazone is a thiazolidinedione antidiabetic. AEMPS authorises it only for type 2 diabetes. Biohacking and longevity-stack communities promote pioglitazone as an «anti-aging drug» on the basis of improved insulin sensitivity and reduced systemic inflammation. The link is not confirmed: pioglitazone is not in the TAME protocol (which tests metformin) and there are no completed lifespan RCTs in non-diabetic adults. Use without a diagnosis carries real risks: 3–4 kg weight gain, oedema, heart failure, bladder cancer (cumulative risk with long use), distal-bone fractures in postmenopausal women (twofold vs metformin), macular oedema. If pioglitazone was prescribed for «longevity» – consider seeking a second opinion.
- FPiracetamNot recommended · Old «nootropics» (local classification)Piracetam is the original nootropic drug, developed in the 1960s. In biohacker communities, piracetam is promoted as the original nootropic for cognitive enhancement in healthy adults. International clinical guidelines (AAN, ESO, NICE) do not mention piracetam, and the FDA has not approved it. No clinical studies in healthy adults with endpoints on productivity, working memory, or attention exist. International anti-aging guidelines do not include piracetam. The drug is relatively safe but can cause nervousness, insomnia, and GI disturbances. If piracetam is being taken for anti-aging, concentration, or productivity, consider seeking a second opinion.
- FPirfenidoneNot recommended · Antifibrotic agentsPirfenidone is an antifibrotic drug with anti-inflammatory action. It is prescribed only for idiopathic pulmonary fibrosis (AEMPS Ficha Técnica, ASCEND 2014). In alt-anti-aging circles, pirfenidone is occasionally promoted as an antifibrotic for anti-aging of the lungs and other tissues in healthy people. In healthy adults, no clinical studies of such use exist. The drug has serious risks: severe photosensitivity (skin reactions in sunlight), GI disturbances (nausea, vomiting, diarrhea, weight loss), hepatotoxicity (requires regular liver enzyme monitoring), and elevated cardiovascular event risk. If pirfenidone was recommended to a healthy person, seek a second opinion immediately.
- FPitavastatinNot recommended · Statin (HMG-CoA reductase inhibitor)Pitavastatin is a new-generation statin with minimal CYP3A4 interaction. It is prescribed for hyperlipidemia and for primary/secondary CV prevention in high-risk patients (ESC/EAS 2019). In anti-aging and longevity communities, pitavastatin is promoted as a means for life extension and vessel protection in healthy adults. In people with normal lipid profile and low CV risk, no clinical studies of prophylactic use exist, and meta-analyses do not confirm benefit. The drug causes myalgia, elevated liver enzymes, risk of rhabdomyolysis (rare but dangerous), elevated glucose, and new-onset diabetes risk. If pitavastatin was prescribed at a normal lipid profile, consider seeking a second opinion.
- FPotassium iodideNot recommended · Iodine therapy for thyroid functionPotassium iodide is a source of iodine prescribed for iodine deficiency prevention, hypothyroidism in iodine-deficient populations, and thyroid blockade in nuclear emergencies. In anti-aging communities, potassium iodide is sold to slow aging and extend life, often combined with other detox protocols. In areas with adequate iodine intake (most developed countries use iodized salt), additional iodine is unnecessary; international guidelines do not mention potassium iodide as an anti-aging agent. Iodine overdose causes iodine-induced hyperthyroidism (especially in older adults with nodular goiter) or, paradoxically, hypothyroidism (the Wolff-Chaikoff effect). If potassium iodide is being taken for longevity, consider seeking a second opinion.
- FPravastatinNot recommended · Statin (HMG-CoA reductase inhibitor)Pravastatin is a weak-to-moderate hydrophilic statin with minimal CNS penetration. It is prescribed for hyperlipidemia and for primary/secondary CV prevention in high-risk patients (ESC/EAS 2019). In anti-aging practice, pravastatin is positioned as a mild statin for continuous vessel protection in people with normal lipids. In people with normal lipid profile, no clinical studies of prophylactic use exist. The drug causes myalgia, elevated liver enzymes, and new-onset diabetes risk. If pravastatin was prescribed at normal lipid levels, consider seeking a second opinion.
- FPregnenoloneNot recommended · Endogenous C21 steroid precursor; sold as a supplement on iHerb and Amazon; not registered as a drug in the EUPregnenolone joins the biohacker master youth hormone stack alongside DHEA. There is no human anti-aging data: no long-term RCTs in healthy people with mortality or age-related disease endpoints have been done, and the only longevity finding is lifespan extension in the worm C. elegans, a model-organism surrogate, not clinical evidence. Pregnenolone is an active steroid precursor: it converts to androgens, estrogens, and cortisol, so uncontrolled use carries a real adverse profile (acne, hirsutism, hair loss, palpitations, insomnia, menstrual disruption) and is hazardous in hormone-dependent conditions (prostate and breast cancer, PCOS, thrombosis risk), with additive risk alongside HRT, combined contraceptives, DHEA, or testosterone. Benefit is unproven while harm is documented, which places it at F. What slows ageing is physical activity, a Mediterranean diet, smoking cessation, and blood-pressure and glucose control.
- FPterostilbene (dimethyl resveratrol analogue)Not recommended · Plant stilbene, supplement. Natural polyphenol from blueberries, grapes and red sandalwood. Often sold combined with nicotinamide riboside (NR) in longevity complexesPterostilbene is actively sold in the longevity segment as «improved resveratrol» with better bioavailability, often combined with nicotinamide riboside (NR) in Basis by Elysium Health. No RCTs with lifespan, biological ageing slowing (Horvath/GrimAge epigenetic clocks) or all-cause mortality endpoints in humans. Memorial Sloan Kettering 2024 resveratrol and analogues monograph notes «no clinical evidence for anti-aging or longevity claims». Most claims rest on mouse model translation (David Sinclair et al.) and in vitro SIRT1 activation. Proven lifespan measures: smoking cessation, blood pressure, glucose, body weight control, physical activity, Mediterranean diet. If pterostilbene was recommended as part of an anti-aging protocol, consider seeking a second opinion from a general practitioner.
- FPyridoxine (vitamin B6)Not recommended · Vitamins. CoenzymeVitamin B6 (pyridoxine) is a water-soluble vitamin. Its clinical indications are prevention and treatment of B6 deficiency, isoniazid-induced neuropathy, and some rare diseases. In anti-aging regimens, vitamin B6 is sold to slow aging, extend life, and support cognitive function. No clinical studies of prophylactic B6 use in healthy adults for anti-aging exist; international guidelines do not include vitamin B6 as an anti-aging agent. High-dose B6 (above 100 mg/day chronically) can paradoxically cause sensory neuropathy (numbness and tingling in the extremities, described by Schaumburg 1983) – one of the few vitamin toxicities with genuine neurological consequences. If vitamin B6 is being taken in high doses for anti-aging, consider seeking a second opinion.
- FRamiprilNot recommended · Angiotensin-converting enzyme inhibitor (ACE-I)Ramipril is a long-acting ACE inhibitor. It is prescribed for hypertension, heart failure, diabetic nephropathy, and for secondary cardiovascular prevention after myocardial infarction or stroke (ESC/ESH 2023, SEH-LELHA; the HOPE 2000 trial demonstrated benefit at high CV risk). In anti-aging regimens, ramipril is given to healthy normotensives for anti-aging of vessels and for suppressing chronic inflammation of aging. In people with normal blood pressure and no confirmed high CV risk (diabetes, coronary disease, prior stroke), prophylactic use is not justified. The drug causes a dry cough, hyperkalemia, dizziness, and angioedema in predisposed people. If ramipril was prescribed to a healthy person, consider seeking a second opinion.
- FRanolazineNot recommended · Antianginal – late sodium current inhibitorRanolazine is an antianginal drug with a metabolic mechanism of action (a late sodium current inhibitor). It is prescribed for stable angina as add-on therapy to β-blockers or CCBs when symptom control is inadequate (ESC 2024, AEMPS Ficha Técnica). In anti-aging regimens, ranolazine is positioned as a metabolic modulator for anti-aging of the myocardium in healthy adults. In people without angina, no clinical studies of prophylactic use exist. The drug causes constipation, nausea, dizziness, QT-interval prolongation, and CYP3A4-mediated drug interactions. If ranolazine was prescribed to a person without angina, consider seeking a second opinion.
- FResveratrolNot recommended · Dietary supplements, plant polyphenols (local classification)Resveratrol gained the «longevity molecule» label after Sinclair-group work in the early 2000s – in lab models it activated the sirtuin SIRT1 and extended lifespan in yeast and nematodes. The mammalian lifespan effect did not reproduce: mice on normal feeding showed no rise in median survival. EFSA in 2011 rejected all resveratrol health claims – no «cell protection», «heart health» or «brain function» submission passed evaluation. Oral bioavailability is very low: Walle 2011 review reports under 1% of an oral dose reaching plasma unchanged. The Berman systematic review 2017 in Ann N Y Acad Sci found no quality clinical outcomes in humans. If resveratrol was bought or prescribed «for longevity», consider seeking a second opinion; the efficacy is not proven, and real strategies to lengthen healthy lifespan are smoking cessation, BP and glucose control, physical activity, Mediterranean diet and sleep.
- FRetinolNot recommended · Fat-soluble vitamin ARetinol capsules are sold as a skin rejuvenation or anti-aging tool. Oral retinol does not act on skin: tissue concentrations do not reach a level at which retinoic acid activates the renewal programme. That effect comes only from topical retinoids (tretinoin, retinol in cream form) used for many months. Oral high-dose retinol does not rejuvenate – it causes dry skin and hair loss and accumulates in the liver. If retinol capsules were recommended for rejuvenation, consider seeking a second opinion.
- FRisedronic acidNot recommended · Nitrogen-containing bisphosphonateRisedronic acid is a second-generation bisphosphonate. It is prescribed for osteoporosis with confirmed reduced bone density, Paget's disease, and glucocorticoid-induced osteoporosis (NOGG 2021, AACE 2020). In anti-aging circles, risedronate is promoted for anti-aging bone strengthening in healthy perimenopausal women without diagnosed osteoporosis. In people without confirmed osteoporosis, no clinical studies of prophylactic use exist. The drug has serious adverse effects: esophageal erosions and ulcers (requires intake with plenty of water in upright position), osteonecrosis of the jaw, and atypical femoral fractures on long-term use. If risedronate was prescribed without confirmed osteoporosis, consider seeking a second opinion.
- FRoflumilastNot recommended · Selective phosphodiesterase-4 (PDE-4) inhibitorRoflumilast is a selective phosphodiesterase-4 (PDE4) inhibitor. It is prescribed for severe COPD with a frequent-exacerbation phenotype and chronic bronchitis (GOLD 2024, AEMPS Ficha Técnica). In biohacker circles, roflumilast is occasionally promoted to suppress chronic inflammation and for anti-aging. In healthy adults, no clinical studies of such use exist. The drug has serious risks: pronounced weight loss (5–10% of baseline), GI disturbances (nausea, diarrhea, abdominal pain), neuropsychiatric adverse effects (insomnia, anxiety, depression, suicidal ideation – FDA warning), and sleep disturbances. If roflumilast was recommended to a healthy person, seek a second opinion immediately.
- FRosuvastatinNot recommended · HMG-CoA reductase inhibitors (statins)Rosuvastatin is a high-potency statin. It is prescribed for hyperlipidemia and for primary/secondary CV prevention in high-risk patients (ESC/EAS 2019, ACC/AHA 2018; the JUPITER 2008 trial showed benefit at LDL below 130 mg/dL with elevated hsCRP). In biohacker and longevity communities, rosuvastatin is actively promoted as a life-extension drug and a suppressor of chronic inflammation of aging. In people with normal lipid profile and low CV risk, clinical studies do not justify prophylactic use: the Ridker 2012 meta-analysis showed that JUPITER's benefit is limited to patients with specific risk markers. The drug causes myalgia, elevated transaminases, risk of rhabdomyolysis, elevated glucose, and new-onset diabetes risk. If rosuvastatin was prescribed at normal lipid levels, consider seeking a second opinion.
- FRoyal jellyNot recommended · Bee product, secretion of pharyngeal glands of worker honeybees (Apis mellifera), supplement with high allergen riskRoyal jelly is marketed as a «longevity secret» and «youth elixir», invoking the lifespan difference between worker bees and the queen. This argument is biologically wrong: the difference reflects the genetic programme of a social insect, not a transferable human effect. RCTs of longevity and age-related mortality reduction with royal jelly do not exist. Proven methods to extend active life are smoking cessation, Mediterranean diet, physical activity, control of blood pressure, cholesterol and diabetes (USPSTF, AHA, ESC). Royal jelly is not in these guidelines. Given the high allergen risk, the «rejuvenation» idea creates a real chance of anaphylactic shock instead of the promised youth. If royal jelly was bought «for longevity», discuss with a doctor; basic prevention and regular monitoring work – the bee secretion does not.
- FSelenium (oral salts and chelates: selenomethionine, sodium selenite, selenium yeast)Not recommended · Mineral supplements. Trace elementsSelenium is a trace element required in small amounts (recommended daily allowance 55 mcg for adults). Selenium is found in fish, meat, eggs, and Brazil nuts (1–2 nuts cover the daily requirement). In anti-aging regimens, selenium is sold to slow aging and extend life in people without deficiency. The Cochrane review by Vinceti 2018 showed that selenium supplementation in non-deficient people does not reduce cancer, cardiovascular events, or all-cause mortality; the large SELECT trial (JAMA 2009) was stopped early – selenium and vitamin E supplements in men did not reduce prostate cancer risk but increased type 2 diabetes risk. Selenium overdose causes selenosis: brittle hair and nails, hair loss, and neurological symptoms. If selenium is being taken for longevity, consider seeking a second opinion.
- FSemaglutideNot recommended · GLP-1 receptor agonistsSemaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist. It is prescribed for type 2 diabetes (Ozempic) and for obesity or overweight with comorbidities (Wegovy) (ADA 2024, AACE 2023, EASO 2023). In anti-aging and longevity circles, semaglutide is promoted as a drug for metabolic rejuvenation in people with normal weight and without diabetes. In people without diabetes and without overweight (BMI below 27 kg/m²), no clinical studies of prophylactic use exist. The drug has serious risks: GI disturbances (nausea, vomiting, diarrhea in 30–40%), pancreatitis, medullary thyroid cancer risk (FDA boxed warning in MEN-2 patients), cholelithiasis, potential depression, and severe muscle atrophy with rapid weight loss. If semaglutide was prescribed to a person with normal weight and without diabetes, consider seeking a second opinion.
- FSildenafilNot recommended · Phosphodiesterase type 5 inhibitors (PDE5)Sildenafil is a phosphodiesterase-5 (PDE5) inhibitor. It is prescribed for erectile dysfunction and pulmonary arterial hypertension (AEMPS Ficha Técnica). In anti-aging communities, sildenafil and other PDE5 inhibitors are promoted as rejuvenating, improving cerebral and vascular blood flow, and boosting endurance. In people without erectile dysfunction or pulmonary hypertension, no clinical studies of prophylactic use exist; cerebral blood flow improvement and life extension via PDE5 inhibitors have not been demonstrated. The drug causes headache, facial flushing, nasal congestion, dyspepsia, visual disturbances (bluish tint), and rarely non-arteritic anterior ischemic optic neuropathy (risk of permanent vision loss). It is dangerous combined with nitrates (sharp blood pressure drop, shock risk). If sildenafil is being taken for anti-aging, consider seeking a second opinion.
- FSilodosinNot recommended · Highly selective α1A-adrenergic blockerSilodosin is a highly selective α1A-adrenergic blocker. It is prescribed for men with benign prostatic hyperplasia (BPH) (AUA 2023, AEMPS Ficha Técnica). Silodosin is prescribed to men for anti-aging improvement of urination outside a BPH indication. No clinical studies of prophylactic use in this setting exist. The drug has pronounced retrograde ejaculation (in 28% of patients – abnormally frequent versus other α1-blockers), orthostatic hypotension, dizziness, and risk of intraoperative cataract surgery complications (intraoperative floppy iris syndrome). If silodosin was prescribed outside confirmed BPH, consider seeking a second opinion.
- FSimvastatinNot recommended · HMG-CoA reductase inhibitors (statins)Simvastatin is a moderate-potency statin, one of the most prescribed statins worldwide. It is prescribed for hyperlipidemia and for primary/secondary CV prevention (ESC/EAS 2019). In healthy adults, simvastatin is occasionally prescribed for general vascular protection or anti-aging, citing older meta-analyses. In people without confirmed CV risk factors, clinical studies do not justify prophylactic use. Simvastatin interacts with CYP3A4 more strongly than other statins (combinations with clarithromycin, erythromycin, itraconazole, and large amounts of grapefruit juice are prohibited due to rhabdomyolysis risk). In 2011 the FDA limited the maximum simvastatin dose to 40 mg/day due to dose-dependent muscle toxicity risk. If simvastatin was prescribed at normal lipid levels, consider seeking a second opinion.
- FSolifenacinNot recommended · Antimuscarinic for overactive bladderSolifenacin is an antimuscarinic drug. It is prescribed for overactive bladder with frequency and urgency symptoms (AEMPS Ficha Técnica). Solifenacin is prescribed for anti-aging strengthening of the urinary system outside an overactive bladder indication. No clinical studies of prophylactic use in this setting exist. The drug causes anticholinergic adverse effects: dry mouth, constipation, blurred vision, confusion (especially in older adults; the AGS Beers Criteria 2023 lists antimuscarinics as potentially inappropriate for older adults), urinary retention (paradoxically), and QT prolongation. If solifenacin was prescribed outside confirmed overactive bladder, consider seeking a second opinion.
- FSpironolactoneNot recommended · Potassium-sparing diuretics (mineralocorticoid receptor antagonists)Spironolactone is a potassium-sparing diuretic and aldosterone antagonist. It is prescribed for primary aldosteronism, heart failure, and resistant hypertension (ESC 2024). Spironolactone is actively prescribed to women for acne, hirsutism, and androgenic alopecia, citing its antiandrogen effect (the AEMPS Ficha Técnica does not include these indications; AAD 2024 and EADV 2023 consider spironolactone an off-label option as second- or third-line for female acne). For mild acne or anti-aging hair in women, clinical studies of prophylactic use are limited. The drug has specific risks: hyperkalemia (especially in older adults, renal impairment, or with ACE inhibitor/ARB), gynecomastia and mastodynia in men and women, erectile dysfunction in men, menstrual disturbances, and teratogenicity in male fetuses. If spironolactone was prescribed for dermatology or anti-aging without a discussion of risks, consider seeking a second opinion.
- FSulfasalazineNot recommended · Intestinal aminosalicylate and disease-modifying antirheumatic drug (DMARD)Sulfasalazine is a disease-modifying antirheumatic drug and an anti-inflammatory for bowel diseases. It is prescribed for rheumatoid arthritis, psoriatic arthritis, Crohn's disease, and ulcerative colitis (EULAR 2023, ACG 2024 guidelines). In anti-aging circles, sulfasalazine is prescribed to suppress chronic inflammation in healthy people. In healthy adults, no clinical studies of such use exist. The drug has specific risks: myelosuppression (leukopenia, agranulocytosis, aplastic anemia), severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS syndrome), hepatotoxicity, hemolytic anemia in G6PD-deficient patients, and reversible male infertility. If sulfasalazine was recommended to a healthy person to suppress inflammation, consider seeking a second opinion.
- FTacrolimusNot recommended · Calcineurin inhibitor (immunosuppressant)Tacrolimus is a calcineurin inhibitor immunosuppressant, more potent than cyclosporine. It is prescribed to prevent organ transplant rejection and for severe atopic dermatitis (topical forms) (AEMPS Ficha Técnica). In alt-anti-aging circles, tacrolimus is promoted as a potent immunosuppressant to slow immune system aging. In healthy adults, no clinical studies of such use exist. The drug has serious risks: nephrotoxicity (often irreversible), neurotoxicity (tremor, headache, confusion, seizures), increased malignancy risk (especially lymphomas and skin cancer, FDA boxed warning), hypertension, hyperkalemia, hyperglycemia and new-onset diabetes, and severe opportunistic infections. If tacrolimus was recommended to a healthy person, seek a second opinion immediately.
- FTamsulosinNot recommended · Alpha-adrenergic blockers for prostatic disordersTamsulosin is a selective α1A-adrenergic blocker. It is prescribed for men with benign prostatic hyperplasia (BPH) for improving urination (AUA 2023, AEMPS Ficha Técnica). Tamsulosin is prescribed to men without confirmed BPH diagnosis for anti-aging improvement of urination. In men without BPH, no clinical studies of prophylactic use exist. The drug can cause orthostatic hypotension (especially in older adults, fall risk), retrograde ejaculation, and abnormalities of the ocular choroid with intraoperative cataract surgery complications (intraoperative floppy iris syndrome – requires informing the ophthalmologist). If tamsulosin was prescribed without confirmed BPH, consider seeking a second opinion.
- FTelmisartanNot recommended · Angiotensin II receptor blocker (ARB)Telmisartan is an ARB with additional partial PPARγ agonist activity. It is prescribed for hypertension and for secondary CV prevention in high-risk patients (ESC/ESH 2023, SEH-LELHA, ACC/AHA 2017). In anti-aging and longevity communities, telmisartan is promoted as a partial PPARγ agonist with metabolic effects in healthy normotensives. In people with normal blood pressure, no clinical studies of prophylactic use for metabolic purposes exist. The drug can cause dizziness, hyperkalemia, and teratogenicity. If telmisartan was prescribed to a healthy person, consider seeking a second opinion.
- FThiocolchicosideNot recommended · Centrally acting muscle relaxantThiocolchicoside is a centrally acting muscle relaxant, an agonist at GABA-A and glycine receptors. It is prescribed in short courses for acute painful muscle spasm associated with spinal or muscular pathology (AEMPS Ficha Técnica, maximum 5–7 days). In anti-aging regimens, thiocolchicoside is used long-term for muscle relaxation in healthy adults. Long-term use is not justified: in 2014 the EMA restricted thiocolchicoside to short courses for acute muscle spasm after evidence of genotoxicity of the active metabolite (DNA damage risk and potential carcinogenicity). The drug is not approved in the US (FDA has not approved it). Specific risks: diarrhea, allergic reactions, and seizures (especially with dose exceedance or in those predisposed to epilepsy). If thiocolchicoside was prescribed for chronic use in muscle tension, consider seeking a second opinion.
- FTiboloneNot recommended · Synthetic steroid with estrogenic, progestogenic and weak androgenic activityTibolone is a synthetic steroid with estrogenic, progestogenic, and weak androgenic activity. It is prescribed for marked vasomotor symptoms of menopause and for postmenopausal osteoporosis prevention in women more than one year after menopause (NAMS 2022, NICE NG23). In anti-aging practice, tibolone is positioned as a universal anti-aging drug for postmenopausal women to rejuvenate skin and libido. In women without marked menopausal symptoms, no clinical studies of prophylactic anti-aging use exist. The LIFT trial (2008) showed increased stroke risk in women over 60 on tibolone. Also: increased breast cancer recurrence (LIBERATE 2009), venous thromboembolism, and gallbladder disease. If tibolone was prescribed for anti-aging, consider seeking a second opinion.
- FUstekinumabNot recommended · Biologic – interleukin-12 and -23 inhibitorUstekinumab is a monoclonal antibody against interleukins 12 and 23 (IL-12/23). It is prescribed for moderate-to-severe psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis (AAD 2020, ACG 2024, EULAR 2023 guidelines). In anti-aging circles, ustekinumab is promoted as a biological against aging-related inflammation and autoimmune background in healthy people. In healthy adults, no clinical studies of prophylactic use exist. The drug has serious risks: severe infections (including opportunistic), reactivation of tuberculosis (requires screening before start), increased malignancy risk on long-term use, and hypersensitivity reactions. If ustekinumab was recommended to suppress aging-related inflammation in a healthy person, seek a second opinion immediately.
- FValsartanNot recommended · Angiotensin II receptor blockers (ARBs)Valsartan is an angiotensin II receptor blocker. It is prescribed for hypertension, heart failure, and after myocardial infarction (ESC/ESH 2023, SEH-LELHA, ACC/AHA 2017). In anti-aging regimens, valsartan is given to healthy normotensives for general vessel protection. In people with normal blood pressure, no clinical studies of prophylactic use exist. The drug can cause dizziness, hyperkalemia, angioedema in predisposed people, and teratogenicity. If valsartan was prescribed to a healthy person, consider seeking a second opinion.
- FZinc (oral salts: picolinate, citrate, gluconate, oxide, acetate)Not recommended · Mineral supplements. Trace elementsZinc is a trace element required in small amounts (recommended daily allowance 8–11 mg for adults). Zinc is found in red meat, seafood (especially oysters), legumes, and nuts. In anti-aging communities, zinc is sold to slow aging, prevent dementia, and extend life. In people without zinc deficiency, no clinical studies of prophylactic use for anti-aging exist; international guidelines do not include zinc as an anti-aging agent. Zinc overdose (above 40 mg/day chronically) causes copper deficiency with reduced immunity, anemia, and neurological symptoms; it can also reduce absorption of antibiotics (tetracyclines, fluoroquinolones). If zinc is being taken in high doses for longevity, consider seeking a second opinion.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit