Microdosing pharmaceuticals for healthspan: Lower risks and costs

Finasteride efficacy as low as 0.2 mg - 0.05 mg (1 mg regular dose for hair loss):

image

Ezetimibe efficacy as low as 0.25 mg (10 mg regular dose):

image

Rosuvastatin efficacy as low as 1 mg (5-40 mg regular dose):

image

It would be interesting to know about other drugs efficacy at lower doses than prescribed, for BP medications, SGLT2 inhibitors, GLP-1 agonists, mTOR inhibitors, PCSK9 inhibitors, acarbose, etc. There might not exist clinical trials so other markers of efficacy have to be used. I would guess for SGLT2 inhibitors that would be how much glucose is in urine at different doses, for example.

Is something missing with this reasoning?
What other drugs do you know of?
What do you think are the benefits and drawbacks of microdosing?

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Claude 3.5 Sonnet gives some input:

The image presents data on the efficacy of lower doses of several medications compared to their standard doses:

  1. Finasteride: Shows efficacy at doses as low as 0.2 mg - 0.05 mg, compared to the regular 1 mg dose for hair loss treatment.

  2. Ezetimibe: Demonstrates efficacy at 0.25 mg, versus the standard 10 mg dose.

  3. Rosuvastatin: Exhibits efficacy at 1 mg, compared to the usual 5-40 mg dose range.

The graphs illustrate dose-response relationships, showing that lower doses can still produce significant effects.

Regarding your question about the reasoning:

The approach seems sound, exploring the potential of microdosing pharmaceuticals for health benefits while potentially reducing side effects. However, it’s important to note that efficacy at lower doses doesn’t automatically mean these doses are optimal or safe for long-term use without proper clinical trials.

Other drugs that might be interesting to study at lower doses could include:

  1. Metformin for diabetes/longevity
  2. Low-dose aspirin for cardiovascular protection
  3. SSRIs for mood disorders
  4. Beta-blockers for hypertension

Benefits of microdosing might include:

  1. Reduced side effects
  2. Lower costs
  3. Potentially improved long-term safety

Drawbacks could be:

  1. Reduced efficacy for some individuals
  2. Need for more frequent dosing
  3. Lack of long-term data on safety and efficacy at lower doses

It’s crucial to emphasize that any changes in medication dosing should only be done under medical supervision, as individual responses can vary greatly.

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How to create lower doses of finasteride, ezetimibe, rosuvastatin, etc:

Just mix the tablet that is not needed to be enteric coated (see end) with something inert or which you have at hand like creatine and fill up 00 capsules.

  1. Buy capsule machine, fills 24 capsules ($20).
  2. Buy mortar and pestle ($25).
  3. Buy 1000, 00 capsules ($18).
  4. Split tablet with pill cutter if necessary, if for example 1/2 tablet is enough for one 24 capsule batch.
  5. Fill 24 capsules in capsule machine with creatine or something similar, on one side of capsule, empty capsules and put the measured creatine to the side.
  6. Crush tablet in mortar and pestle, remove about same amount of powder from creatine that is left aside as the amount from the tablet, so it fills up evenly.
  7. Use geometric dilution method for even mixing, this means you add about same amount of creatine or other powder as the tablet. Then mix, and repeat with same amount of creatine as the powdered mix, doubling each time. This is the same method used, and with mortar and pestle in pharmacies.
  8. Add the mix to the capsules and cap them with the machine, 24 capsules done.

There might be more automatic ways of doing this, with some better machine, and this doesn’t work with drugs that needs to be enteric coated because they need to resist stomach acid. Enteric capsules does not work, it needs a special coating from a factory on a tablet.

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