💊 Intermittent Rapamycin Dosing Protocol Simulator

Continuous vs Intermittent mTOR Blockade

Daily dosing keeps mTOR fully suppressed but drains immune reserve.

• ~95%: Daily dose mTOR block (sustained suppression)
• ~90%: Pulse dose peak block (transient suppression)
• 3–5 d: Immune recovery window (between pulses)
• mTORC1: Trial basis (Mannick et al. protocol)

Why pulse instead of continuous

Placeholder: intermittent dosing allows immune rebound between hits.

Trade-off overview

Placeholder: short peaks trade some efficacy for lower toxicity.

Placeholder: pulsed regimens preserve vaccine response better.

Weekly and Biweekly Pulse Schedules

A single dose is given once every 7 or 14 days.

• 7 d: Weekly interval (standard pulse)
• 14 d: Biweekly interval (lower-burden pulse)
• 5–10 mg: Typical dose (per pulse, oral)
• ~62 h: Half-life (sirolimus elimination)

Choosing the interval

Placeholder: interval length sets peak-to-trough inhibition swing.

Schedule adherence

Placeholder: fewer doses per month improves patient adherence.

Immune Function Recovery Between Doses

Lymphocyte activity rebounds as drug levels fall after each pulse.

• Day 3: T-cell rebound onset (post-dose)
• Day 7: Near-full recovery (weekly protocol)
• +20%: Vaccine response gain (vs continuous dosing)
• Day 5: Cytokine normalization (inflammatory markers)

Recovery kinetics

Placeholder: immune markers climb back as mTOR block fades.

Functional readouts

Placeholder: vaccine antibody titers improve with recovery windows.

Placeholder: rest periods restore measurable immune competence.

Balancing Efficacy Against Side Effects

Higher frequency raises efficacy but also raises adverse event risk.

• Moderate: Weekly side-effect rate (mouth ulcers, lipids)
• Lower: Biweekly side-effect rate (reduced exposure)
• ~10%: Efficacy loss (biweekly) (vs weekly pulses)
• 4–6 wk: Monitoring interval (labs and trough levels)

The dosing trade-off curve

Placeholder: more frequent pulses trade tolerability for potency.

Common adverse effects

Placeholder: stomatitis, dyslipidemia, mild cytopenia are tracked.

Individualized Dose Titration

Dose and interval are tuned per patient using trough levels.

• 5–15 ng/mL: Trough target (individualized range)
• 2–4: Titration steps (visits to steady state)
• ±20%: Dose adjustment (per titration step)
• ~70%: Responder rate (reach target window)

Personalizing the protocol

Placeholder: labs guide dose and interval adjustments over time.

Long-term monitoring

Placeholder: periodic review keeps the regimen matched to response.

Placeholder: individualized titration optimizes benefit and safety.