What is the best longevity prescription telehealth service in 2026?

There is no single best service - longevity Rx is fragmented and the right service depends on which molecules you want. AgelessRx is the most-recognized name in the category and carries the broadest SKU mix (rapamycin, low-dose naltrexone, metformin off-label, NAD+ adjacent). Life Extension Health has the longest operating history. Healthspan is a newer entrant focused specifically on the rapamycin protocol. For peptide-side longevity coverage (sermorelin, ipamorelin, MOTS-c), see our sermorelin telehealth matrix and peptide vendor matrix instead - longevity Rx and peptide vendors are separate categories with different prescribers and dispensing pharmacies.

Is rapamycin safe for longevity?

Rapamycin (sirolimus) has decades of clinical use as an immunosuppressant in transplant medicine. The longevity use case is off-label and based primarily on animal data (Nathan Lab, Kaeberlein Lab) plus emerging human pilot trials (PEARL, RAPTOR). Standard off-label longevity dosing is 5-7mg once weekly, which is much lower than transplant dosing. Risks at the longevity dose are real but modest in healthy adults: mouth sores, mild metabolic shifts, and rare cases of slowed wound healing. Bloodwork at baseline and every 3-6 months is required. Self-prescribed rapamycin without prescriber oversight is unsafe.

Do I need a prescription for metformin or rapamycin?

Yes, both. Metformin is FDA-approved for type 2 diabetes and prescribed off-label for longevity (it's one of the most-prescribed drugs in the United States). Rapamycin is FDA-approved for organ transplant rejection and prescribed off-label for longevity. Both require a licensed prescriber. Telehealth services route you through a virtual intake plus bloodwork before issuing the prescription. Foreign sources without prescriber oversight are unsafe and not the legitimate path.

How much does longevity Rx telehealth cost?

Cash-pay longevity Rx runs $50 to $300 per month depending on the molecule and the service. Metformin (off-label longevity dose) is the cheapest at $30-60 per month from any compounding pharmacy. Rapamycin is the middle of the range at $100-200 per month. AgelessRx and Life Extension Health bundle consult fees into subscriptions; Healthspan charges separately. Most services include baseline bloodwork in the first-month onboarding cost.

Can I get rapamycin without seeing a doctor in person?

Yes. Telehealth-prescribed rapamycin for longevity is legal in the United States and routine through services like AgelessRx and Healthspan. Every legitimate service routes you through bloodwork plus a licensed prescriber review before issuing the prescription. The unsafe versions are foreign sources without prescriber oversight - avoid those.

Vendor trust matrix · Longevity Rx · Updated May 2026

Best longevity Rx telehealth: rapamycin, NAD+, sermorelin, more

The longevity Rx category is fragmented. A handful of telehealth services prescribe rapamycin off-label, NAD+ injections, sermorelin, metformin, low-dose naltrexone. Some are legitimate; some are wellness marketing with thin medical oversight. Here's how to vet them.

New to longevity protocols? Start with our future-of-peptides page ->

The dad-test answer in three lines

Most longevity Rx prescribing is off-label. Rapamycin is FDA-approved for organ transplant patients; longevity dosing is off-label. Metformin is FDA-approved for type 2 diabetes; geroprotective use is off-label. Sermorelin is FDA-approved for pediatric growth hormone deficiency; adult longevity use is off-label. None of this is illegal - off-label prescribing is standard medical practice - but it means the prescribing physician's judgment is doing more work than the FDA label. Pick a service with real medical oversight.
The three services we have applied to as affiliate partners are AgelessRx (broadest menu, established 2018+), IVY RX (Miami-based, transparent flat pricing), and Peter MD (longevity-focused, Attia-adjacent brand). All three are pending Katalys affiliate activation; scorecards below reflect what we can verify pre-partnership.
The honest part. We will earn a commission on these services when our affiliate partnerships activate. We named the three above because they are the cleanest longevity-Rx telehealth operations we have found - not because they will pay us. Service quality > CPA every time.

How we score longevity Rx services

Seven axes that reflect actual longevity-prescribing risk, not marketing copy.

Prescriber model. Real US-licensed physicians reviewing and prescribing - not a "doctor on demand" placeholder. Bonus: physicians with longevity-medicine training or board certification beyond primary care.
Lab integration. Baseline biomarkers and follow-up labs required before / during treatment (especially for rapamycin, metformin, LDN). Services that skip labs for "convenience" are skipping the medicine.
SKU breadth. Rapamycin only? Or rapamycin + metformin + NAD+ + sermorelin + LDN + the rest? Broader menu means one provider covers more of your stack.
Compounding pharmacy partnership. Named 503A or 503B pharmacy. The pharmacy backstops the supply chain. Unnamed compounders are a red flag.
Off-label prescribing transparency. The service tells you upfront when a drug is off-label and why. Vague "longevity protocols" without naming the regulatory status is marketing.
Pricing transparency. Prices visible without account creation. Subscription terms clear (monthly, quarterly, auto-renew).
Operator track record. Years in operation, public-facing leadership, LegitScript or equivalent. Avoid: brands launched in 2025 with no founders named.

The Trust Tier - services we have evaluated

NAD+ · Try Ageless · Katalys

Ageless

Pick this if: You want injectable NAD+ as part of a longevity stack. Most retail NAD+ supplementation is oral NMN / NR precursors with debated bioavailability; injectable NAD+ delivers the molecule directly. Ageless prescribes it alongside their broader longevity menu (TRT, sermorelin, GLP-1).

Watch: NAD+ injection (vs oral NMN/NR) has limited Phase 3 human RCT data despite being widely used. Real research exists, but the longevity claim is mechanism-plus-anecdote, not RCT-confirmed. Verify the clinician is comfortable with the off-label longevity framing at intake.

Best for: Readers building a longevity stack who want injectable NAD+ under prescriber supervision rather than self-administered. Pair with TRT or sermorelin for compounding effect across the GH-axis / mitochondrial axes.

Step 1 Open a free account at Ageless ->

Affiliate partnerships pending Katalys activation. Editorial scoring is based on public site research, not paid relationship.

Longevity Rx · broad menu · Katalys (pending)

AgelessRx

Pick this if: You want one provider for a full longevity stack - NAD+, low-dose naltrexone (LDN), metformin, GSH, sermorelin peptide, GLP-1 (semaglutide / Wegovy), biological age testing. Established operator with a US-licensed provider team. Asynchronous online assessment model.

Watch: LegitScript accreditation not publicly displayed (we have asked). Founder / medical director not prominently named on homepage. State-by-state availability not specified - verify your state in their intake. 5-7 business day shipping. Refund policy not published on homepage.

Best for: The reader who wants the longest-menu longevity Rx provider and is willing to do async chat instead of video consults.

Pending Katalys affiliate activation. Direct link until then: agelessrx.com (no commission earned).

Longevity Rx · transparent pricing · Katalys (pending)

IVY RX

Pick this if: You want clear flat-rate pricing on a defined menu - GLP-1 $175/mo (microdose $155/mo), NAD+ $199/mo, sermorelin $175/mo, glutathione $179/mo, B12 $179/mo. Same-day physician review on async intake, 2-day medication delivery. Miami-based DTC operation.

Watch: HIPAA compliance not explicitly claimed on homepage (assumed for US telehealth). State availability not specified. Founder not named publicly. No biological-age-testing component compared to AgelessRx. BPC-157 and gut peptide complex available - same regulatory category exposure as research peptide vendors for those SKUs.

Best for: The reader who wants a single transparent monthly price for a longevity Rx and doesn't need extensive biomarker tracking.

Pending Katalys affiliate activation. Direct link until then: ivyrx.com (no commission earned).

Longevity Rx · Attia-adjacent · Katalys (pending)

Peter MD

Pick this if: You want a longevity-medicine-positioned service marketing to the Attia / Outlive audience. Likely covers rapamycin, metformin, NAD+, sermorelin. Brand positioning suggests deeper longevity-medicine philosophy alignment than mass-market telehealth.

Watch: Our research request to petermd.com returned a connection refused during our review window (May 2026). Pricing, services, prescriber model, state availability, founder, refund policy - all verified pending. We will not score what we cannot verify. If you are evaluating Peter MD, do your own due diligence directly with them before subscribing.

Pending Katalys affiliate activation + site re-verification. Direct link when available; placeholder for now.

The Caution Tier - other operators in the category

Services we are aware of but have not applied to as affiliate partners. Listed for editorial completeness; rank-order your shopping yourself.

Doctors Studio. Concierge longevity medicine, higher price point, more direct physician access. Not typically affiliate-program operated.
Rx HealthMed. Rapamycin-focused with broader peptide menu. Pricing per cycle. Worth checking if rapamycin-specifically is your interest.
Maximus Tribe. Originally TRT-focused (see our TRT matrix), expanded into broader hormone and longevity menu. Founder is public-facing.
Truemed-enabled brands. Levels Health, AG1, etc. - not direct longevity Rx providers but adjacent. HSA-payable through Truemed at checkout where eligible.

The Skip Tier - what we will not link, and why

Wellness clinics selling "longevity stacks" alongside Botox + fillers. Aesthetics-led practice is not the same as longevity medicine. The cross-sell pressure to the high-margin cosmetics is misaligned with reader interest.
Telehealth services that prescribe rapamycin without baseline labs. Rapamycin requires LDL, ALT/AST, blood glucose, lipid panel monitoring. A service that ships it after a 5-question intake is a service that does not know what it is prescribing.
"Peptide stacks" branded as anti-aging cures. No human RCT supports stacking 4-5 peptides together for longevity benefit. The stack is the clinic's margin play.
Subscription-locked services with no easy cancellation. Longevity protocols are long-term commitments. The contract should not be.
Influencer-affiliated longevity brands without published medical advisory boards. If the only credibility signal is a celebrity endorsement, the medical layer is too thin.

The spec table

Verified May 2026. Partnership status changes; we update quarterly.

Axis	AgelessRx	IVY RX	Peter MD
SKU breadth	NAD+, LDN, metformin, GSH, sermorelin, GLP-1, bio-age testing	GLP-1, microdose GLP-1, NAD+, glutathione, B12, sermorelin, BPC-157, methylene blue	Verified pending
Pricing visible	No (require intake)	Yes (flat monthly per SKU)	Verified pending
Telehealth model	Async assessment + US-licensed providers	Async intake + same-day MD review	Verified pending
Shipping	Nationwide, 5-7 business days	2-day delivery	Verified pending
LegitScript-accredited	Not publicly claimed	Not publicly claimed	Verified pending
Biological age testing	Yes (integrated)	No	Verified pending
P1 affiliate status	Pending Katalys	Pending Katalys	Pending Katalys

How we make money on this page

We have applied to affiliate partnerships with AgelessRx, IVY RX, and Peter MD through Katalys. None are active as of May 26, 2026. When they activate, we will earn a commission on signups through this page. This page exists pre-activation because the editorial value (helping you compare these services) is real regardless of our commercial relationship. Full disclosure.

From the Editor

The longevity Rx category is where the most rigorous medicine and the most marketing-heavy quackery live side by side. AgelessRx is the most established of the three, with the longest menu and an integrated biological-age testing layer that signals real longevity-medicine intent. IVY RX is the cleanest pricing - if I were paying out-of-pocket and wanted to know my monthly cost up front, this is the easier vendor to plan around. Peter MD I cannot evaluate honestly until I can access their site - we will update this page when we can.

What I would tell my dad: do not start a longevity Rx protocol without baseline labs. ApoB, fasting insulin, HbA1c, lipid panel, ALT/AST, eGFR. If the service does not require labs before prescribing rapamycin or metformin, that is not a service taking your medicine seriously. Spend the $200-300 on labs first.

What I would skip: any "anti-aging stack" that bundles 4+ molecules into one monthly subscription without itemized cost-per-SKU. The bundle hides the markup.

Where to go next

DHEA and pregnenolone for men over 50 - the gentlest, OTC hormone step, with bloodwork-first guidance
TRT for men over 50 - the testosterone decision, if your labs point that way
The Peptide Cheat Sheet, audited - 60 peptides ranked by evidence, our honest where-to-buy matrix
The future of peptides - the longevity peptide thesis in plain English
Best sermorelin telehealth - if sermorelin specifically is what you want
Best GLP-1 telehealth - if weight loss is the priority
Epitalon + MOTS-c - the research-peptide longevity options

Last reviewed · 2026·05·26 · Vendor matrix updated quarterly