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Table 3. Examples of current FDA-approved pharmacotherapies with anti-aging potential
Name of FDA-approved Mechanism(s) of action Evidence of anti-aging Limitations
drug indication(s) of use potential
Metformin Type 2 diabetes Antihyperglycemic, decreases PCK1 gene upregulation, Lactic acidosis, renal impairment,
hydrochloride mellitus in adults and gluconeogenesis, reduces PARP1 gene hypoglycemia, diarrhea, nausea and
children as an adjunct intestinal absorption of glucose, downregulation and vomiting, indigestion, abdominal
to diet and improves insulin sensitivity and promotion of pyruvate discomfort and/or headache [152]
[152] [153] [154]
exercise activates AMPK metabolism
Sirolimus Prophylactic for organ Inhibits T-lymphocyte Extends lifespan, increases Hyperlipidemia, renal dysfunction,
rejection in renal activation and proliferation, autophagy, reduces age- hypertension, abdominal pain, nausea,
transplant patients [155] antibody production and mTOR related gut pathologies [156] headache, myalgia and/or
activation to suppress the and reduces oxidative hypercholesterolemia [155]
[152] [157]
immune system stress
Potential hepatotoxic Promotes glutathione Increases lifespan, Nausea, vomiting, diarrhea, flatus,
N-acetylcysteine dose of APAP and production to detoxify liver, attenuates senescence and gastroesophageal reflux and/or
abnormal mucous breaks up mucus, scavenges suppresses mTOR anaphylactic reaction (via IV) [158]
[159]
secretion (e.g., free radicals and increases ATP pathway
bronchitis) [158] production [158]
Dasatinib Subtypes of leukemia Inhibits kinases and prevents When combined with Thrombocytopenia, neutropenia, anemia,
in adults with the proliferation of leukemia quercetin, dasatinib (D+Q) platelet dysfunction, fluid retention,
[160]
resistance or cells acts as a senolytic, cardiac ventricular repolarization,
intolerance to prior increases lifespan and gastrointestinal issues (diarrhea, nausea,
therapy [160] ameliorates premature vomiting, etc.), bleeding events and/or
[161] [160]
frailty infection
FDA: Food and Drug Administration; PCK1: phosphoenolpyruvate carboxykinase 1; PARP1: poly [ADP-ribose] polymerase 1; AMPK: 5’ AMP-
activated protein kinase; mTOR: mammalian target of rapamycin; APAP: acetaminophen; IV: intravenous.

others. Dietary functional oligosaccharides, such as galacto-oligosaccharides (GOS), are among the most
studied prebiotics for human health. Previous research has demonstrated the ability of GOS to reduce
weight gain and hyperplasia and hypertrophy of adipose tissue in diet-induced obese rats to the same extent
as Orlistat. Clinical evidence also suggests that supplementation of GOS leads to an increased abundance of
Bifiobacterium strains in fecal samples of obese adults . In aged mice, dietary GOS had significant impacts
[166]
on the gut microbiome compared to age-matched controls, increasing the abundance of beneficial bacteria
and reducing intestinal permeability and colon inflammation . Interestingly, however, GOS
[167]
supplementation did not have a bifidogenic effect. Other oligosaccharides have also demonstrated the ability
to regulate glucose control and reduce serum lipid levels , while studies show Drosophila melanogaster
[168]
lifespan extension, increased antioxidant capacity, beneficial gut modulation, and improved intestinal
immunity (i.e., via upregulated IMD gene expression) following supplementation with marine agar
[169]
oligosaccharide . Moreover, quercetin is one of the most well-studied dietary flavonoids and is present in
many vegetables, fruits, tea, and red wine . Previously, quercetin has been demonstrated to prevent HFD-
[170]
induced obesity in mice, possibly mediated by lipogenesis regulation and MAPK pathway inhibition . As
[171]
presented in Table 2, quercetin is also considered a senolytic agent that may play a key role in the treatment
of aging. The anti-inflammatory and anti-oxidative properties of quercetin are well-researched, although the
mechanisms remain largely unknown. Recent research suggests Sirt1 as a potential mechanism for its anti-
aging benefits ; however, many studies on quercetin discuss the combination therapy with Dasatinib (i.e.,
[172]
D+Q) , leaving the effects of quercetin alone largely unknown. The extensive evidence of D+Q has led to
[173]
the pursuit of clinical trials for its use in aging diseases, including AD . Additionally, investigation on
[174]
quercetin’s gut modulatory abilities is promising, with recent research showing amelioration of gut
microbial dysbiosis and improved gut barrier function in antibiotic-treated mice and abdominal obesity-
induced models [175,176] . Findings also reveal a positive effect of quercetin treatment on locomotor activity and
oxygen consumption, inferring therapeutic potential against neuronal damage .
[175]