What doctors want you to know before you take a prescription drug off-label
Medications once used to treat illness are increasingly being taken for prevention. Experts explain what’s behind the shift—and what the science actually supports.
When Deborah M. Kado attends cocktail parties, she says people ask her all the time about what medications they “should” be taking or what she thinks about certain prescription medications used for longevity. “I’m a soft biohacker,” says Kado, a medical doctor, professor of geriatric medicine, and co-director of the Stanford Longevity Center. “From the beginning of humanity, people have been dreading their own mortality and thinking of ways in which they can forestall it, or maybe even avoid it.”
In the modern era, that impulse has largely played out in the supplement aisle. Today, roughly 75 percent of Americans across age groups take some kind of dietary supplement, from omega-3s to vitamin D to creatine.
But increasingly, the focus is shifting beyond vitamins and powders. A growing number of people are turning to prescription drugs in hopes of improving health and slowing age-related decline.
Cases in point: Ozempic and other GLP-1s, originally developed to treat diabetes, are now widely used for weight management and are being studied to treat conditions ranging from addiction to kidney disease. Rapamycin, a drug designed for organ transplant patients, is being taken by some for its purported “anti-aging” effects. Even testosterone replacement therapy is sometimes positioned as a longevity or performance enhancer.
Kado describes this moment as the next evolution in how people attempt to take control of their health. And while prescription drugs are harder to obtain than supplements, direct-to-consumer telehealth companies have made access easier, helping reframe medications as lifestyle tools rather than last-resort treatments.
That shift has clear appeal. Prescription drugs are regulated, measurable, and—unlike many supplements—backed by at least some clinical data. For people frustrated by a slow or inaccessible healthcare system, access to this kind of medication can feel empowering.
But there are also clear risks, as some of these medications haven’t been approved—or extensively studied—for these off-label, preventive uses. And, counterintuitively, studies, including a 2025 study in the Journal of the American Geriatrics Society, have found an association between taking more medications and higher mortality risk. “The people that I see who are 100,” Kado says, “literally take less than five meds.” So why are prescription drugs being reframed as tools for prevention now?
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Why are people turning to these meds in the first place?
The shift toward prescription drugs as preventive tools didn’t happen in a vacuum. Arthur L. Caplan, founding head of the Division of Medical Ethics at NYU Grossman School of Medicine’s Department of Population Health, says this trend is a reflection of today’s “fast medicine” culture.
“People in America really like to believe that they don’t have to follow good health habits,” he says, like exercising and eating well. “What they [want] to do is find the right magic bullet, elixir, supplement, tonic, voodoo chant, and that’ll do it.”
Jennifer Schrack, a professor of epidemiology and medicine and the director of the Center on Aging and Health at Johns Hopkins University, agrees that it’s natural for people to find the idea of taking a pill that will keep them healthier to be appealing. “I’ve always said whenever a pill comes out that mimics exercise, I’m going to be out of business,” she says.
While she doesn’t rule out the possibility that some drugs could one day meaningfully support healthy aging, “there’s no evidence that these are going to be [lifespan] altering agents.” What we do know now is that staying active and socially and mentally engaged matters, but people want more than that.
Of course, another key driver is money. “This is all being driven by economics,” Kado says. Unlike in many other countries, drug companies are allowed to market directly to consumers in the U.S., point out both Kado and Caplan.
About two-thirds of adults in a University of Chicago survey said they’d seen ads for prescription medications (including those for weight loss such as Ozempic, Wegovy, or Mounjaro) on social media in the past 12 months. “[Companies are] taking note that people really want to have agency and live healthy and be their best possible selves, and they prey upon that when the medical evidence really isn’t there,” Kado says.
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Caplan adds that, as a business model, medicine in the U.S. also means that drugs approved for one use can be prescribed for other uses. “In most countries, you can’t sell something beyond what it got approved [for],” he says. While the mentality in the U.S. is “the fastest way to get new treatments is to let capitalism sell them to us,” Caplan says, “the rest of the world believes that creates conflicts of interest and real problems.”
Fanning the flames is the fact that trust in science and the healthcare system is at “an all time low,” Kado says, and Schrack agrees. “The traditional healthcare system works better for some than for others, but there’s no doubt that we need to try to do better so that there’s more equitable access to care and the things that people need.”
Direct-to-consumer start-ups are emerging alongside this trend, offering more convenient access to these drugs, often marketing them in a lifestyle or self-improvement context—a model that appears to resonate with many consumers. Seventy percent of consumers (and 79 percent of Gen Z) use health tech, a category that includes online prescription services, monthly, per the PwC’s 2025 US Healthcare Consumer Insights Survey. “[DTCs] are proliferating because they are easier in some ways than navigating the traditional healthcare system,” Schrack says. “But these are for-profit companies,” she says, and regulations around them are murky.
Real meds, real risks
Prescription drugs can offer real benefits—but they can also come with real, and sometimes severe, risks. “Whatever you put in your mouth, from a supplement all the way to prescription drugs, you can suffer unintended adverse consequences,” Kado says, adding that even aspirin has the potential to cause bleeding ulcers. Some drugs being explored for preventive use illustrate that tradeoff. Rapamycin, for example, has shown promise, Schrack says, but it can also suppress the immune system, potentially increasing vulnerability to infections.
But Caplan adds that the people most inclined to experiment with these drugs may also be more comfortable with risk in general. “The people who tend to be chasing longevity by repurposing drugs, they tend to be people who are wealthy and often who have careers where taking risks has produced great wealth,” Caplan says. “I think they’re talking to doctors half the time only to say, ‘I want you to write me this prescription, or I’m going to leave and find somebody who will,’” he says.
Risks aside, there’s no guarantee the drugs will deliver the intended benefits—especially when they’re used outside their approved purpose. “The thing about some of these exploratory agents like rapamycin and others, is that a lot of the benefits we see are in animals and they don’t always translate to humans,” Schrack says.
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Resveratrol, for example, was thought to be beneficial for humans, “but the concentration of the resveratrol they were giving the mice versus what we would get in our typical diets was nowhere close,” Schrack says. With GLP-1s, there is “good data” on their use for managing diabetes, but the trials for their use for obesity (not to mention other uses) are more recent, and there are still unknowns, Kado adds.
What’s more, easy access to prescription drugs might mean that some people aren’t getting the medical care they need to go along with them. “The drug is only one part of a complete care cycle, and it’s not necessarily going to fix everything,” Schrack says.
On a larger scale, widespread off-label use can slow scientific progress. “Because if you’re using these drugs off label or for non-indicated purposes, you’re not studying them,” Caplan points out. “Even if they worked, [we] wouldn’t know, if they’re not in any kind of studies.”
The upshot
While experts urge caution around trying prescription drugs for off-label uses, Kado says the desire for more control over one’s health isn’t inherently misguided. “If people in our world felt like they had more agency…over their lives, they would feel better,” she says.
But that sense of control, she adds, doesn’t have to come from medication. “I would find different ways to try to feel better rather than to take prescription drugs and supplements,” she says—though she notes that creatine is one of the few supplements with evidence suggesting a small but measurable benefit for muscle function.The key, she says, before taking anything is to educate yourself, read widely, and approach claims with healthy skepticism. “Go in with your eyes open and weigh the risks and benefits,” Kado says.
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Ideally, that decision-making would be supported by a trusted clinician, Kado says. Limited time with primary care doctors can push people toward alternative sources for reassurance. Caplan agrees that physicians share some responsibility. Too often, he says, medical advice is delivered without context. Doctors should explain why they believe something works, he says—and how recommendations are grounded in evidence—so patients can make informed choices rather than follow instructions.
The other thing to consider is whether you really want endless longevity. If it’s increasing healthspan you’re after, for now, the most substantial evidence still points toward daily habits. “The bottom line is exercise has the best evidence for health and healthspan, for sure,” Kado says.
