ARA-290 (Cibinetide) Dosage Guide: Neuropathy, Nerve Repair & Anti-Inflammation Protocol
ARA-290 (Cibinetide)
ARA-290 (Cibinetide) is a non-erythropoietic peptide derived from erythropoietin (EPO), studied for tissue-protective, anti-inflammatory, neuroprotective, and nerve-repair signaling without stimulating red blood cell production.
How It Works
Innate Repair Receptor Signaling → Inflammation Modulation + Tissue Protection → Nerve-Repair Research
ARA-290 was designed to interact with tissue-protective signaling associated with the innate repair receptor. Research has investigated effects on inflammation, nerve injury, small-fiber neuropathy, tissue protection, and cellular repair. Unlike erythropoietin, ARA-290 was specifically developed to avoid erythropoietic activity and does not act as a red-blood-cell-stimulating agent.
ARA-290 is derived from erythropoietin but is designed to be non-erythropoietic.
It is studied in nerve-repair, inflammatory, tissue-protection, and small-fiber-neuropathy research.
Human clinical research exists, including daily subcutaneous dosing studies.
Research-use protocols should still be kept separate from study-specific clinical dosing.
ARA-290 Research-Use Framework
Important Evidence Distinction:
The protocol below reflects a commonly discussed research-use framework. It is not a universally established clinical ARA-290 protocol. Human trials have used their own study-specific doses, routes, and treatment durations, which are shown separately on this page.
The protocol below reflects a commonly discussed research-use framework. It is not a universally established clinical ARA-290 protocol. Human trials have used their own study-specific doses, routes, and treatment durations, which are shown separately on this page.
10 mg Vial + 1.0 mL PBS → 10 mg/mL → 1 Unit = 100 mcg
Standard Research-Use Setup
Vial
10 mg
PBS (phosphate-buffered saline)
1.0 mL PBS
Concentration
10 mg/mL
Conversion
1 unit = 100 mcg
Research Reconstitution Note:ARA-290 has been described in published research preparations using phosphate-buffered saline (PBS). Some researchers and suppliers prefer PBS because ARA-290 may demonstrate reduced solubility or gel-like behavior with standard water-based diluents. Reconstitution behavior can vary depending on formulation and preparation conditions.
Weeks 1–4
Starting Phase
Dose
2 mg daily
Units
20 units
Volume
0.20 mL
Weeks 5–8
Build Phase
Dose
2–4 mg daily
Units
20–40 units
Volume
0.20–0.40 mL
Protocol Details
Frequency
Once daily
Timing
Morning or early afternoon
Route
Subcutaneous
Cycle Length
4–8 weeks
Simple Structure:
ARA-290 is commonly discussed as a daily nerve-support and tissue-repair research compound. The 2 mg → 2–4 mg progression above is a practical research-use framework, but it should not be confused with a dose-escalation schedule established through controlled human clinical trials.
ARA-290 is commonly discussed as a daily nerve-support and tissue-repair research compound. The 2 mg → 2–4 mg progression above is a practical research-use framework, but it should not be confused with a dose-escalation schedule established through controlled human clinical trials.
Neuropathy Protocol (Research-Use Framework)
Important:
The 4 mg daily, 6–8 week framework below is commonly discussed in neuropathy-focused research-use settings. Published human neuropathy studies support the relevance of 4 mg daily, but key trials used a 28-day treatment period rather than a validated 6–8 week clinical cycle.
The 4 mg daily, 6–8 week framework below is commonly discussed in neuropathy-focused research-use settings. Published human neuropathy studies support the relevance of 4 mg daily, but key trials used a 28-day treatment period rather than a validated 6–8 week clinical cycle.
Targeted Nerve Support → 4 mg Daily → 6–8 Week Research-Use Window
Weeks 1–4
Targeted Start
Dose
4 mg daily
Units
40 units
Volume
0.40 mL
Weeks 5–8
Targeted Support
Dose
4 mg daily
Units
40 units
Volume
0.40 mL
Protocol Details
Frequency
Once daily
Timing
Morning commonly discussed
Route
Subcutaneous
Research-Use Cycle
6–8 weeks
Targeted Use Notes
Commonly discussed in small-fiber-neuropathy and nerve-related research contexts.
4 mg daily has direct human clinical-research precedent.
The 6–8 week duration is a research-use extension beyond the 28-day treatment periods used in key clinical trials.
Combination or supportive recovery protocols have not been standardized in controlled human research.
What the Human Research Actually Shows
Published Human Dosing
Early Sarcoidosis Study
2 mg IV, 3x weekly for 4 weeks
Neuropathy Research
4 mg SC once daily for 28 days
Phase 2b Dose Study
1 mg, 4 mg, or 8 mg SC daily for 28 days
Clinical Findings
Human studies have reported improvements in some neuropathic symptom measures.
Clinical research has reported changes in corneal small nerve-fiber measures.
A Phase 2b study reported increased corneal nerve fiber area and regenerating cutaneous nerve fibers in the 4 mg group.
Research findings remain condition-specific and do not establish ARA-290 as an approved neuropathy treatment.
Why this matters:
ARA-290 has more human dosing evidence than many experimental peptides. That makes it appropriate to show both the clinical study regimens and the separate research-use frameworks. Neither should be used to erase or redefine the other.
ARA-290 has more human dosing evidence than many experimental peptides. That makes it appropriate to show both the clinical study regimens and the separate research-use frameworks. Neither should be used to erase or redefine the other.
When & Where to Inject
Subcutaneous administration is used in human ARA-290 clinical research.
Common research-use sites include the abdomen, thigh, or upper arm.
Rotate injection sites regularly.
Use a consistent schedule when tracking response.
Timing Notes
Morning administration is commonly discussed in research-use protocols.
Early afternoon is also commonly discussed when morning use is not practical.
Human clinical research does not establish a specific morning-vs-evening advantage.
Consistency can make symptom and response tracking easier.
Reconstitution & Dose Conversion (10 mg Vial)
Example Reconstitution Setup
Vial
10 mg
PBS (phosphate-buffered saline)
1.0 mL PBS
Concentration
10 mg/mL
Conversion
1 unit = 100 mcg
Conversion Reference
10 units = 1 mg
20 units = 2 mg
40 units = 4 mg
80 units = 8 mg
Reconstitution Steps
Draw 1.0 mL PBS (phosphate-buffered saline)
Add slowly to the vial
Gently swirl rather than shaking vigorously
Allow complete dissolution
Label with the reconstitution date and concentration
Refrigerate after mixing when appropriate for the specific product
Research Reconstitution Note:
ARA-290 has been described in research preparations using phosphate-buffered saline (PBS). While bacteriostatic water is commonly used for many peptide preparations, PBS is frequently referenced with ARA-290 because of its formulation and solubility characteristics.
Research Context:
These values are mathematical concentration and syringe conversions. The 10 mg / 1.0 mL setup is a research-use preparation example and should not be assumed to be the same formulation used in published clinical trials.
ARA-290 has been described in research preparations using phosphate-buffered saline (PBS). While bacteriostatic water is commonly used for many peptide preparations, PBS is frequently referenced with ARA-290 because of its formulation and solubility characteristics.
Research Context:
These values are mathematical concentration and syringe conversions. The 10 mg / 1.0 mL setup is a research-use preparation example and should not be assumed to be the same formulation used in published clinical trials.
Storage & Shelf Life
Research-Use Handling
Lyophilized Material
Cold, dry, light-protected storage is commonly recommended in laboratory and supplier guidance.
Frozen storage is commonly used for longer-term laboratory storage.
Avoid moisture and repeated temperature changes.
Reconstituted Material
Refrigerated storage is commonly used after aqueous reconstitution.
A 30-day use window is commonly discussed in research-use settings.
That 30-day window is not a universal clinical stability standard for every ARA-290 formulation.
Best Practice:
Product-specific manufacturer, pharmacy, or laboratory stability information should take priority when available because shelf life depends on formulation, solvent, concentration, sterility, container, and storage conditions.
Product-specific manufacturer, pharmacy, or laboratory stability information should take priority when available because shelf life depends on formulation, solvent, concentration, sterility, container, and storage conditions.
Cycle Length & Time Between Cycles
4–8 Week Research-Use Cycle → 2–4 Week Break → Reassess
Commonly Discussed Research-Use Framework
General Cycle
4–8 weeks
Neuropathy Framework
6–8 weeks
Commonly Discussed Break
2–4 weeks
Required Clinical Off-Period
Not established
Evidence Distinction:
The 4–8 week cycle, 6–8 week neuropathy framework, and 2–4 week break are research-use conventions. Key human subcutaneous neuropathy studies used 28-day treatment periods and did not establish a required washout period or universal repeat-cycle schedule.
The 4–8 week cycle, 6–8 week neuropathy framework, and 2–4 week break are research-use conventions. Key human subcutaneous neuropathy studies used 28-day treatment periods and did not establish a required washout period or universal repeat-cycle schedule.
When to Reassess or Pause
No meaningful change is observed after the defined research period.
Injection-site irritation becomes persistent.
Unexpected fatigue, headache, or systemic symptoms appear.
The research period is continuing without a defined nerve, inflammatory, or tissue-repair goal.
Monitoring During Use
Neuropathic pain and symptom changes
Sensation and sensory-function changes
Functional or mobility changes when relevant
Injection-site tolerance
Unexpected local or systemic symptoms
Study-specific nerve-fiber or metabolic markers when clinically evaluated
Benefits & Research Findings
Human studies have reported improvements in some neuropathic symptom measures.
Clinical research has reported changes in corneal small nerve-fiber measures.
A Phase 2b study reported increased corneal nerve fiber area and regenerating cutaneous nerve fibers in the 4 mg group.
Preclinical research supports anti-inflammatory, cytoprotective, and tissue-repair signaling.
ARA-290 was designed to provide tissue-protective signaling without erythropoietic activity.
Evidence Note:
These findings support continued research into neuropathy and tissue-repair pathways, but they do not establish ARA-290 as an approved treatment for neuropathy, nerve regeneration, inflammation, or other medical conditions.
These findings support continued research into neuropathy and tissue-repair pathways, but they do not establish ARA-290 as an approved treatment for neuropathy, nerve regeneration, inflammation, or other medical conditions.
Potential Side Effects
Short human trials generally reported acceptable tolerability.
Injection-site irritation or local reactions may occur with subcutaneous administration.
Headache, fatigue, or other systemic symptoms may occur and should be tracked rather than assumed to be expected.
Short-term study safety does not establish long-term safety of repeated research-use cycles.
ARA-290 was specifically designed to avoid the hematopoietic effects associated with erythropoietin.
Important Notes
ARA-290 and cibinetide refer to the same investigational peptide.
It is derived from erythropoietin but designed to provide tissue-protective signaling without stimulating red blood cell production.
Human research exists, including both intravenous and subcutaneous administration.
2 mg IV three times weekly for 4 weeks has been studied in sarcoidosis-associated neuropathy.
4 mg SC once daily for 28 days has been studied in human neuropathy trials.
A Phase 2b trial evaluated 1 mg, 4 mg, and 8 mg SC daily for 28 days.
The 2–4 mg, 4–8 week, and 6–8 week protocols shown on this page are preserved as research-use frameworks and should not be confused with clinically established treatment schedules.
A required 2–4 week break, morning administration requirement, and long-term maintenance protocol have not been established in human clinical research.
Important Disclaimer
ARA-290 (Cibinetide) is an investigational peptide and is not FDA-approved. This content is for educational and research purposes only.
Research & References
Primary Research
- Brines M, Grasso G, Fiordaliso F, et al. Erythropoietin Mediates Tissue Protection Through an Erythropoietin and Common Beta-Subunit Heteroreceptor. Proceedings of the National Academy of Sciences. 2004.
- Culver DA, Dahan A, Bajorunas D, et al. Cibinetide Improves Corneal Nerve Fiber Abundance in Patients With Sarcoidosis-Associated Small Nerve Fiber Loss and Neuropathic Pain. Investigative Ophthalmology & Visual Science. 2017.
- Bitto A, Irrera N, Pizzino G, et al. Activation of the EPOR-Beta Common Receptor Complex by Cibinetide Ameliorates Impaired Wound Healing in Mice with Genetic Diabetes. Biochimica et Biophysica Acta Molecular Basis of Disease. 2018.
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