Ara-290 (16mg)
Ara-290 (cibinetide) is a non-erythropoietic 11-amino acid peptide derived from the helix-B domain of erythropoietin. It selectively activates the innate repair receptor (IRR), an EPOR/CD131 heterodimer, to promote anti-inflammatory and tissue-protective effects without stimulating red blood cell production. Clinical trials have shown benefits for diabetic neuropathy and sarcoidosis-associated small fiber neuropathy.
Reviewed by the AllPeptides.eu Editorial Team·Last reviewed: 2026-06-16
Educational information. Not medical advice, and no efficacy claim is implied. Regulatory approval is not a use recommendation by AllPeptides.eu.
⚠️ For informational/educational purposes only. Not medical advice. We do not sell any products. Self-treatment carries serious risks — consult a healthcare professional. Disclaimer
How It Works
Ara-290 (cibinetide) binds to the innate repair receptor (IRR), a heterodimer of EPOR and CD131, distinct from the classical erythropoietin receptor. This selective binding activates anti-apoptotic and anti-inflammatory signaling pathways that protect tissues and promote repair without stimulating erythropoiesis. Preclinical studies show that Ara-290 can reprogram a pro-inflammatory environment to one that favors healing. Additionally, analgesic effects have been observed through inhibition of TRPV1 channels.
Quick Start
- Reconstitution: Add 2.0 mL bacteriostatic water → 8 mg/mL concentration.
- Target Dose: 4 mg once daily subcutaneously (after initial 2 mg titration).
- Storage: Lyophilized: refrigerate 2–8 °C or freeze −20 °C; reconstituted: refrigerate, use within 28 days.
Typical / Titration Approach (2.0 mL = 8 mg/mL)
Route: Subcutaneously | Frequency: Once daily
| Week | Dose | Units (per injection) |
|---|---|---|
| Week 1 | 2 mg (2,000 mcg) | 25 Units (0.25 mL) |
| Weeks 2–8 (or up to 16) | 4 mg (4,000 mcg) | 50 Units (0.50 mL) |
Studies report administration once daily subcutaneously. Clinical studies used 4 mg/day as the target dose; no additional benefit was observed at 8 mg. Starting at 2 mg for the first week allows for assessment of individual tolerance.
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Reconstitution Steps
- Withdraw 2.0 mL of bacteriostatic water.
- Inject slowly down the side wall; avoid foaming.
- Gently swirl until fully dissolved (do not shake vigorously).
- Note the date of reconstitution and refrigerate at 2–8 °C.
Protocol Overview
- Goal: Support tissue protection, anti-inflammatory signaling, and management of neuropathic symptoms via IRR activation.
- Schedule: Daily subcutaneous injections for 4–8 weeks (clinical trials used 28-day protocols; extension to 8–16 weeks based on individual response).
- Storage: Lyophilized refrigerated or frozen; reconstituted refrigerated up to 28 days.
Dosing Protocol
- Initiation: 2 mg daily during Week 1.
- Target: 4 mg daily from Week 2.
- Frequency: Once daily (subcutaneously).
- Cycle Duration: 4–8 weeks; extend to 16 weeks as appropriate.
- Timing: Any consistent time; rotate sites.
- Break between cycles: After the cycle (4–16 weeks), a 4–6 week pause is recommended. Ara-290 activates the IRR—the pause allows for assessment of neuronal regeneration.
Washout & Cycle Restart
When can I restart?
After the cycle (4–16 weeks), a 4–6 week pause is recommended. Ara-290 activates the IRR—the pause allows for assessment of neuronal regeneration.
Minimum wait period: 4 weeks
Storage Instructions
- Lyophilized: Refrigerate 2–8 °C for up to 2 years; freeze −20 °C for extended storage up to 3 years.
- Reconstituted: Refrigerate 2–8 °C; use within 28 days; do not freeze the liquid solution.
- Allow vials to reach room temperature before opening; protect from light.
- Discard if discoloration, cloudiness, or particulate matter is observed.
Important Notes
- No clinically significant adverse events were reported at 4 mg/day in 28-day clinical trials.
Potential Benefits & Side Effects
Potential Benefits:
- Neuroprotection: Clinical trials in diabetic neuropathy showed improvements in HbA1c, lipid profiles, and neuropathic pain.
- Nerve Regeneration: Significant increase in corneal nerve fiber density and improvement of symptoms in sarcoidosis.
- Tissue Protection: Anti-inflammatory and anti-apoptotic effects in multiple systems.
- No Erythropoietic Effects: Does not stimulate red blood cell production.
- Tolerability: Well-tolerated; mild injection site reactions.
Potential Side Effects:
- Injection site reactions (redness, itching, tenderness).
- Transient headache.
- Mild dizziness or fatigue post-administration.
- Slight autonomic changes (blood pressure, feeling of warmth).
- Rarely: immune dysregulation in autoimmune diseases.
⚠️ Serious Warnings & Long-Term Risks
The following warnings are based on published literature, FDA labels, and post-marketing surveillance. They do not constitute medical advice. Consult a healthcare professional.
Immunosuppression via EPOR/CD131
ARA-290 activates the tissue-protective EPO receptor. Theoretical risk of immunosuppression with chronic use. Phase 2 data limited.
📄 Mol Med 2013References
- IUPHAR/BPS Guide to Pharmacology — Cibinetide (ARA-290): pharmacological profile
View Source - Brines M et al. — Molecular Medicine (2008) — Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin
View Source - Molecular Medicine (2014) — ARA 290 improves metabolic control and neuropathic symptoms in type 2 DM
View Source - Molecular Medicine (2013) — ARA 290 improves sarcoidosis symptoms and increases nerve fiber density
View Source - Peptides Journal (2016) — ARA 290 relieves pain by targeting the TRPV1 channel
View Source
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External Sources & Regulatory Status
Regulatory Approvals
Sarcoidosis / Neuropathy
Sarcoidosis
Phase II (FDA + EMA)
Educational information. Not medical advice, and no efficacy claim is implied. Regulatory approval is not a use recommendation by AllPeptides.eu.
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