Healing · 10mg × 10 vials
Ara-290 is the "tissue repair half" of EPO carved out and given as its own peptide, hitting an innate repair receptor that turns down inflammation and helps small nerves and blood vessels regrow, with none of the red blood cell side of EPO.
Ara-290 (cibinetide) is an 11-amino-acid peptide engineered from the helix B domain of erythropoietin (EPO). The reason it exists is that EPO itself has two separate jobs in the body: it drives red blood cell production through the classical homodimeric EPO receptor (EPOR/EPOR), and it does a completely different anti-inflammatory and tissue-repair job through a heterocomplex called the Innate Repair Receptor (IRR), which is built from one EPOR subunit plus the common beta-chain (CD131) shared with GM-CSF and IL-3/IL-5. The Brines and Cerami group at the Feinstein Institute spent the better part of a decade dissecting this and showed that the IRR pathway lives in a structurally distinct face of the EPO molecule (helix B), and a small synthetic peptide modeled on that surface keeps the tissue-protective signaling without touching the erythropoietic receptor. That peptide is Ara-290. It binds the IRR on injured/stressed tissue, activates PI3K/Akt and Jak2/STAT3 survival pathways, reduces TNF-alpha, IL-1beta, IL-6, and other NF-kB-driven cytokines, and promotes regeneration of small nerve fibers and damaged endothelium. Crucially, because Ara-290 does not bind the homodimeric EPOR, it does not raise hematocrit, does not increase thrombosis risk, and does not require hemoglobin monitoring, which is what blocked EPO itself from ever being used as an anti-inflammatory drug. In plain language: Ara-290 is the "tissue repair half" of EPO carved out and given as its own peptide, hitting an innate repair receptor that turns down inflammation and helps small nerves and blood vessels regrow, with none of the red blood cell side of EPO.
Typical dose ranges by experience level - educational reference. Message us and we tailor it to you.
2 mg daily matches the lower trial arm in the sarcoidosis small-fiber-neuropathy Phase 2 work (Brines et al, Heij et al). Beginner-friendly because Ara-290 has an exceptionally clean side effect profile in published data, comparable to placebo across the AE table. Reconstitute 10 mg vial with 2 ml BAC = 5 mg/ml, so 2 mg = 0.40 ml = 40 IU on a U-100 syringe.
4 mg daily is the upper trial arm and where the strongest neuropathic pain and quality-of-life signals showed up in the Heij sarcoidosis trial and the Brines diabetic neuropathy pilots. This is the "working dose" band for most PP customers running it for diabetic peripheral neuropathy, sarcoidosis small-fiber neuropathy, or chronic neuroinflammatory pain. 4 mg = 0.80 ml = 80 IU on a U-100 syringe at 5 mg/ml.
8 mg/day is community-derived, above published trial doses. Used for refractory neuropathic pain, long-running sarcoidosis cases, and chronic inflammatory cases that didn't shift at 4 mg. No published safety ceiling has been hit in trials at the doses tested; community reports at 8 mg are uneventful side-effect-wise but cost per cycle is the practical limiter (one 10 mg vial lasts ~1.25 days at 8 mg, so a 10-vial kit covers ~12-13 days). Most customers run 4 mg and only push to 6-8 mg if the 4 mg block plateaued.
Straight talk - what people actually report, and what the studies measured.
Peer-reviewed studies and clinical guidelines - tap any to read the source.
foundational review of EPO's tissue-protective signaling and the IRR concept
Read study ↗PubMedBrines et al, "Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin", PNAS 2008original design and characterization of the helix B surface peptide that became Ara-290
Read study ↗PubMedHeij L et al, "Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study", Molecular Medicine 2012Phase 2 sarcoidosis SFN trial, neuropathic pain and QOL improvements
Read study ↗PubMedDahan A et al, "ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density"corneal confocal microscopy evidence of nerve fiber regeneration
Read study ↗PubMedBrines M et al, "ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes"diabetic neuropathy Phase 2 data, HbA1c and neuropathy symptom improvements
Read study ↗PubMedCibinetide review, Curr Opin Investig Drugsclinical development overview
Read study ↗Aggregated sentiment from public forums & socials - real-world reports, not individual endorsements.
Injection site soreness: occasional, mild, manageable with site rotation
Transient fatigue first 3-5 days: reported by a minority, usually resolves
Mild headache early in the cycle: occasional, usually self-limited within the first week
Mood lift / reduced "inflammation brain fog": reported as a side benefit, especially in sarcoidosis and long-COVID users
Sleep changes: small subset report better sleep, attributed to reduced background pain/inflammation
"Nothing happened" reports: a meaningful subset of users running it for general inflammation without a clear small-fiber neuropathy diagnosis report no perceptible effect, which fits the mechanism (IRR signal lights up most where tissue is actively stressed/injured)
Route: SubQ
Injection site: abdomen, outer thigh, or upper outer arm; rotate sites
Storage: refrigerated, ~28 days after reconstitution; keep unreconstituted vial refrigerated
Notes: The trial dosing in sarcoidosis used 2 mg and 4 mg SubQ daily. Community has stretched to 8 mg/day for stubborn neuropathic pain. IRR signaling effects persist beyond the plasma half-life because the downstream Akt/STAT3 cascade outlasts the peptide, which is why once-daily dosing works despite the short systemic half-life. Do not shake the vial after recon, swirl gently. Allow to reach room temp before injecting.