Quickstart Highlights
Ara-290 (cibinetide) is an 11–amino acid, non-erythropoietic peptide derived from the helix-B domain of erythropoietin. It selectively activates the innate repair receptor (IRR), an EPOR/CD131 heterodimer, to support anti-inflammatory and tissue-protective effects without triggering red blood cell production. Clinical trials have shown benefits in diabetic neuropathy and sarcoidosis-associated small-fiber neuropathy.
- Reconstitute: Add 2.0 mL bacteriostatic water → 8 mg/mL concentration.
- Target dose: 4 mg once daily subcutaneously (after initial 2 mg titration).
- Easy measuring: At 8 mg/mL, 1 unit = 0.01 mL = 80 mcg on a U-100 insulin syringe.
- Storage: Lyophilized: refrigerate at 2–8 °C (35.6–46.4 °F) or freeze at −20 °C (−4 °F); reconstituted: refrigerate and use within 28 days.
Dosing & Reconstitution Guide
Educational guide for reconstitution and daily dosing
Standard / Gradual Approach (2.0 mL = 8 mg/mL)
| WEEK | DAILY DOSE | UNITS (PER INJECTION) (ML) |
|---|
| 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) |
| | | |
Frequency: Inject once daily subcutaneously. Clinical studies used 4 mg/day as the target therapeutic dose, with no additional benefit observed at 8 mg. Starting at 2 mg for the first week allows assessment of individual tolerance before reaching the maintenance dose.
Reconstitution Steps
- Draw 2.0 mL bacteriostatic water with a sterile syringe.
- Inject slowly down the vial wall; avoid foaming.
- Gently swirl or roll until fully dissolved (do not shake vigorously).
- Label with reconstitution date and refrigerate at 2–8 °C (35.6–46.4 °F), protected from light.
Supplies Needed
Plan based on an 8–16 week daily protocol with gradual titration (2 mg week 1, then 4 mg daily).
- Peptide Vials (Ara-290, 16 mg each):
- 8 weeks ≈ 14 vials
- 12 weeks ≈ 21 vials
- 16 weeks ≈ 28 vials
- Insulin Syringes (U-100):
- Per week: 7 syringes (1/day)
- 8 weeks: 56 syringes
- 12 weeks: 84 syringes
- 16 weeks: 112 syringes
- Bacteriostatic Water (10 mL bottles): Use 2.0 mL per vial for reconstitution.
- 8 weeks (14 vials): 28 mL → 3 × 10 mL bottles
- 12 weeks (21 vials): 42 mL → 5 × 10 mL bottles
- 16 weeks (28 vials): 56 mL → 6 × 10 mL bottles
- Alcohol Swabs: One for the vial stopper + one for the injection site each day.
- Per week: 14 swabs (2/day)
- 8 weeks: 112 swabs → recommend 2 × 100-count boxes
- 12 weeks: 168 swabs → recommend 2 × 100-count boxes
- 16 weeks: 224 swabs → recommend 3 × 100-count boxes
Protocol Overview
Concise summary of the once-daily regimen based on clinical trial designs.
- Goal: Support tissue protection, anti-inflammatory signaling, and neuropathic symptom management 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).
- Dose Range: 2–4 mg daily; 4 mg is the established target dose.
- Reconstitution: 2.0 mL per 16 mg vial (8 mg/mL) for accurate unit measurements.
- Storage: Lyophilized refrigerated or frozen; reconstituted refrigerated up to 28 days.
Dosing Protocol
Suggested daily titration approach reflecting clinical study parameters.
- Start: 2 mg daily during week 1 to assess tolerance.
- Target: 4 mg daily from week 2 onward.
- Frequency: Once per day (subcutaneous).
- Cycle Length: 4–8 weeks standard; may extend to 16 weeks based on individual assessment.
- Timing: Any consistent time daily; rotate injection sites.
Storage Instructions
Proper storage preserves peptide integrity and potency.
- Lyophilized: Refrigerate at 2–8 °C (35.6–46.4 °F) for up to 2 years; freeze at −20 °C (−4 °F) for extended storage up to 3 years.
- Reconstituted: Refrigerate at 2–8 °C (35.6–46.4 °F); use within 28 days and do not freeze the liquid solution.
- Allow vials to reach room temperature before opening to minimize condensation; protect from light.
- Discard if discoloration, cloudiness, or particulate matter is observed.
Important Notes
Practical considerations for consistency and safety.
- Use a fresh sterile insulin syringe for each injection and dispose of it in an approved sharps container.
- Rotate injection sites (abdomen, thighs, upper arms) to help minimize local irritation and reduce the risk of lipohypertrophy.
- Inject slowly; wait a few seconds before withdrawing the needle.
- Record the daily dose and injection site to ensure consistent administration.
- No clinically significant adverse effects were reported with 4 mg/day dosing in 28-day clinical trials
How it works
Ara-290 (cibinetide) interacts with the innate repair receptor (IRR), a heterodimer composed of EPOR and CD131 (the βc subunit), which is separate from the conventional erythropoietin receptor. Through this selective receptor engagement, it initiates anti-inflammatory and anti-apoptotic signaling pathways that support tissue protection and repair without inducing erythropoiesis. Preclinical studies show that Ara-290 can shift a pro-inflammatory, tissue-injuring milieu toward one that favors healing and regeneration. In addition, analgesic effects have been reported, mediated by immunomodulatory actions and direct inhibition of TRPV1 ion channels activated by capsaicin.
Potential Benefits & Side Effects
Observations from preclinical and clinical literature.
- Neuroprotection: Clinical studies in diabetic neuropathy reported improvements in HbA1c, lipid parameters, and neuropathic pain scores with daily dosing at 4 mg.
- Nerve regeneration: In sarcoidosis-associated small-fiber neuropathy, treatment resulted in significant increases in corneal nerve fiber density—an objective marker of nerve regrowth—along with symptom improvement compared with placebo.
- Tissue protection: Anti-inflammatory and anti-apoptotic actions have been observed across multiple organ systems in preclinical models.
- No erythropoietic effects: In contrast to full erythropoietin, Ara-290 does not stimulate red blood cell production, thereby avoiding related adverse effects.
- Tolerability: Generally well tolerated in clinical studies; occasional mild injection-site reactions, such as redness or transient discomfort, may occur with subcutaneous use.
Lifestyle Factors
Complementary strategies that may support therapeutic goals.
- Optimize glycemic control through appropriate diet choices and consistent medication adherence when managing diabetic neuropathy.
- Engage in regular physical activity suited to individual capacity to help support nerve health and circulation.
- Prioritize sufficient sleep and effective stress management to aid tissue repair processes.
- Avoid smoking and limit alcohol intake, as both may worsen neuropathic conditions.
Injection Technique
General subcutaneous guidance from clinical best-practice resources.
- Clean the vial stopper and injection site with alcohol swabs; allow to dry completely.
- Select a fatty subcutaneous site: lower abdomen (at least 2 inches from navel), outer thigh, or back of upper arm.
- Pinch a skinfold; insert the needle at 45–90° into subcutaneous tissue.
- Aspiration is not required for subcutaneous injections; inject slowly and steadily.
- Rotate sites systematically with each dose to avoid lipohypertrophy and local tissue changes.
- After injection, withdraw the needle and apply gentle pressure with clean gauze; do not rub the site.
Recommended Source
We recommend Ion Peptide for high-purity Ara-290 (16 mg)
Why Ion Peptide?
- High-purity, third-party-tested batches with accompanying COAs.
- Consistent, ISO-aligned handling practices and documentation.
- Dependable fulfillment processes to preserve cold-chain integrity.
Shop at Ion Peptides
Important Note
This content is intended for therapeutic educational purposes only and does not constitute medical advice, diagnosis, or treatment.