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№ 041

ARA-290 (Cibinetide)

A compound studied for calming nerve pain and inflammation without raising red blood cells. An EPO-derived peptide that targets the innate-repair receptor without the red-blood-cell side of erythropoietin, studied for neuropathic pain, sarcoidosis, and diabetic complications.

Healing
Evidence: Moderate

ARA-290 (Cibinetide): A compound studied for calming nerve pain and inflammation without raising red blood cells. An EPO-derived peptide that targets the innate-repair receptor without the red-blood-cell side of erythropoietin, studied for neuropathic pain, sarcoidosis, and diabetic complications. ARA-290 is derived from EPO (erythropoietin) but doesn't bump red blood cells the way EPO does.

FDA ⓘ
Not approved
WADA
Not banned
Typical dose
2-4 mg sub-q daily.
Half-life ⓘ
~20 min terminal (subcutaneous; ~2 min IV)
Route ⓘ
Subcutaneous
Schedule
Once daily
In plain English

ARA-290 is derived from EPO (erythropoietin) but doesn't bump red blood cells the way EPO does. It targets the innate-repair receptor instead. Real Phase 2 data for neuropathic pain and sarcoidosis. Useful for chronic nerve issues.

Status & legalityWhat do these mean? →
Natty? ⓘ
Grey area
FDA ⓘ
Not approved

Investigational. Phase 2 trials in sarcoidosis and diabetic neuropathy.

Compounding ⓘ
Category 3

FDA lists it as cibinetide in Category 3 of the 503A nominations: nominated for the list without enough supporting information for FDA to evaluate it. It is also unapproved and still investigational.

WADA ⓘ
Not listed

Doesn't trigger erythropoiesis like EPO does, but interpretation varies.

Prescribed ⓘ

Not commercially available.

Who it's for

  • →Users with neuropathic pain (small-fiber neuropathy)
  • →Sarcoidosis patients (Phase 2 data)
  • →Healing stacks for nerve-involved injuries

What to expect

  1. Week 1

    Subtle. Some neuropathic pain users notice first nerve-tingling reduction.

  2. Week 4

    Cumulative effect. Sarcoidosis trial endpoint.

  3. Week 8

    Sustained users see compounding benefits.

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How it works (mechanism)

Erythropoietin-derived peptide that activates the innate-repair receptor (heteromer of EPO-R and CD131) without triggering erythropoiesis. Reduces inflammation and supports nerve and tissue healing without raising red blood cells.

Dosing protocol

Members only

Stacks well with

Members only

Side effects

01Generally well tolerated
02Rare: mild headache
03Injection-site reaction

When NOT to use

  • ⚠Pregnancy / nursing
  • ⚠Active malignancy, limited data

Bloodwork to monitor

  • • CBC (no measurable RBC effect, but cheap monitoring if running long)

Common mistakes

  • • Expecting fast pain relief (cumulative over weeks)
  • • Stopping too early
  • • Underdosing, 1 mg often produces no measurable change

What it actually is

ARA-290, also called cibinetide, is an 11-amino-acid fragment of erythropoietin — the hormone that tells your bone marrow to make red blood cells. The fragment was chosen deliberately to keep EPO's tissue-protective and anti-inflammatory action while losing the part that raises red cell count, because raising red cell count is what makes EPO dangerous. It has been through real human trials in neuropathic pain and sarcoidosis and is not approved.

EPO turns out to have two jobs. Through the classic EPO receptor it drives red blood cell production. Through a second, different receptor — a complex of the EPO receptor with the beta-common receptor, called the innate repair receptor — it protects tissue and dampens inflammation. ARA-290 binds only the second one. That is a genuinely elegant piece of drug design: separating the useful signal from the one that thickens blood and causes clots.

Forms, and which is which

Lyophilised powder, subcutaneousHow all non-trial use happens

Buyer reconstitutes. Research-chemical supply with unverified identity.

Verdict: The only form outside a trial, unregulated.

Clinical trial supplyThe studied context

Trials in small-fibre neuropathy from sarcoidosis and in diabetes ran with characterised material and monitoring.

Verdict: Where the actual evidence comes from.

Erythropoietin itselfThe approved relative

Approved for anaemia. It raises red cell count, which is the effect ARA-290 was designed to avoid, and it carries thrombotic risk.

Verdict: The parent hormone, with the risk this fragment removes.

Oral or topical preparationsNothing

Not absorbed intact by these routes.

Verdict: Not plausible as described.

What it is claimed to do, graded

Reduces neuropathic pain in small-fibre neuropathyModerate

This is the best-studied use, with randomised trials in sarcoidosis-associated small-fibre neuropathy showing improvement in symptom scores and corneal nerve fibre measures. Three indexed randomised-trial records — real, and small.

Dampens innate immune inflammationModerate

Demonstrated mechanistically and in animal models of autoimmune disease, and consistent with the receptor it targets.

Protects pancreatic islets and helps metabolic controlLimited

Shown to protect isolated human islets under stress and improve engraftment. Promising, and a long way from a clinical outcome.

Does not raise haemoglobin or red cell countModerate

The design intent, and it holds up in the trials — this is one of its better-supported properties and the reason it exists at all.

Treats general neuropathy or chronic painNone shown

The trials are in specific, narrow populations. Extrapolating to chronic pain generally is not supported.

Grades describe how much human evidence exists for that specific claim, not whether it will work for you or whether it is safe.

Pros and cons

Pros
  • • A genuinely clever design that separates EPO's tissue protection from its blood-thickening effect
  • • Real randomised human trials, which most peptides in this catalog lack entirely
  • • Injection-site reactions were common in the trials; the broader safety picture comes from a small rare-disease population
  • • Does not carry EPO's thrombotic risk, which is the whole point
Cons
  • • Not approved anywhere despite years of development
  • • The evidence is in narrow populations, mostly sarcoidosis-associated neuropathy
  • • Very short half-life, around 20 minutes subcutaneously
  • • Research-chemical supply outside trials with no identity assurance
  • • The immune-dampening mechanism is unstudied in people with cancer

When to stop

  • • No change in symptoms after a full 12-week course
  • • Injection-site reaction that spreads
  • • Any new cancer diagnosis
  • • Any sign of infection that is slow to resolve, given the immune-dampening mechanism

Interactions

Erythropoietin or EPO-stimulating agentsCaution

Overlapping receptor biology. No interaction data, and the combination defeats the purpose of the fragment.

ImmunosuppressantsMonitor

ARA-290 dampens innate immune function. Additive immune suppression is unstudied.

Active or suspected cancerAvoid

Damping innate immune surveillance in a body with a tumour is unstudied in either direction.

AnticoagulantsCompatible

Unlike EPO itself, ARA-290 is not expected to raise clot risk. That is the design intent rather than a demonstrated safety finding.

Diabetes medicationMonitor

Islet-protective effects are being studied. Glucose is worth watching if you take glucose-lowering drugs.

Is this for you?

Probably worth reading further if
  • • People with small-fibre neuropathy who have read the sarcoidosis trials and understand the population
  • • Anyone interested in a peptide with actual randomised human data behind it
Skip it if
  • • You have active cancer
  • • You are on immunosuppressants
  • • You are pregnant or nursing
  • • You want it for general chronic pain — that is not what was studied

The one number

3 indexed randomised-trial records, and haemoglobin does not rise — the property it was designed for
Pepdex evidence index — counts are indexed PubMed records, not deduplicated trials; PubMed query for cibinetide / ARA-290

Sources for the claims above

Drug & supplement interactions

  • ⚠Limited documented interactions
  • ⚠Doesn't trigger erythropoiesis like EPO does, less interaction with iron / hematinic agents
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Member answer
is 250mcg of bpc enough for a knee injury?
For a knee, is the standard working dose and a solid place to start. The trick with BPC is consistency, give it weeks, not days. , run it , and don't drop below , results tend to fall off under that line. If nothing's moved by week 3, that's when earns its place.
how much bac water for a 10mg reta vial?
is the standard play for a 10 mg reta vial. That gives you , clean unit math across the whole titration: on a 100-unit insulin syringe. Run instead if you want fewer, more concentrated shots. Most people titrate up over , and that mix keeps the numbers cleanest.
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Lipid panel, ALT/AST (liver enzymes), and an A1C, baseline before you start then every 3 months. If you've got metabolic-syndrome history, add fasting glucose and insulin so you can actually watch insulin sensitivity improve. You don't need a big hormone panel for a GLP-1.

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Frequently asked

What is ARA-290 (Cibinetide)?+
ARA-290 is derived from EPO (erythropoietin) but doesn't bump red blood cells the way EPO does. It targets the innate-repair receptor instead. Real Phase 2 data for neuropathic pain and sarcoidosis. Useful for chronic nerve issues.
Is ARA-290 (Cibinetide) FDA approved?+
Investigational. Phase 2 trials in sarcoidosis and diabetic neuropathy.
Is ARA-290 (Cibinetide) legal?+
ARA-290 (Cibinetide) is not FDA-approved, so there is no approved prescription version. Most supply is sold as "research only" by peptide vendors. A compounding pharmacy may only use substances the FDA permits for compounding, and many research peptides are not permitted — do not assume a compounded prescription is available. Possession is generally not criminalized but distribution without authorization may be. Verify local laws.
Is ARA-290 (Cibinetide) banned by WADA?+
ARA-290 (Cibinetide) is not currently on the WADA prohibited list. Doesn't trigger erythropoiesis like EPO does, but interpretation varies.
Are you still natty after taking ARA-290 (Cibinetide)?+
Grey area. Federations differ on whether this disqualifies natty status.
Do doctors prescribe ARA-290 (Cibinetide)?+
Not commercially available.
What's the typical dose of ARA-290 (Cibinetide)?+
Dosing depends on your goal, experience, and tolerance. The full ARA-290 (Cibinetide) protocol (dose, frequency, and how to titrate) is in the members section on the entry page.
What are the side effects of ARA-290 (Cibinetide)?+
Common side effects include: Generally well tolerated; Rare: mild headache; Injection-site reaction. Less common effects and full safety details are on the entry page.
How long until ARA-290 (Cibinetide) starts working?+
Subtle. Some neuropathic pain users notice first nerve-tingling reduction.
What can you stack with ARA-290 (Cibinetide)?+
ARA-290 (Cibinetide) is commonly combined with complementary compounds. The full stacking protocol (what to pair, dosing, and timing) is in the members section on the entry page.
Where do people get ARA-290 (Cibinetide)?+
Pepdex does not sell, ship, or recommend suppliers. ARA-290 (Cibinetide) is not FDA-approved; prescription versions require licensed clinical care, and "research only" markets carry real legal and quality risks. /coa explains how to verify a Certificate of Analysis and /guides/scam-vendor-spotting covers the red flags.

Common questions about ARA-290 (Cibinetide)

Tracked alongside ARA-290 (Cibinetide)

Same goal, different aisle — each graded on its own evidence in the Pepdex catalog.

Curcumin →
the inflammation entry most recovery stacks already include
Glucosamine →
the joint-specific comparison people actually ask about
Omega-3 →
baseline anti-inflammatory support, strong evidence
Tart cherry →
recovery-adjacent, honestly graded

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