Peptide Profile
ARA-290 (Cibinetide)
A peptide that awakens your body's natural repair system to heal damaged nerves and reduce pain
Dose Range
0.16 mg-0.8 mgmg
Frequency
Once daily
Route
Subcutaneous injection
Cycle Length
Ongoing/indefinite
Onset
Moderate (1-2 weeks)
Evidence
Moderate
Compound Profile
Scientific & Efficacy Data
C51H84N16O21
Molecular Formula
1257.31 g/mol
Molecular Weight
Approximately 1-2 hours in circulation, but cellular effects last much longer
Half-Life
Subcutaneous: ~100% (complete absorption); Intravenous: Immediate
Bioavailability
1208243-50-8
CAS #
91810664
PubChem ID ↗
Developed By · 2008
Araim Pharmaceuticals Research Team
Araim Pharmaceuticals
Primary Benefits
ARA-290 actively regrows small nerve fibers that die from diabetes, neuropathy, or injury. Studies show real improvements in nerve density on corneal imaging.
Reduces neuropathic pain through both nerve repair and anti-inflammatory pathways. Users report decreased shooting pain and burning sensations.
Protects pancreatic cells, organs, and tissues from stress damage. Works especially well in diabetes where tissues face constant oxidative harm.
Amino Acid Sequence
{Glp}-Glu-Gln-Leu-Glu-Arg-Ala-Leu-Asn-Ser-SerDosing
How much
do I take?
Timing
Best time to take
Administer ARA-290 (Cibinetide) at the same time each day (or on the same day each week for weekly injections). Many users prefer morning or evening administration. Pick a time you'll remember consistently.
With food?
ARA-290 (Cibinetide) injections can be given regardless of meal timing. However, if GI effects occur, administering on an empty stomach or with a light meal may help reduce discomfort.
If stacking
ARA-290 (Cibinetide) should be used as directed by your healthcare provider. If combining with other medications or supplements, discuss potential interactions with your provider. Avoid combining with compounds that have overlapping mechanisms unless specifically guided by a medical professional.
Adjusting Your Dose
Increase if
- +You've tolerated the current dose for the recommended period without significant side effects
- +Therapeutic goals haven't been met at the current dose level
- +Your healthcare provider recommends dose escalation based on your response
- +Lab work or clinical assessments support a higher dose
Decrease if
- -Side effects are bothersome or impacting daily life despite management strategies
- -You experience any signs of an adverse reaction
- -Lab results indicate the need for dose reduction
- -Your healthcare provider recommends a lower dose based on your response
Signs of right dose
- ✓Therapeutic goals being met with minimal side effects
- ✓Stable and consistent response to treatment
- ✓Lab values or clinical markers trending in the right direction
- ✓Good tolerance with manageable or absent side effects
Dosing Calculator
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Suitability
Is this
right for me?
Best For
Treating small fiber neuropathy
ARA-290 (Cibinetide) is particularly well-suited for individuals focused on treating small fiber neuropathy. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Managing neuropathic pain from diabetes or sarcoidosis
ARA-290 (Cibinetide) is particularly well-suited for individuals focused on managing neuropathic pain from diabetes or sarcoidosis. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Supporting nerve regeneration after injury
ARA-290 (Cibinetide) is particularly well-suited for individuals focused on supporting nerve regeneration after injury. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Reducing chronic inflammation
ARA-290 (Cibinetide) is particularly well-suited for individuals focused on reducing chronic inflammation. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Consider Alternatives If
Who Should Avoid
Do not use if
- ×Polycythemia vera or erythrocytosis
- ×Uncontrolled hypertension
- ×Pregnancy or breastfeeding
- ×Known hypersensitivity to peptides
- ×Concurrent use with certain cancer medications
Use with caution if
- !You are taking other medications—discuss potential interactions with your healthcare provider
- !You have a history of liver or kidney disease
- !You are elderly or have multiple medical conditions
- !You are planning surgery in the near future—inform your surgeon about ARA-290 (Cibinetide) use
- !You have any chronic health conditions that require regular monitoring
Administration
How do I
use it?
Reconstitution
What you need
- •ARA-290 (Cibinetide) vial (lyophilized powder or solution)
- •Bacteriostatic water or sterile sodium chloride for reconstitution
- •Alcohol swabs for cleaning vial tops and injection sites
- •Appropriately sized syringes with fine-gauge needles (27-30 gauge)
- •Sharps disposal container
Injection
Route
Subcutaneous injection (into the fatty tissue just under the skin)—allows for consistent absorption and can be self-administered at home after proper training
Best sites
- •Abdomen (stomach area)—at least 2 inches from the belly button, most popular choice for self-injection
- •Front of thighs—middle to upper portion of the outer leg
- •Back of upper arm—outer area (may need assistance from another person)
Technique
- 1.Wash your hands thoroughly with soap and water before handling supplies
- 2.Clean the injection site with an alcohol swab and let it air dry completely
- 3.Pinch a fold of skin at the chosen injection site
- 4.Insert the needle at a 45-90 degree angle (depending on needle length and body composition)
- 5.Inject the medication slowly and steadily over 5-10 seconds
- 6.Release the skin fold and remove the needle, applying gentle pressure with a clean swab
- 7.Rotate injection sites to prevent tissue irritation or lipodystrophy
- 8.Dispose of the needle safely in a sharps container—never recap or reuse needles
Storage
Signs of degradation
Sample Daily Schedule
Safety
Is it
safe?
Safety Profile
ARA-290 is a synthetic innate repair receptor agonist that has completed Phase 2 clinical trials for small fiber neuropathy and is under active development. Animal toxicology studies show a good safety margin with no organ damage or cytotoxicity at doses far exceeding therapeutic levels. Early clinical data from Phase 2 trials demonstrate tolerability with mild injection site reactions and transient headache as primary concerns. However, immunogenicity remains a potential risk with repeated dosing of synthetic peptides, requiring anti-drug antibody monitoring. Long-term safety data beyond 12 weeks does not yet exist.
Evidence comes from preclinical toxicology studies, Phase 1 dose-escalation and safety data, and Phase 2 efficacy trials in small fiber neuropathy patients. The phase 2 trial enrolled 127 patients with a primary endpoint of safety and tolerability. No serious adverse events directly attributable to ARA-290 were reported in early studies. Data suggests good safety at doses up to 1 mg subcutaneously twice weekly, but longer-term outcomes and immunogenicity assessments continue.
Common Side Effects
Experienced by some users
Injection Site Reactions
Redness, mild swelling, or bruising at injection site lasting a few hours to a day
Management: Rotate injection sites, apply ice pack after injection, massage gently to improve absorption
Headache
Mild to moderate headache typically in first few hours after injection
Management: Stay hydrated, rest in a quiet space, over-the-counter pain reliever if needed
Dizziness
Brief dizziness or lightheadedness, especially when standing up quickly
Management: Rise slowly from sitting or lying, avoid sudden movements, inform your doctor if persistent
Less Common
- •Elevated Blood Pressure
- •Fatigue
These typically resolve with continued use or dose adjustment.
Stop and Seek Help If
- ×Severe or worsening side effects that don't improve with dose adjustment or supportive care
- ×Signs of an allergic reaction—rash, hives, swelling, or difficulty breathing
- ×Your healthcare provider recommends discontinuation based on your clinical response
- ×Development of any new medical condition that may be contraindicated with ARA-290 (Cibinetide)
- ×Pregnancy or planning to become pregnant (unless specifically approved for use during pregnancy)
- ×Abnormal lab results or clinical markers that suggest adverse effects
ARA-290 (Cibinetide) should only be started, adjusted, or discontinued under medical supervision. This information is for educational purposes only and does not replace professional medical advice. Never stop a prescribed treatment without consulting your healthcare provider first, as abrupt discontinuation may have consequences.
Interactions
With other peptides
- ✓Enhances antioxidant protection and reduces inflammation to complement nerve regeneration
- ✓Fat-soluble form of B1 vitamin that supports nerve function alongside ARA-290's regenerative effects
- ✓Essential for nerve health and myelin formation, works synergistically with nerve repair
With medications
- !Erythropoietin (EPO) - Both activate similar pathways; combining could cause excessive red blood cell production
- !Uncontrolled antihypertensive medications - May cause dangerous blood pressure fluctuations
- !Anticoagulants at high doses - May increase thrombosis risk
With supplements
- ✓Multivitamins - Generally safe to take alongside ARA-290 (Cibinetide). Space doses apart if taking oral formulations to ensure optimal absorption.
- ✓Electrolyte supplements - Helpful if experiencing any GI side effects that could lead to dehydration. Safe to combine.
Effectiveness
Does it
work?
Evidence Level
Moderate human trials
What to Expect
Week 1-2: Initial Response (First two weeks)
What you might notice
- •You may notice improved energy, better sleep, or mild improvement in pain
- •Injection site reactions are most common now
- •Your body's repair systems are just starting to activate
What's normal
- •Initial response to ARA-290 (Cibinetide) is beginning at the cellular level
- •Different individuals experience ARA-290 (Cibinetide)'s onset at different rates
- •Transient systemic effects from initial ARA-290 (Cibinetide) exposure are common
What's next
- →Maintain consistent ARA-290 (Cibinetide) administration as prescribed
- →Document subjective effects and physical markers daily
- →Schedule a check-in with your provider about initial observations
Week 3-8: Noticeable Changes (Weeks 3-8)
What you might notice
- •Pain reduction becomes more apparent
- •Inflammation starts decreasing
- •Some users report better blood sugar control
- •Nerve regeneration is happening but may not be felt yet
What's normal
- •ARA-290 (Cibinetide) is now achieving steady-state pharmacokinetics
- •Measurable changes aligned with ARA-290 (Cibinetide)'s mechanism may appear
- •Initial adjustment effects typically resolve by this point
What's next
- →Maintain ARA-290 (Cibinetide) dosing exactly as established
- →Track progress toward intended outcomes in detail
- →Review lab work or biomarker changes with your healthcare team
Week 9-16: Significant Improvement (Weeks 9-16)
What you might notice
- •Neuropathic pain noticeably reduced
- •Increased sensation in feet (if neuropathy was present)
- •Better energy and mood
- •Healing effects becoming measurable
What's normal
- •ARA-290 (Cibinetide) has achieved stable, long-term homeostatic integration
- •Sustained efficacy of ARA-290 (Cibinetide) remains consistent
- •Chronic ARA-290 (Cibinetide) effects remain stable and predictable
What's next
- →Maintain your established ARA-290 (Cibinetide) protocol for sustained benefits
- →Continue periodic monitoring to confirm ARA-290 (Cibinetide) efficacy
- →Review comprehensive ARA-290 (Cibinetide) response with your provider
Month 4+: Full Benefits Realized (4+ months)
What you might notice
- •Maximum nerve fiber regrowth visible on corneal imaging
- •Sustained pain reduction
- •Improved daily function and quality of life
- •Benefits continue with ongoing treatment
What's normal
- •Full therapeutic effects of ARA-290 (Cibinetide) are well-characterized at this point
- •Maintenance of ARA-290 (Cibinetide)'s therapeutic effects is typical
- •Tolerance patterns with ARA-290 (Cibinetide) are generally stable over months
What's next
- →Comprehensive assessment of ARA-290 (Cibinetide) efficacy should be conducted
- →Discuss long-term continuation, cycling, or protocol modifications
- →Continue regular monitoring of relevant biomarkers or symptoms
Signs It's Working
Treatment Response
- ✓Improvement in the primary symptoms or condition being treated
- ✓Positive changes in relevant lab values or clinical markers
- ✓Consistent, stable response to ARA-290 (Cibinetide) over time
- ✓Reduction in symptom frequency or severity
General Well-being
- ✓Improved energy levels and daily functioning
- ✓Better quality of life related to the treated condition
- ✓Manageable or absent side effects indicating good tolerance
- ✓Positive feedback from healthcare provider during check-ups
Not Seeing Results?
Common reasons
- •Not at therapeutic dose yet—initial doses are for building tolerance, not maximum effect
- •Insufficient time at target dose—most compounds need several weeks to show full benefits
- •Inconsistent dosing schedule—regular, consistent use is crucial for optimal results
- •Individual variation in response—genetics, metabolism, and other factors affect outcomes
- •Underlying conditions or medications interfering with absorption or effectiveness
- •Improper storage leading to degraded product—always verify proper storage conditions
Key Research
"ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic pain symptoms in patients with type 2 diabetes"
Research investigators, 2015
Finding: ARA-290 treatment resulted in significant improvement of neuropathic pain in diabetic patients along with increased corneal nerve fibers. The peptide showed disease-modifying properties with long-lasting beneficial effects on both pain-related and non-pain-related symptoms.
View Study"Cibinetide Improves Corneal Nerve Fiber Abundance in Patients With Sarcoidosis-Associated Small Nerve Fiber Loss and Neuropathic Pain"
Research investigators, 2017
Finding: Cibinetide at 4 mg daily significantly increased corneal nerve fiber area by 697 μm², along with increased regenerating intraepidermal fibers. Pain improved significantly in all groups, with changes in nerve fiber abundance correlating with improvements in walking distance and pain severity.
View Study"Corneal nerve fiber size adds utility to the diagnosis and assessment of therapeutic response in patients with small fiber neuropathy"
Research investigators, 2018
Finding: Corneal nerve fiber area measurements proved useful for tracking therapeutic response to ARA-290 treatment in neuropathy. The metric showed quantifiable changes in nerve morphology and provided superior sensitivity to identify nerve repair compared to skin biopsy.
View Study"Erythropoietin-derived nonerythropoietic peptide ameliorates experimental autoimmune neuritis by inflammation suppression and tissue protection"
Research investigators, 2014
Finding: ARA 290 greatly improved recovery from autoimmune nerve inflammation by promoting nerve regeneration and remyelination while suppressing inflammation. The treatment increased protective regulatory T cells and reduced pro-inflammatory immune responses.
View Study"ARA 290 for treatment of small fiber neuropathy in sarcoidosis"
Research investigators, 2014
Finding: ARA 290 treatment was associated with significant improvements in neuropathic pain, increased corneal nerve fibers, improved sensory thresholds, and better quality of life in sarcoidosis patients. The excellent safety profile combined with disease-modifying properties makes it promising for treating this orphan disease.
View StudyFrequently Asked Questions