Porcine brain-derived neuropeptide preparation containing bioactive peptide fragments of neurotrophic factors, used clinically in over 40 countries for stroke recovery, traumatic brain injury, and cognitive impairment
Written by Michael Carroll — Owner, Director of Research · Reviewed by the Peptide Initiative Research Team · Editorial standards
Intravenous (IV) or infusion
Route
3 recommended
Sites
Once daily
Frequency
Preparation
Cerebrolysin 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
Pro tip
Prepare all supplies on a clean surface before you begin. Having everything ready makes the process smoother and more sterile.
Mixing
Wash your hands thoroughly with soap and water. Gather all supplies on a clean, flat surface.
Remove the plastic cap from the peptide vial and wipe the rubber stopper with an alcohol swab. Let it air dry.
Draw the appropriate amount of bacteriostatic water into a sterile syringe.
Insert the needle into the vial at an angle, aiming at the inside wall of the vial. Slowly push the plunger to let the water trickle down the glass wall -- do NOT squirt directly onto the powder.
Once all water is added, gently swirl the vial in a slow circular motion. Never shake the vial, as this can damage the peptide bonds.
Continue swirling until the powder is completely dissolved and the solution is clear. If particles remain, let the vial sit for a few minutes and swirl again.
Label the vial with the date of reconstitution, the peptide name, and the concentration (e.g. 250mcg per 0.1mL).
Example calculation
Add the recommended volume of bacteriostatic water to the Cerebrolysin vial. Gently swirl (do not shake) until the powder is fully dissolved. The resulting solution should be clear. Calculate your individual dose based on the concentration and your prescribed amount.
Dose calculation
Your dose of Cerebrolysin is determined by your healthcare provider. Using an insulin syringe marked in units, draw up the exact amount prescribed. For example, if the reconstituted concentration is 1mg/mL and your dose is 0.5mg, draw up 0.5mL (50 units on an insulin syringe). Always double-check calculations before injection.
Pro tip
Always add the bacteriostatic water slowly, letting it run down the side of the vial. Never shake the vial -- swirl gently to avoid damaging the peptide.
Location
Site 01
Abdomen
Pinch the skin 2 inches from navel. Avoid the area directly around the belly button. Rotate between left and right sides.
Site 02
Outer Thigh
Middle third of the outer thigh. Keep at least 4 inches above the knee and below the hip. Alternate legs each injection.
Site 03
Upper Arm
Back or outer area of the upper arm. This site may require assistance from another person for proper technique.
Rotate between 3 sites to prevent tissue buildup and ensure consistent absorption.
Pro tip
Rotate your injection sites with each dose to prevent lipohypertrophy (buildup of fatty tissue). Keep a simple log of where you last injected.
Step by step
Wash your hands thoroughly with soap and water before handling supplies
Clean the injection site with an alcohol swab and let it air dry completely
Pinch a fold of skin at the chosen injection site
Insert the needle at a 45-90 degree angle (depending on needle length and body composition)
Inject the medication slowly and steadily over 5-10 seconds
Release the skin fold and remove the needle, applying gentle pressure with a clean swab
Rotate injection sites to prevent tissue irritation or lipodystrophy
Dispose of the needle safely in a sharps container—never recap or reuse needles
Pro tip
This peptide uses subcutaneous injection (into the fatty tissue just under the skin)—allows for consistent absorption and can be self-administered at home after proper training. Inject at a 45-90 degree angle into pinched skin. Aspirate before injecting to ensure you haven't hit a blood vessel.
Timing
Optimal timing
Best time
Morning administration is generally preferred to minimize potential for agitation or sleep disruption [10].
With food?
Administration is by injection and is independent of food intake. No fasting required.
Stacking notes
If combining Cerebrolysin with other peptides or supplements, space administrations by at least 15-30 minutes when possible. Consult with a healthcare provider before combining with prescription medications.
Sample daily schedule
As prescribed (once daily)
As prescribed by your healthcare provider injection
Site: Intravenous (IV) injection or infusion—rotate sites if applicable
Maintain a consistent schedule for optimal results with Cerebrolysin. Set reminders if needed. If you miss a dose, follow your healthcare provider's instructions—do not double up on doses to compensate.
Dosing tiers
Dose
10 mL
Frequency
Once daily
Duration
10-20 day course, repeated every 3-6 months
A gentle starting dose given as a slow IV infusion (often diluted in saline). Used in dementia and recovery programs. [6][7]
Dose
20-30 mL
Frequency
Once daily
Duration
10-21 day course, repeated in cycles
The common clinical dose. Trials in vascular dementia used 20 mL daily, and stroke trials used 30 mL daily (diluted to about 100 mL saline) infused over ~30 minutes. [6][7]
Dose
30-50 mL
Frequency
Once daily
Duration
10-21 days for stroke or severe brain injury
The higher end used for acute stroke and severe traumatic brain injury, given as a diluted IV infusion under medical supervision. [7]
Dose
5-10 mL
Frequency
Once daily
Duration
Up to 10-20 days per course
For smaller doses, Cerebrolysin can be given as an intramuscular injection (no more than ~5 mL per injection site). Often used for milder cases or maintenance between IV cycles. [7]
Preservation
Before mixing
Store Cerebrolysin in the refrigerator at 36-46°F (2-8°C) in its original packaging. Protect from light and moisture. Do not freeze. Check the expiration date before use. Some formulations may be stored at room temperature for limited periods—check your specific product labeling.
After mixing
Once reconstituted, Cerebrolysin should be kept refrigerated at 36-46°F (2-8°C) and used within the timeframe specified on your product labeling (typically 14-28 days). Label the vial with the reconstitution date. Do not use if the solution appears cloudy, discolored, or contains particles.
Shelf life after mixing
Use within the timeframe specified on product labeling (typically 14-28 days refrigerated)
Signs of degradation
Discard the vial immediately if you notice any of these:
Solution appears cloudy, discolored, or contains visible particles (should be clear)
Product has been exposed to temperatures outside the recommended storage range
Product has been frozen (unless specifically designed for freeze-thaw stability)
Expiration date has passed or reconstituted solution has exceeded its use-by date
Unusual odor, color change, or visible contamination
Important
When to stop
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 Cerebrolysin
Pregnancy or planning to become pregnant (unless specifically approved for use during pregnancy)
Abnormal lab results or clinical markers that suggest adverse effects
Cerebrolysin 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.
Clean technique checklist
Wash hands thoroughly with soap and water before handling supplies
Swab vial tops and injection site with alcohol and let dry
Never touch the needle tip or allow it to contact non-sterile surfaces
Use a new syringe and needle for each injection
Dispose of used sharps in a proper sharps container
Store reconstituted peptides according to the storage instructions above
Published research
Gavrilova SI, Alvarez A · 2021
After 30 years of clinical use, Cerebrolysin has proven to be both safe and effective for Alzheimer's patients, especially when combined with standard brain-boosting drugs like cholinesterase inhibitors. The peptide works through multiple pathways—like a multi-tool rather than a single fix—making it one of the most promising brain protective treatments available.
Mureșanu DF, Livinț Popa L, Chira D et al. · 2022
Cerebrolysin's ability to repair damaged brain tissue works in both the immediate aftermath of a stroke and weeks or months later during recovery. The peptide's multi-target action on brain repair pathways makes it uniquely effective at restoring lost function while maintaining a strong safety record.
Kojder K, Jarosz K, Bosiacki M et al. · 2023
When researchers looked at all available studies of Cerebrolysin in patients with catastrophic brain bleeding, the evidence suggested the drug could save lives by reducing mortality. However, the field still needs larger, carefully controlled studies to confirm this life-saving potential.
Fiani B, Chacon D, Jarrah R et al. · 2021
Newborns with oxygen-starved brains can be treated with Cerebrolysin for up to 6 months after birth, and injections twice weekly helped babies recover better motor control and speech ability. This rare 6-month window offers hope for protecting developing brains from permanent damage.
Al-Kuraishy HM, Al-Gareeb AI, Zekry SH et al. · 2025
Cerebrolysin's brain-protecting peptides work against three major causes of vascular dementia: inflammation in the brain, damage to the blood-brain barrier, and chronic blood flow shortages. This triple action makes it a promising strategy for both preventing and treating this common form of dementia.
Guekht AB et al. · 2011
Vascular dementia trial used intravenous Cerebrolysin 20 mL once daily, infused over 2 treatment cycles, showing clinical improvement versus placebo.
2012
Acute ischemic stroke protocols used 30 mL Cerebrolysin diluted to 100 mL saline, infused once daily over ~30 minutes for 10 days. General stroke and TBI practice uses 10-50 mL IV daily for 10-21 days, with 5-10 mL IM used for lower-dose courses.
Ziganshina LE, Abakumova T, Nurkhametova D, Ivanchenko K · 2023
Cochrane review. Cerebrolysin is a mixture of low-molecular-weight peptides and amino acids derived from porcine brain, widely used for acute ischaemic stroke in Russia, Eastern Europe, China and other Asian and post-Soviet countries. Seven RCTs (1773 participants); risk of bias unclear or high across most domains, three multicentre studies supported by the manufacturer. Little to no difference in total adverse events, but a probable increase in non-fatal serious adverse events.
Cui S, Chen N, Yang M, Guo J, Zhou M, Zhu C, He L · 2019
Cochrane review. Six randomised trials, 597 participants total, conducted in China, Russia and Romania; beneficial effect on cognition and global function but very low-quality evidence, high risk of bias in the included papers, and all studies with declared funding were industry-supported. No difference in rates of adverse effects.
EVER Neuro Pharma GmbH · 2023
Manufacturer handling and prescribing handbook. Daily dose by disorder: stroke 20-50 mL for 10-21 days; traumatic brain injury 20-50 mL for 7-30 days; Alzheimer's disease and vascular dementia 10-30 mL, one cycle of 5 days weekly for 4 weeks, 2-4 cycles per year. Routes: IV infusion 10-50 mL diluted to at least 100 mL and infused over 15-60 minutes; IV injection up to 10 mL undiluted over 3 minutes; IM injection up to 5 mL. Morning administration preferred because the infusion is stimulating and may cause excitability. Fever occurs in rare cases and is linked to rate of administration and to microbial growth in an opened ampoule. Contraindications: hypersensitivity, status epilepticus, severe renal failure. One mL contains 215.2 mg of Cerebrolysin concentrate; marketing authorisation holder EVER Neuro Pharma GmbH, Unterach, Austria.
EVER Neuro Pharma GmbH (registered product information) · 2024
Registered product information. One mL contains 215.2 mg of Cerebrolysin concentrate, a peptide complex from pig brain. Doses by indication: Alzheimer's disease 10-30 mL, ischaemic stroke 10-50 mL acute and 5-30 mL in recovery, traumatic brain injury 5-50 mL, cognitive impairment 5-30 mL. IM up to 5 mL, IV bolus up to 10 mL, 10-50 mL only by slow IV infusion after dilution over 15-60 minutes; rapid injection can cause heat sensation, sweating and dizziness. Course 10-20 days daily, repeat courses every 3-6 months. Contraindications: hypersensitivity, severe renal failure, status epilepticus. Adverse reactions: rare agitation, confusion, insomnia and dizziness; very rare hypersensitivity and allergic reactions, fever, dyspnoea, collapsoid state, tachycardia, arrhythmia, dyspepsia, nausea, vomiting, diarrhoea, constipation, and injection-site erythema, burning and pruritus.
Fiani B, Covarrubias C, Wong A, Doan T, Reardon T, Nikolaidis D, Sarno E · 2021
Cerebrolysin is not approved for use in the USA but is used clinically in over 50 countries worldwide. The review outlines the molecular signaling pathways through which Cerebrolysin acts in the central nervous system, and reports that it is generally safe for human use with inconsistent efficacy results across clinical studies.
Muresanu DF, Heiss WD, Hoemberg V, Bajenaru O, Popescu CD, Vester JC, Rahlfs VW, Doppler E, Meier D, Moessler H, Guekht A · 2016
30 mL/day Cerebrolysin for 21 days started 24-72 h after stroke, alongside standardised rehabilitation, produced a large superiority over placebo on upper-extremity motor function (Action Research Arm Test) at day 90 and a small-to-medium superiority on global status across 12 outcome scales. Safety was comparable with placebo.
Vester JC, Buzoianu AD, Florian SI, Hömberg V, Kim SH, Lee TMC, Matula C, Poon WS, Sandesc D, von Steinbüchel N, Strilciuc S, Vos PE, von Wild K, Muresanu D · 2021
Two phase IIIb/IV randomised, double-blind, placebo-controlled trials in moderate-severe TBI (GCS 6-12), 185 patients, using 50 mL/day for ten days followed by two cycles of 10 mL/day for 10 days. The multidimensional functional and neuropsychological outcome ensemble favoured Cerebrolysin at day 30 and day 90, with comparable safety and tolerability to placebo.
Alvarez XA, Cacabelos R, Sampedro C, Couceiro V, Aleixandre M, Vargas M, Linares C, Granizo E, García-Fantini M, Baurecht W, Doppler E, Moessler H · 2011
Randomised double-blind trial of Cerebrolysin 10 mL (n=64), donepezil 10 mg (n=66) and the combination (n=67) in mild-to-moderate Alzheimer's disease. Cognitive performance improved in all three arms with the best scores in the combination group at every study visit; global outcome favoured Cerebrolysin and the combination. The combination of neurotrophic and cholinergic treatment was safe.
Rejdak K, Sienkiewicz-Jarosz H, Bienkowski P, Alvarez A · 2023
Review of five neurotrophic factors — NGF, IGF-1, BDNF, VEGF and TNF-alpha — and of Cerebrolysin, which resembles their activities and modulates the expression of endogenous neurotrophic factors. Covers the effects of these factors and of Cerebrolysin on neuroplasticity, neurogenesis, angiogenesis and inflammation in dementia, stroke and TBI.
Avci S, Gunaydin S, Ari NS, Karaca Sulukoglu E, Polat OE, Gecili I, Yeni Y, Yilmaz A, Genc S, Hacimuftuoglu A, Yildirim S, Mokresh MY, Findik DG, Tsatsakis A, Margina D, Tsarouhas K, Wallace DR, Taghizadehghalehjoughi A · 2022
Cerebrolysin is described as a mixture of enzymatically treated peptides derived from pig brain including neurotrophic factors such as BDNF, GDNF, NGF and CNTF. In primary cortical neuron culture exposed to glutamate, cerebrolysin protected neurons by lowering synaptic-cleft glutamate via the glutamate transporters EAAT1 and EAAT2, raising antioxidant activity and reducing inflammatory cytokines.
Marghani BH, Rezk S, Ateya AI, Alotaibi BS, Othman BH, Sayed SM, Alshehri MA, Shukry M, Mansour MM · 2023
In a mouse forebrain ischaemia-reperfusion model, cerebrolysin given 3 h after reperfusion improved neurological recovery, reduced apoptotic neuronal death and inhibited reactive microglial and astrocyte activation, reducing TLR/NF-kB/cytokine signalling while activating the Keap1/Nrf2 antioxidant pathway.
Lu W, Zhu Z, Shi D, Li X, Luo J, Liao X · 2022
Cerebrolysin decreased TNF-alpha, IL-1beta, IL-6 and NF-kB after traumatic brain injury and significantly lowered Toll-like receptor 2 and Toll-like receptor 4 levels, reducing hippocampal neuronal apoptosis. The same reduction in inflammatory mediators was seen in TBI patients.
Karimian A, Abdolmaleki A, Asadi A, Zahri S, Ghanimi HA · 2025
Cerebrolysin improved functional outcomes and axonal regeneration after nerve injury and induced a shift in macrophage polarisation from the pro-inflammatory M1 phenotype to the pro-healing M2 phenotype. The review notes that Cerebrolysin crosses the blood-brain barrier and contains neuropeptides and growth factors from pig brain such as BDNF, NGF and GDNF.
Aguilar-Hernández L, Flores-Gómez GD, Nacher J, Morales-Medina JC, Flores G · 2025
Cerebrolysin limited age-related loss of dendritic spines and memory decline in mice. The mechanism is framed through BDNF acting on its tyrosine kinase B (TrkB) receptor and the downstream PI3K/Akt/CREB and ERK/MAPK signalling cascades, which drive spine morphogenesis, synaptic transmission and neurogenesis.
Trimmel H, Tauber W, Zikeli M · 2024
Case report of a fulminant, laboratory-confirmed anaphylactic reaction after intravenous cerebrolysin in an 85-year-old man with subacute stroke. The drug is described as obtained from highly purified porcine brain proteins by standardised enzymatic degradation, consisting of 25% low molecular weight peptides and free amino acids. Only rare cases of anaphylaxis to cerebrolysin have been published.
Anandan P, Rengarajan S, Venkatachalam S, Pattabi S, Jones S, Prabhu K, Krishna V, Prasanth K · 2024
States that Cerebrolysin, a peptidergic medication, is composed of 75% free amino acids and 25% low-molecular-weight peptides. In an oxidative-stress model of neuronal injury, cerebrolysin produced modest neuroprotection and upregulated BDNF and Neuregulin 1 expression.
Plosker GL, Gauthier S · 2009
Review of the parenterally administered porcine brain-derived peptide preparation in Alzheimer's disease and vascular dementia. Cerebrolysin was generally well tolerated in clinical trials, with dizziness (or vertigo) the most frequently reported adverse event.
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