ARA-290 (Cibinetide) dosing & administration
A peptide that awakens your body's natural repair system to heal damaged nerves and reduce pain
Written by Michael Carroll — Owner, Director of Research · Reviewed by the Peptide Initiative Research Team · Editorial standards
Dosing
How much do I take?
Subcutaneous: A small injection into the fatty layer just under the skin — the same way insulin is given.
Bioavailability High — most of the dose reaches your bloodstream, just more gradually than an IV.
3 documented dose levels — separate regimens, not a titration schedule
1 mg
Frequency
Once daily
Duration
28 days
Lowest dose tested in the phase 2 sarcoidosis nerve study. A good starting point while watching how the body responds [1].
4 mg
Frequency
Once daily
Duration
28 days
8 mg
Frequency
Once daily
Duration
28 days
Highest daily dose studied in the sarcoidosis trial. It was safe but did not beat 4 mg for nerve outcomes [1].
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
Administration
How do I use it?
Reconstitution
What you need
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
Storage
Before reconstitution
Store ARA-290 (Cibinetide) 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 reconstitution
Once reconstituted, ARA-290 (Cibinetide) 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.
Signs of degradation — discard the vial
Sample daily schedule
As prescribed (once daily)
As prescribed by your healthcare provider injection
Site: Subcutaneous injection—rotate sites if applicable
Maintain a consistent schedule for optimal results with ARA-290 (Cibinetide). Set reminders if needed. If you miss a dose, follow your healthcare provider's instructions—do not double up on doses to compensate.
Safety
Is it safe?
Side effects
Commonly reported: Injection Site Reactions, Headache, Dizziness
Less common: Elevated Blood Pressure, Fatigue
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.
Flagged pairings
- 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
Published research
What the studies show
Brines M, et al. · 2015
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.
Culver DA, et al. · 2017
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.
Brines M, et al. · 2018
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.
Liu Y, et al. · 2014
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.
van Velzen M, et al. · 2014
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.
Heij L, Niesters M, Swartjes M, et al. · 2012
Intravenous ARA 290 at 2 mg three times weekly for 4 weeks improved small fiber neuropathy symptoms versus placebo in sarcoidosis patients.
Head to head
ARA-290 (Cibinetide) compared
Want the full picture?
The complete ARA-290 (Cibinetide) research profile: mechanism of action, clinical studies, effectiveness timeline, and FAQ.