Human studiesTissue-protective peptide (EPO-derived)

ARA-290

Q: What is the usual ARA-290 dose?

From human studies (Phase 2, sarcoidosis neuropathy): 4 mg once daily for 28 days. 1 mg and 8 mg were also tested; 4 mg met the main goal. These are the amounts sources reference, not recommendations.

Q: How much water do I mix ARA-290 with?

There’s no single right amount, because the water only sets the strength. With 1 mL of bacteriostatic water in a 10 mg vial, the strength is 10 mg/mL, so 4 mg is 40 units on a U-100 insulin syringe. More water makes small doses easier to measure. The dose chart above shows other volumes.

Q: What is the half-life of ARA-290?

About 20 minutes, measured in human studies. Terminal half-life after 4 mg subcutaneous in healthy volunteers; peak about 3 ng/mL.

Q: How should ARA-290 be stored?

Before mixing: Freezer (about −20 °C) for long-term storage. After mixing: Fridge (2–8 °C); use within about 4 weeks. This is common practice; no product label covers it.

Q: Is ARA-290 banned in sport?

Yes. Not named, but it is an innate repair receptor agonist, a class banned at all times under S2.1.5 (examples: asialo EPO, CEPO).

Q: Has ARA-290 been studied in people?

Yes. The human studies section lists 5 published studies. The largest, from 2017, included 64 people. Only 4 mg significantly raised corneal nerve fiber area vs placebo (+697 µm², P = 0.012); pain improved in all groups.

Cibinetide

Common dose: 4 mg daily for 28 days
Cycle: One 4-week course
Vial sizes: 10 mg
Typical draw: 40 units10 mg with 1 mL, 4 mg

An 11-amino-acid peptide engineered from erythropoietin. It activates EPO’s tissue-protective receptor without raising red blood cell production.

Evidence. Phase 2 trials in small-fiber neuropathy (sarcoidosis and type 2 diabetes). A small 12-week Phase 2 trial in diabetic macular edema found no gain in vision or retinal thickness. Not approved.

Status

Approval: Not approved in the US or EU; investigational, with Phase 2 trials published.
Sport (WADA 2026): Banned in sportNot named, but it is an innate repair receptor agonist, a class banned at all times under S2.1.5 (examples: asialo EPO, CEPO).

Sport status follows the WADA Prohibited List in force since January 1, 2026; athletes should confirm with their anti-doping organization. Checked October 5, 2026.

Protocol

Trial

Phase 2, sarcoidosis neuropathy

4 mg once daily for 28 days. 1 mg and 8 mg were also tested; 4 mg met the main goal.

Frequency: Once daily
Route: Subcutaneous injection
Cycle: A single 28-day course in trials.
One 4-week course, shown over 26 weeks

Common protocols

The ways ARA-290 is most often run, each tagged with where it comes from.

Trial protocol

Trial

Dose: 4 mg
How often: Once daily
How long: 28 days

Used in phase 2 trials in sarcoidosis and type 2 diabetes. Patients injected themselves under the skin.

Draw 40 units10 mg + 1 mL

Other trial doses

Trial

Dose: 1 mg or 8 mg
How often: Once daily
How long: 28 days

Tested alongside 4 mg in the 64-person sarcoidosis trial. 4 mg is the dose that met the main goal.

Taking it

Where it goes

In trials, a once-daily injection under the skin that patients gave themselves. Rotating standard spots such as the belly or thigh is usual practice.

If you miss a dose

The trial reports don’t give a missed-dose rule. Skip it and continue the daily schedule; don’t double up.

What to expect

Day 28
Sarcoidosis trial, 4 mg: small-nerve-fiber area in the cornea grew vs placebo; 6-minute walk rose 17.7 m vs 1.2 m on placebo.
Trial
Day 28
Type 2 diabetes trial, 4 mg: nerve-pain score improved 3.3 points vs 1.1 on placebo; HbA1c dipped 0.16 points.
Trial
Day 56
Four weeks after stopping, diabetes trial gains held: pain score 4.2 points better vs 0.74 on placebo; HbA1c down 0.21 vs up 0.21.
Trial

Side effects and what to do

Injection-site pain (trial)

Among the most common events in the sarcoidosis trial. Rotate sites.

Diarrhea, nausea, tiredness or headache (trial)

Also common in trials. Overall event counts were similar to placebo in the diabetes trial.

Kidney function change (trial, 1 case)

One diabetes patient with borderline kidney function had a creatinine rise and stopped at day 15. Take care with kidney disease.

Blood counts (trial)

No meaningful blood or chemistry changes were seen. Unlike EPO, it isn’t built to raise red cells.

Stop and get medical help

Hives, face or throat swelling, trouble breathing, chest pain or fainting; much less urine or new leg swelling (possible kidney trouble); or spreading redness, heat or pus at a site.

Tracking and pairing

Worth tracking

Kidney function (creatinine), especially with existing kidney disease
Blood sugar or HbA1c if diabetic
Nerve pain and numbness symptoms

Often paired with

Usually run on its own.

Human studies

5 key published human studies, with how many people took part. Animal studies aren’t listed here.

201764 people

Only 4 mg significantly raised corneal nerve fiber area vs placebo (+697 µm², P = 0.012); pain improved in all groups.

Design
Phase 2b randomized placebo-controlled trial, sarcoidosis small-fiber neuropathy
Dose
1, 4 or 8 mg subcutaneous daily
Length
28 days

Culver et al., Invest Ophthalmol Vis Sci 2017, PMID 28475703
201448 people

By day 56 HbA1c fell 0.21% with ARA 290 vs a 0.21% rise with placebo; PainDetect scores improved 4.2 vs 0.7 points.

Design
Phase 2 double-blind placebo-controlled trial, type 2 diabetes with painful neuropathy
Dose
4 mg subcutaneous daily
Length
28 days, then 28 days follow-up

Brines et al., Mol Med 2014, PMID 25387363
201338 people

Symptom score (SFNSL) fell 12.2 vs 3.8 points with placebo (P = 0.005); 6-minute walk rose 18.7 m vs a 15.1 m drop (P = 0.049).

Design
Randomized double-blind placebo-controlled trial, sarcoidosis small-fiber neuropathy
Dose
4 mg subcutaneous daily
Length
28 days

Dahan et al., Mol Med 2013, PMID 24136731
201222 people

Symptom score (SFNSL) improved 11.5 vs 2.9 points with placebo (P < 0.05); no safety concerns.

Design
Randomized double-blind placebo-controlled pilot, sarcoidosis small-fiber neuropathy
Dose
2 mg IV three times weekly
Length
4 weeks

Heij et al., Mol Med 2012, PMID 23168581
20209 people

No mean improvement in vision or retinal thickness; no serious adverse events or anti-drug antibodies.

Design
Phase 2 trial without a control group, diabetic macular edema
Dose
4 mg subcutaneous daily
Length
12 weeks

Lois et al., J Clin Med 2020, PMID 32674280

Mixing your vial

Vial	Water	Common dose	Draw	Strength	Action
10 mg	1 mL	4 mg	40 units (0.40 mL)	10 mg/mL

Dose chart

10 mg vial

Syringe units for common doses at different water volumes. Select a cell to open it in the calculator.

Dose	Water added
Dose	1 mL	2 mL	3 mL
1 mg
2 mg
2.5 mg
4 mg
5 mg
7.5 mg
8 mg

U-100 insulin syringe: 100 units is 1 mL. Draws over 100 units show in mL. Faded values are under 2 units, which is hard to measure. Check that your vial holds the larger volumes.

Datasheet

Half-life: about 20 minutes TrialTerminal half-life after 4 mg subcutaneous in healthy volunteers; peak about 3 ng/mL.
Type: Peptide, 11 amino acids
Molecular weight: 1,257.3 g/mol
Formula: C₅₁H₈₄N₁₆O₂₁
Sequence: pEQLERALNSS
Storage before use: Freezer (about −20 °C) for long-term storage.
After mixing or opening: Fridge (2–8 °C); use within about 4 weeks.

Half-life: Brines et al., Mol Med 2014, PMID 25387363 (citing Niesters et al. 2013)
Molecule: PubChem CID 91810664 (UNII 9W5677JKDA); p = N-terminal pyroglutamate
Storage: Community Common practice for research peptides; no approved label exists.

Cautions

Investigational.
Human safety data come from small trials of up to 12 weeks.
Prohibited in sport (WADA).

Questions

What is ARA-290?

An 11-amino-acid peptide engineered from erythropoietin. It activates EPO’s tissue-protective receptor without raising red blood cell production.

Is ARA-290 FDA-approved?

Not approved in the US or EU; investigational, with Phase 2 trials published.

What is the usual ARA-290 dose?

From human studies (Phase 2, sarcoidosis neuropathy): 4 mg once daily for 28 days. 1 mg and 8 mg were also tested; 4 mg met the main goal. These are the amounts sources reference, not recommendations.

How much water do I mix ARA-290 with?

There’s no single right amount, because the water only sets the strength. With 1 mL of bacteriostatic water in a 10 mg vial, the strength is 10 mg/mL, so 4 mg is 40 units on a U-100 insulin syringe. More water makes small doses easier to measure. The dose chart above shows other volumes.

What is the half-life of ARA-290?

About 20 minutes, measured in human studies. Terminal half-life after 4 mg subcutaneous in healthy volunteers; peak about 3 ng/mL.

How should ARA-290 be stored?

Before mixing: Freezer (about −20 °C) for long-term storage. After mixing: Fridge (2–8 °C); use within about 4 weeks. This is common practice; no product label covers it.

Is ARA-290 banned in sport?

Yes. Not named, but it is an innate repair receptor agonist, a class banned at all times under S2.1.5 (examples: asialo EPO, CEPO).

Has ARA-290 been studied in people?

Yes. The human studies section lists 5 published studies. The largest, from 2017, included 64 people. Only 4 mg significantly raised corneal nerve fiber area vs placebo (+697 µm², P = 0.012); pain improved in all groups.

Sources

Araim: cibinetide regenerates small nerve fibers in sarcoidosis (Phase 2b)
ARA 290 in type 2 diabetes (University of Manchester)
Lois et al., cibinetide for diabetic macular edema (J Clin Med 2020) PMID 32674280

For the protocol details

Culver et al. 2017, cibinetide in sarcoidosis small nerve fiber loss (IOVS)
Brines et al. 2014, ARA 290 in type 2 diabetes (Molecular Medicine) doi:10.2119/molmed.2014.00215

By Vial Guide editorsLast reviewed October 5, 2026

How we review