Ara-290 (16 mg vial)

Protocol Overview

Concise summary of the regimen.

Dosing & Reconstitution

Frequency: Inject once daily subcutaneously. Clinical studies used 4 mg/day as the target therapeutic dose, with no additional benefit observed at 8 mg. Starting at 2 mg for the first week allows assessment of individual tolerance before reaching the maintenance dose.

Reconstitution Steps

1. Draw 2.0 mL bacteriostatic water with a sterile syringe.
2. Inject slowly down the vial wall; avoid foaming.
3. Gently swirl or roll until fully dissolved (do not shake vigorously).
4. Label with reconstitution date and refrigerate at 2 to 8 °C, protected from light. At 8 mg/mL, 1 unit = 0.01 mL = 80 mcg on a U-100 insulin syringe.

Storage Instructions

Proper storage preserves peptide quality.

• Lyophilized: refrigerate at 2 to 8 °C for up to 2 years; freeze at -20 °C for extended storage up to 3 years.
• Reconstituted: refrigerate at 2 to 8 °C; use within 28 days; do not freeze the liquid solution.
• Allow vials to reach room temperature before opening to minimize condensation; protect from light.
• Discard if discoloration, cloudiness, or particulate matter is observed.

Supplies Needed

Plan based on an 8 to 16 week daily protocol with gradual titration (2 mg week 1, then 4 mg daily).

Peptide Vials (Ara-290, 16 mg each):

• 8 weeks: ~14 vials.
• 12 weeks: ~21 vials.
• 16 weeks: ~28 vials.

Insulin Syringes (U-100):

• Per week: 7 syringes (1/day).
• 8 weeks: 56. 12 weeks: 84. 16 weeks: 112.

Bacteriostatic Water (10 mL bottles):

• 8 weeks (14 vials): 3 bottles. 12 weeks (21 vials): 5 bottles. 16 weeks (28 vials): 6 bottles.

Alcohol Swabs:

• Per week: 14 swabs.
• 8 weeks: 112 (2 x 100-count). 16 weeks: 224 (3 x 100-count).

Important Notes

Practical considerations for consistency and safety.

• Use a new sterile insulin syringe for each injection; dispose in a sharps container.
• Rotate injection sites (abdomen, thighs, upper arms) to reduce local irritation and prevent

lipohypertrophy.

• Inject slowly; wait a few seconds before withdrawing the needle.
• Document daily dose and injection site to maintain consistency.
• No clinically significant adverse effects were reported at 4 mg/day in 28-day clinical trials.

How This Works

Ara-290 (cibinetide) binds to the innate repair receptor (IRR), a heterodimer of EPOR and CD131 (bc subunit), which is distinct from the classical erythropoietin receptor. This selective binding triggers anti-apoptotic and anti-inflammatory signaling cascades that protect tissues and promote repair without stimulating erythropoiesis. Preclinical research demonstrates that Ara-290 can reprogram a pro-inflammatory, tissue-damaging environment into one favoring healing and regeneration. Additionally, analgesic effects have been observed through immunomodulation and direct inhibition of TRPV1 ion channels activated by capsaicin.

Benefits & Side Effects

Observations from preclinical and clinical literature.

• Neuroprotection: Clinical trials in diabetic neuropathy showed improvements in HbA1c, lipid profiles,

and neuropathic pain scores with 4 mg daily dosing.

• Nerve regeneration: In sarcoidosis-associated small-fiber neuropathy, treatment led to significant

increases in corneal nerve fiber density and improved symptoms compared to placebo.

• Tissue protection: Anti-inflammatory and anti-apoptotic effects observed across multiple organ systems

in preclinical models.

• No erythropoietic effects: Unlike full EPO, Ara-290 does not stimulate red blood cell production,

avoiding related side effects.

• Tolerability: Well tolerated in clinical studies; occasional mild injection-site reactions (redness, transient

discomfort) may occur with subcutaneous administration.

Lifestyle Factors

Complementary strategies for best outcomes.

• Optimize glycemic control through diet and medication adherence if addressing diabetic neuropathy.
• Incorporate regular physical activity appropriate to individual capacity to support nerve health and

circulation.

• Prioritize adequate sleep and stress management to support tissue repair processes.
• Avoid smoking and limit alcohol consumption, both of which can exacerbate neuropathic conditions.

Injection Technique

General subcutaneous guidance from clinical best-practice resources.

1. Clean the vial stopper and skin with alcohol; allow to dry.
2. Pinch a skinfold; insert the needle at 45 to 90 degrees into subcutaneous tissue.
3. Do not aspirate for subcutaneous injections; inject slowly and steadily.
4. Wait 5 to 10 seconds before withdrawing; dispose of syringe in sharps container.
5. Rotate sites systematically (abdomen, thighs, upper arms) to avoid lipohypertrophy.

References

Source citations for further reading.

1. Brines M et al. ARA 290 improves metabolic control and neuropathic symptoms in type 2 diabetes (Molecular Medicine, 2014).
2. Dahan A et al. ARA 290 improves symptoms in sarcoidosis-associated small nerve fiber loss (Molecular Medicine, 2013).
3. Brines & Cerami. Discovery and development of the innate repair receptor and its non-erythropoietic ligands (Molecular Medicine, 2008).
4. Zhang W et al. ARA 290 relieves pathophysiological pain by targeting TRPV1 channel (Peptides Journal, 2016). Ara-290 (16 mg vial) Once-daily subcutaneous protocol for innate repair receptor activation research. Ara-290 (cibinetide) is an 11 amino acid non-erythropoietic peptide derived from erythropoietin's helix-B domain. It selectively activates the innate repair receptor (IRR), an EPOR/CD131 heterodimer, to promote anti-inflammatory and tissue-protective effects without stimulating red blood cell production. Clinical trials have demonstrated benefits for diabetic neuropathy and sarcoidosis-related small-fiber neuropathy. Protocol Overview Concise summary of the regimen. Goal: Support tissue protection, anti-inflammatory signaling, and neuropathic symptom management via IRR activation. Schedule: Daily subcutaneous injections for 4 to 8 weeks (clinical trials used 28-day protocols; extension to 8 to 16 weeks based on individual response). Dose Range: 2 to 4 mg daily; 4 mg is the established target dose. Reconstitution: 2.0 mL per 16 mg vial (8 mg/mL). Storage: Lyophilized refrigerated or frozen; reconstituted refrigerated up to 28 days. Dosing & Reconstitution Guide Standard / gradual approach (2.0 mL = 8 mg/mL). WEEK DAILY DOSE UNITS PER INJECTION Week 1 2 mg (2,000 mcg) 25 units (0.25 mL) Weeks 2 to 8 (or up to 16) 4 mg (4,000 mcg) 50 units (0.50 mL) Frequency: Inject once daily subcutaneously. Clinical studies used 4 mg/day as the target therapeutic dose, with no additional benefit observed at 8 mg. Starting at 2 mg for the first week allows assessment of individual tolerance before reaching the maintenance dose. Reconstitution Steps
5. Draw 2.0 mL bacteriostatic water with a sterile syringe.
6. Inject slowly down the vial wall; avoid foaming.
7. Gently swirl or roll until fully dissolved (do not shake vigorously).
8. Label with reconstitution date and refrigerate at 2 to 8 °C, protected from light. At 8 mg/mL, 1 unit = 0.01 mL = 80 mcg on a U-100 insulin syringe. Storage Instructions Proper storage preserves peptide quality. • Lyophilized: refrigerate at 2 to 8 °C for up to 2 years; freeze at -20 °C for extended storage up to 3 years. • Reconstituted: refrigerate at 2 to 8 °C; use within 28 days and do not freeze the liquid solution. • Allow vials to reach room temperature before opening to minimize condensation; protect from light. • Discard if discoloration, cloudiness, or particulate matter is observed. Supplies Needed Plan based on an 8 to 16 week daily protocol with gradual titration. Peptide Vials (Ara-290, 16 mg each): • 8 weeks: ~14 vials. 12 weeks: ~21 vials. 16 weeks: ~28 vials. Insulin Syringes (U-100): • Per week: 7 syringes (1/day). • 8 weeks: 56. 12 weeks: 84. 16 weeks: 112. Bacteriostatic Water (10 mL bottles): • 8 weeks (14 vials): 3 bottles. 12 weeks (21 vials): 5 bottles. 16 weeks (28 vials): 6 bottles. Alcohol Swabs: • Per week: 14 swabs. • 16 weeks: 224 swabs (3 x 100-count boxes). Important Notes Practical considerations for consistency and safety. • Use a new sterile insulin syringe for each injection; dispose in a sharps container. • Rotate injection sites (abdomen, thighs, upper arms) to reduce local irritation and prevent lipohypertrophy. • Inject slowly; wait a few seconds before withdrawing the needle. • Document daily dose and injection site to maintain consistency. • No clinically significant adverse effects were reported at 4 mg/day in 28-day clinical trials. How This Works Ara-290 (cibinetide) binds to the innate repair receptor (IRR), a heterodimer of EPOR and CD131 (bc subunit), which is distinct from the classical erythropoietin receptor. This selective binding triggers anti-apoptotic and anti-inflammatory signaling cascades that protect tissues and promote repair without stimulating erythropoiesis. Preclinical research demonstrates that Ara-290 can reprogram a pro-inflammatory, tissue-damaging environment into one favoring healing and regeneration. Additionally, analgesic effects have been observed through immunomodulation and direct inhibition of TRPV1 ion channels activated by capsaicin. Potential Benefits and Side Effects Observations from preclinical and clinical literature. • Neuroprotection: Clinical trials in diabetic neuropathy showed improvements in HbA1c, lipid profiles, and neuropathic pain scores with 4 mg daily dosing. • Nerve regeneration: In sarcoidosis-associated small-fiber neuropathy, treatment led to significant increases in corneal nerve fiber density (objective nerve regrowth) and improved symptoms compared to placebo. • Tissue protection: Anti-inflammatory and anti-apoptotic effects observed across multiple organ systems in preclinical models. • No erythropoietic effects: Unlike full EPO, Ara-290 does not stimulate red blood cell production, avoiding related side effects. • Tolerability: Well tolerated in clinical studies; occasional mild injection-site reactions (redness, transient discomfort) may occur. Lifestyle Factors Complementary strategies for best outcomes. • Optimize glycemic control through diet and medication adherence if addressing diabetic neuropathy. • Incorporate regular physical activity appropriate to individual capacity to support nerve health and circulation. • Prioritize adequate sleep and stress management to support tissue repair processes. • Avoid smoking and limit alcohol consumption, both of which can exacerbate neuropathic conditions. Injection Technique General subcutaneous guidance from clinical best-practice resources.
9. Clean the vial stopper and skin with alcohol; allow to dry.
10. Pinch a skinfold; insert the needle at 45 to 90 degrees into subcutaneous tissue.
11. Do not aspirate for subcutaneous injections; inject slowly and steadily.
12. Wait 5 to 10 seconds before withdrawing; dispose of syringe in sharps container.
13. Rotate sites systematically (abdomen, thighs, upper arms) to avoid lipohypertrophy. Recommended Source NTN Performance recommends ION Peptide for high-purity Ara-290 (16 mg). If unavailable at ION Peptide, our trusted backup is Amino Tech. Why ION Peptide? • Lab-verified purity with batch Certificates of Analysis. • Consistent handling and documentation standards. • Reliable fulfillment with cold-chain integrity. Primary: Ara-290 at ION Peptide (code PROFIT). Backup: Ara-290 at Amino Tech (code PROFIT). References Source citations for further reading.
14. Brines & Cerami. Discovery and development of the innate repair receptor and its non-erythropoietic ligands (Molecular Medicine, 2008).
15. Brines M et al. ARA 290 improves metabolic control and neuropathic symptoms in patients with type 2 diabetes (Molecular Medicine, 2014).
16. Dahan A et al. ARA 290 improves symptoms in sarcoidosis-associated small nerve fiber loss (Molecular Medicine, 2013).
17. Davis T et al. Targeting the innate repair receptor to treat neuropathy (Pain Reports, 2017).