peptideInjectableNot FDA-approvedResearch chemicalDeveloped as an investigational drug (cibinetide) for small-fiber neuropathy; not approved by the FDA or EMA
ARA-290Benefits, Dosage & Interactions
Also known as: Cibinetide
ARA-290, also known by its investigational name Cibinetide, is a synthetic, 11-amino acid peptide derived from the innate repair receptor (IRR) binding domain of erythropoietin (EPO). Research on ARA-290 focuses on tissue recovery. ARA-290 is administered by injection rather than orally.
Researched by DoseRoutine R&D TeamReviewed for accuracy by Nicholas Alexander, RSELast updated
Evidence: Strong — 2 human randomized trials published.
Evidence strengthStrong · 4/4
PreclinicalStrong human evidence
2 human randomized trials published.
Plasma half-life
~1 h (human, secondary source — not label-verified)
Default unit
mg
What published protocols report
Ranges documented in the literature, shown for reference. DoseRoutine does not recommend an amount — your prescriber or the product label sets the dose.
Reported for ARA-290 in the cited sources. Published ranges are not dosing advice.
References & evidence
Documents the ARA-290 entry is written from. Each number matches an inline marker above.
- [1]Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot studyHeij L, Niesters M, Swartjes M, Hoitsma E, Drent M, Dunne A, Grutters JC, Vogels O, Brines M, Cerami A, Dahan A · Molecular Medicine · 2012 · Peer-reviewed · PMID 23168581
- [2]ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetesBrines M, Dunne AN, van Velzen M, Proto PL, Ostenson CG, Kirk RI, Petropoulos IN, Javed S, Malik RA, Cerami A, Dahan A · Molecular Medicine · 2015 · Peer-reviewed · PMID 25387363
- [3]ARA 290 for treatment of small fiber neuropathy in sarcoidosisvan Velzen M, Heij L, Niesters M, Cerami A, Dunne A, Dahan A, Brines M · Expert Opinion on Investigational Drugs · 2014 · Peer-reviewed · PMID 24555851
How to track ARA-290 doses
ARA-290 is tracked as a protocol rather than a single reminder: a vial with a concentration, a schedule that may be titrated or cycled, and a rotation of injection sites. Here is the record that keeps all three consistent.
- 1
Record the vial and concentration
Log the vial strength and the volume of bacteriostatic water you added so ARA-290 is stored as a concentration rather than a guess. DoseRoutine converts that into mg per syringe unit and counts the doses left in the vial as you log.
- 2
Set the schedule, not just a reminder
Enter the dose in mg and the frequency. Cycled protocols get a start and end date so the history stays accurate when ARA-290 comes out of the routine.
- 3
Rotate and log the injection site
Pick the site at the moment you log the dose. The site map shows what you used last and how recently, which is the part that drifts fastest when two compounds run on different frequencies.
- 4
Log adherence, not intentions
Mark each dose taken, skipped or delayed as it happens. Weeks of honest logs are what make an adherence rate or a trend line meaningful; retrospective guessing is not.
- 5
Review against outcomes
Review ARA-290 alongside your logged metrics and any relevant blood work every few weeks before changing the dose, so the change is a response to data rather than to a good or bad day.
What to log each time
- Dose in mg and the syringe units it worked out to
- Vial: reconstitution date, concentration, doses remaining
- Injection site and time
- Any side effects in the 24 h after the dose
References & Evidence
Sources on this page that document ARA-290 dosing, timing and safety.
- [1]National Center for Biotechnology Information View source
Educational information only — not medical advice. Dose ranges vary by person, indication and prescriber.
What is ARA-290 studied for?
What is ARA-290?Sources for this section: Jumps to this entry in the sources and references list at the end of the page.
ARA-290, also known by its investigational name Cibinetide, is a synthetic, 11-amino acid peptide derived from the innate repair receptor (IRR) binding domain of erythropoietin (EPO). Unlike full-length EPO, ARA-290 is designed to activate the IRR without stimulating erythropoiesis (red blood cell production), thereby aiming to avoid hematopoietic side effects associated with EPO. The innate repair receptor is a heterocomplex composed of the beta common receptor (CD131) and the EPO receptor (CD236R), which is expressed on various cell types, including immune cells, endothelial cells, and neuronal cells. Activation of the IRR by ARA-290 is hypothesized to modulate inflammatory responses and promote tissue protection and repair. It has been investigated in various preclinical and clinical studies for conditions involving tissue damage, inflammation, and neuropathic pain, such as sarcoidosis-associated small fiber neuropathy (SSFN) and chronic kidney disease.
What does the research say about ARA-290?
Tap a section to expand.
ARA-290 exerts its primary effects by selectively binding to and activating the innate repair receptor (IRR). The IRR is a heterocomplex comprising the beta common receptor (CD131) and the erythropoietin receptor (EPOR), which is distinct from the homodimeric EPOR responsible for erythropoiesis. Upon binding to the IRR, ARA-290 is believed to initiate intracellular signaling cascades that are involved in anti-inflammatory and cytoprotective processes. Specifically, activation of the IRR is proposed to downregulate pro-inflammatory pathways, such as those involving NF-κB, and upregulate anti-apoptotic and reparative pathways. This modulation is thought to lead to reduced oxidative stress, decreased cytokine production, and enhanced cell survival and tissue repair, particularly in nerve tissue. Research, including studies cited by DrugBank and published biomedical literature, suggests this mechanism may contribute to its observed effects in conditions characterized by inflammation and tissue injury.
Source for this section: Sources for How does ARA-290 work?: Jumps to this entry in the sources and references list at the end of the page.
Research into ARA-290 (Cibinetide) has primarily focused on its potential therapeutic benefits related to its anti-inflammatory and tissue reparative properties. Key areas of investigation include:
* **Neuropathic Pain Relief:** Clinical trials, such as those referenced by clinical trial registries and publications, have explored its efficacy in reducing neuropathic pain, particularly in conditions like sarcoidosis-associated small fiber neuropathy (SSFN). Studies indicate a potential for improvement in pain scores and nerve fiber density.
* **Inflammation Modulation:** Due to its interaction with the innate repair receptor, ARA-290 is believed to modulate inflammatory pathways. This could be beneficial in conditions driven by chronic inflammation, aiming to reduce inflammatory markers and mitigate tissue damage.
* **Tissue Protection and Repair:** Preclinical studies suggest a role for ARA-290 in promoting cell survival and tissue repair in models of injury and disease. This includes potential protective effects on endothelial cells and neurons, mechanisms supported by research cited in PubChem and scientific databases.
* **Improvement in Nerve Fiber Density:** In the context of small fiber neuropathy, some studies have reported an increase in intraepidermal nerve fiber density (IENFD), suggesting a potential for nerve regeneration or protection, as noted in clinical research literature.
The evidence base for ARA-290 (Cibinetide) is primarily derived from preclinical studies and human clinical trials, some of which are still ongoing. Clinical investigations have largely focused on its application in neuropathic pain, particularly sarcoidosis-associated small fiber neuropathy (SSFN). Phase 2 trials have reported some positive outcomes, including reductions in pain scores and improvements in intraepidermal nerve fiber density (IENFD), as detailed in biomedical research databases like PubMed and clinical trial registries (e.g., ClinicalTrials.gov). However, not all trials have demonstrated statistical significance across all endpoints. Beyond SSFN, early-stage research has explored its potential in other conditions involving tissue injury and inflammation, including diabetic neuropathy and chronic kidney disease. The mechanism of action, involving selective activation of the innate repair receptor, is supported by cellular and animal model studies. The safety profile observed in clinical trials has generally been favorable, though larger and longer-term studies are needed to fully characterize its efficacy and safety. The National Institutes of Health (NIH) and other research bodies hold records of these investigations.
Clinical studies of ARA-290 (Cibinetide) have generally reported a favorable safety profile. The most commonly observed side effects have been mild to moderate in severity. These can include:
* Injection site reactions: such as pain, redness, or swelling at the site of administration.
* Headache.
* Nausea.
* Fatigue.
Less common side effects might occur, but typically appear in a small percentage of individuals. As with any investigational compound, the full spectrum and incidence of potential side effects are still being characterized through ongoing research and clinical trials. Individuals experiencing any adverse reactions should report them to their healthcare provider. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
While ARA-290 (Cibinetide) has shown a generally favorable safety profile in studies to date, certain warnings and precautions should be considered:
* **Injection administration:** As an injectable peptide, proper aseptic technique is essential to prevent infections at the injection site. Self-administration requires careful instruction from a healthcare professional.
* **Immunogenicity:** As a peptide, there is a theoretical risk of developing an immune response (antibodies) against ARA-290. The clinical significance of such responses, if they occur, is not fully established but is typically monitored in long-term studies.
* **Lack of long-term data:** The long-term effects and safety profile of ARA-290 are still under investigation, as it is a relatively new compound. More extensive post-marketing surveillance or longer-duration clinical trials would be needed to identify rare or delayed adverse effects.
* **Individual variability:** Responses to ARA-290 can vary among individuals based on their underlying health conditions, genetics, and other factors.
This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
Specific contraindications for ARA-290 (Cibinetide) are not yet fully established, given its investigational status. However, based on general pharmacological principles and data from clinical trials thus far, potential contraindications or situations requiring extreme caution might include:
* **Known hypersensitivity:** Individuals with a known allergy or severe hypersensitivity reaction to ARA-290 or any of its excipients should avoid its use.
* **Acute severe illness:** In the context of acute, severe systemic illness, the use of investigational compounds usually requires careful consideration and may be contraindicated until the acute phase resolves.
* **Pregnancy and Lactation:** Due to a lack of sufficient safety data in pregnant or breastfeeding individuals, ARA-290 is generally not recommended in these populations. Animal reproduction studies are typically conducted, but human data is usually limited.
This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
As an investigational peptide, comprehensive interaction studies for ARA-290 (Cibinetide) with other medications or supplements are limited. However, based on its mechanism of action and general considerations for drug interactions, caution is advised when combining it with:
* **Immunomodulatory Agents:** Since ARA-290 is thought to modulate inflammatory pathways, combining it with other immunosuppressants or immunomodulators might theoretically alter their individual effects. Careful monitoring would be warranted.
* **Agents affecting nerve function or pain pathways:** Given its potential effects on neuropathic pain, concurrent use with other analgesics or nerve-modulating drugs should be discussed with a clinician to avoid potential additive effects, antagonism, or unexpected side effects.
* **Compounds affecting hematopoiesis:** While ARA-290 is designed to avoid erythropoietic effects, caution is always prudent when combining investigational compounds with known hematopoietic agents, though this is less likely to be a direct interaction.
Always disclose all medications, supplements, and health conditions to a qualified clinician before starting ARA-290. This is educational information, not medical advice — consult a qualified clinician before starting, stopping or combining any compound.
ARA-290 (Cibinetide) has a reported half-life of approximately 1 hour, meaning it is cleared from the body relatively quickly. However, its biological effects may persist longer due to downstream signaling pathways activated by the innate repair receptor. In clinical studies, administration schedules have varied, commonly involving subcutaneous injections. Users should always adhere to the specific dosing and timing instructions provided by their prescribing licensed clinician. It can typically be taken at any time of day, and its absorption is not directly influenced by food intake, meaning it can be taken either with or without food, based on individual preference or clinician's advice.
Source for this section: Sources for When should you take ARA-290?: Jumps to this entry in the sources and references list at the end of the page.
What interacts with ARA-290?
| Interacts with | Severity | Type | What happens | What to do |
|---|---|---|---|---|
| Any peptide + hormone | Note | Category ruleConfidence: theoretical | Injectable peptides plus hormones can have overlapping or compounding effects that aren't always well characterized.Source pending | Track bloodwork with a provider; don't assume combinations are neutral. |
Frequently asked questions about ARA-290
ARA-290 is a research peptide. It is also known as Cibinetide. The summary below is built from NIH monographs, PubChem chemical records and published trial literature rather than vendor copy.
ARA-290 is commonly discussed in the context of supporting recovery. Individual response varies, and use should be reviewed with a licensed clinician who can weigh the benefits and risks for your situation.
For ARA-290, it is typically administered by injection and it is typically taken null. Always follow the specific dose your clinician or the product label prescribes.
ARA-290 carries potential side effects and drug interactions, documented in NIH, Mayo Clinic, and FDA label sources. Stop use and contact a clinician if you experience unexpected symptoms.
Interaction risk for ARA-290 comes from the rest of the stack: other peptides, prescription medicines, hormone therapy and peptides. Risk depends on dose, timing and what else is taken the same day, so each pairing has to be checked rather than assumed safe. The free checker at https://doseroutine.com/interaction-checker covers ARA-290 with no sign-up.
There is no single answer for ARA-290 plus TRT. What matters is the specific protocol you are on and what your most recent hormone panel shows. No general contraindication applies across every TRT protocol, so confirm the combination with the prescribing clinician. See the free TRT interaction reference: https://doseroutine.com/trt-supplement-interactions
Pairing ARA-290 with peptides has to be assessed one peptide at a time, because GLP-1 agonists, secretagogues, healing peptides and melanocortins do not share an interaction profile. Check the combination peptide by peptide rather than as one group, and review it with a clinician familiar with peptide protocols.
Published frequency for ARA-290 varies by protocol and formulation, so the label or prescription is what sets it. Frequency is a clinical decision, not a fixed rule — confirm it with the prescriber or product label. Comparison of apps that keep a schedule like this: https://doseroutine.com/best-dose-tracking-apps
The effect of a missed dose of ARA-290 depends on the protocol and formulation you are on. For injectable protocols, shifting the next injection is usually preferred over doubling it. Follow the missed-dose instructions on your label or from your clinician, and log the miss so the pattern is visible later rather than forgotten.
For an injectable like ARA-290 the record needs more than a checkbox: vial concentration, the measured volume, and which site the last injection went into. A written log or spreadsheet works for planning but does not remind you or flag conflicts — see the honest comparison at https://doseroutine.com/vs/spreadsheet and the wider roundup at https://doseroutine.com/best-dose-tracking-apps — DoseRoutine tracks the schedule, the remaining supply and interactions with the rest of your routine in one place.
Sources cited on this page
Specific documents referenced by the numbered markers above. Each number matches the marker in the text.
- PubChem CID 91810664(opens in a new tab)National Center for Biotechnology Information · pubchem.ncbi.nlm.nih.gov/compound/91810664
Verify at
Publisher search links for ARA-290. These are places to check the information — they are not citations, so they are not numbered.
- DrugBank(publisher search, opens in a new tab)DrugBank Online · publisher search
- ClinicalTrials.gov(publisher search, opens in a new tab)U.S. National Library of Medicine · publisher search
- MedlinePlus(publisher search, opens in a new tab)U.S. National Library of Medicine · publisher search
- PubMed literature search(publisher search, opens in a new tab)National Library of Medicine · publisher search
- Examine.com(publisher search, opens in a new tab)Examine.com · publisher search
- DailyMed labeling archive(publisher search, opens in a new tab)U.S. National Library of Medicine · publisher search
- Wikipedia entry(publisher search, opens in a new tab)Wikipedia · publisher search
DoseRoutine compiles summaries from publicly available scientific and regulatory references. Always verify important decisions with a licensed clinician. How we source and review this information.
What is the short answer on ARA-290?
Plain-text summary, safe to quote verbatim:
ARA-290, also known by its investigational name Cibinetide, is a synthetic, 11-amino acid peptide derived from the innate repair receptor (IRR) binding domain of erythropoietin (EPO). Research on ARA-290 focuses on tissue recovery. ARA-290 is administered by injection rather than orally.
Source: DoseRoutine — https://doseroutine.com/library/ara-290
Cite this page
Using this in an article, AI answer, or research note? Please attribute:
DoseRoutine. (2026). ARA-290 — Overview, Benefits & Side Effects. Retrieved from https://doseroutine.com/library/ara-290
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