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.
How much ARA-290 do people take?
The two published randomized human pilot trials used a fixed 4 mg subcutaneous dose of ARA-290 (cibinetide). Route reported: Subcutaneous injection in both published human trials. Frequency reported: Once daily in the sarcoidosis trial; daily for 28 days in the type 2 diabetes trial. These are amounts documented in the cited studies and labels for ARA-290 — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
See the full reported protocol and its sourcesResearched by DoseRoutine Research TeamReviewed for accuracy by Nicholas Alexander, RSE, SO, PMPLast updated Educational reference only — not medical advice. Always confirm dosing and safety decisions with a licensed clinician.
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.
Mixing ARA-290: bacteriostatic water and syringe units
The vial arrives as dry powder. How much water you add sets the strength, and the strength sets the mark you draw to on the syringe. The table assumes a 5 mg vial and a 250 mcg example draw on a U-100 insulin syringe, where 100 units is one millilitre. If your vial is a different size, scale it — the arithmetic is the same.
| Bacteriostatic water added | Resulting strength | 250 mcg draws to |
|---|---|---|
| 1 mL | 5 mg/mL | 5 units |
| 2 mL | 2.5 mg/mL | 10 units |
| 3 mL | 1.67 mg/mL | 15 units |
Units, not millilitres. Insulin syringes are marked in units, and mixing up mcg and mg on a peptide label is the single most common error people report. Check the label twice. Run your own vial through the calculator.
Storage and stability
- Before mixing
- Sealed and still as a dry powder, ARA-290 vials are normally kept in the fridge at 2–8 °C, out of light. Short spells at room temperature during shipping are the norm for lyophilized peptides and are not, on their own, a sign the vial is spoiled.
- After mixing
- Once bacteriostatic water goes in, the vial belongs in the fridge and is generally treated as good for about 28 days — that is how long the benzyl alcohol in bacteriostatic water is relied on to hold back bacterial growth. Plain sterile water has no preservative, so a vial mixed with it is a single-session vial. Never freeze a reconstituted vial.
- When to throw it out
- A properly mixed vial is clear. Cloudiness, floating strands, a color change or powder that will not go into solution after gentle swirling all mean the vial should be discarded rather than used. Shaking a peptide vial hard is the usual cause — swirl it, or run the water down the inside wall of the vial instead of onto the powder.
Handling and shelf-life figures describe general practice for lyophilized peptides. They are not a dose and not medical advice — your prescriber or the product label sets the amount.
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
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.
Put it into practice
Reading about ARA-290 is the first step — DoseRoutine helps you act on it. These free tools turn what you just learned into a routine.
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, also called Cibinetide, is a synthetic peptide that is derived from erythropoietin (EPO) but specifically designed to activate the innate repair receptor without stimulating red blood cell production. It is being studied for its potential anti-inflammatory and tissue-protective effects, particularly in conditions involving nerve damage and neuropathic pain.
ARA-290 is primarily being investigated for conditions involving neuropathic pain and inflammation, such as sarcoidosis-associated small fiber neuropathy (SSFN). Research is also exploring its potential in other areas involving tissue injury and repair, such as diabetic neuropathy and chronic kidney disease.
ARA-290 is typically administered via subcutaneous injection. Specific instructions for preparation and injection technique should be provided by a licensed healthcare professional.
No, ARA-290 is specifically designed to activate the innate repair receptor, which is distinct from the receptor responsible for stimulating red blood cell production (erythropoiesis). Therefore, it is intended to avoid the hematopoietic side effects associated with full-length erythropoietin.
In clinical studies, ARA-290 has generally been well-tolerated. Common side effects have been mild and include reactions at the injection site, headache, or nausea. More severe side effects are rare, but all potential risks and benefits should be discussed with a qualified clinician.
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.
ARA-290 is administered by injection, so the measured volume — not a tablet count — is the unit that matters. Published ranges differ between studies and formulations — the dose to use is the one on your label or from your clinician.
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.
The two published randomized human pilot trials used a fixed 4 mg subcutaneous dose of ARA-290 (cibinetide). Route reported: Subcutaneous injection in both published human trials. Frequency reported: Once daily in the sarcoidosis trial; daily for 28 days in the type 2 diabetes trial. These are amounts documented in the cited studies and labels for ARA-290 — they are reported for reference, not a recommendation. Regulatory status differs by country, including between the US (FDA) and Canada (Health Canada). Confirm any amount with a licensed clinician before you take it.
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
- 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
ARA-290 cheat sheet
DoseRoutine cheat sheet · Peptide
ARA-290
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).
Evidence
Strong
2 human randomized trials published.
Studied range
The two published randomized human pilot trials used a fixed 4 mg subcutaneous dose of ARA-290 (cibinetide)
Route
Subcutaneous injection in both published human trials
Frequency studied
Once daily in the sarcoidosis trial; daily for 28 days in the type 2 diabetes trial
Half-life
Not reported in the cited human trials
Storage
Not reported for a human formulation in the cited sources
Not FDA-approvedResearch chemicalDeveloped as an investigational drug (cibinetide) for small-fiber neuropathy; not approved by the FDA or EMARecovery
Key references
- Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study (2012)
- ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes (2015)
- ARA 290 for treatment of small fiber neuropathy in sarcoidosis (2014)
Studied ranges, not dosing advice. Not medical advice — talk to a clinician. 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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