ARA-290 Peptide (Cibinetide): Trial Doses, What the Trials Found and Syringe Units
The short answer
ARA-290, or cibinetide, is a peptide engineered from erythropoietin to protect tissue without raising red blood cells. Its trials gave 1, 4 or 8 mg under the skin daily for 28 days, or 2 mg IV three times a week. The 4 mg dose improved nerve fibre measures in sarcoidosis. It is not approved anywhere.
ARA-290, also called cibinetide, is a small peptide engineered from erythropoietin (EPO). It keeps EPO's tissue-protective signal through what its developers call the innate repair receptor, without stimulating red blood cell production. It has been through a handful of small phase 2 trials, mostly for nerve pain in sarcoidosis and diabetes, and is not approved anywhere. Below are the trial doses, what they found, and the syringe units.
What ARA-290 is
EPO protects tissue as well as making red blood cells, but its blood effects limit its use. ARA-290 was designed from the part of EPO that protects tissue, to act on the innate repair receptor and leave blood counts alone (Brines 2015). It was developed by Araim Pharmaceuticals; several trial authors are officers and shareholders of the company, which the papers declare (Lois 2020).
ARA-290 dosage chart
Every human dose of ARA-290 comes from a trial. Daily injections under the skin used 1, 4 or 8 mg, and 4 mg a day is the dose used most often; the first sarcoidosis study gave 2 mg intravenously three times a week. Updated 8 November 2026.
| Trial | Who | Dose | What it found |
|---|---|---|---|
| Heij 2012 | 22 people with sarcoidosis and small fibre neuropathy | 2 mg IV, three times a week, 4 weeks | Neuropathy symptom score improved more than on placebo (-11.5 against -2.9); no safety concerns |
| Culver 2017 | 64 people with sarcoidosis nerve fibre loss and pain | 1, 4 or 8 mg under the skin daily, 28 days | Corneal nerve fibre area rose at 4 mg (P = 0.012), not significantly at 1 or 8 mg |
| Brines 2015 | People with type 2 diabetes and painful neuropathy | 4 mg under the skin daily, 28 days | Better HbA1c and lipids, fewer neuropathic symptoms; no safety issues |
| Lois 2020 | 9 people with diabetic macular oedema | 4 mg under the skin daily, 12 weeks | No improvement in vision or retinal thickness; safe, no antibodies |
ARA-290 units on a U-100 syringe
ARA-290 is sold in 10 mg and 16 mg vials (Bureau price tracker, readings to 1 November 2026). Units = dose in mg × mL of water × 100 ÷ mg in the vial.
| Dose | 10 mg vial + 2 mL (5 mg/mL) | 16 mg vial + 2 mL (8 mg/mL) |
|---|---|---|
| 1 mg | 20 units | 12.5 units |
| 2 mg | 40 units | 25 units |
| 4 mg | 80 units | 50 units |
| 8 mg | 160 units (over 1 mL) | 100 units |
What the trials found
- Sarcoidosis nerve pain. In the 2012 pilot, 2 mg IV three times a week improved the small fibre neuropathy score more than placebo; pain and fatigue scores improved in both groups alike (Heij 2012). In the larger 2017 phase 2b trial, corneal nerve fibre area grew by a placebo-corrected 697 µm² at 4 mg a day, the only dose to reach significance, and pain improved in all groups including placebo (Culver 2017).
- Type 2 diabetes. 4 mg a day for 28 days improved HbA1c, lipids and neuropathic symptoms against placebo (Brines 2015). The abstract gives no size for the HbA1c change.
- Diabetic macular oedema. 4 mg a day for 12 weeks did not improve vision or retinal thickness in 9 patients (Lois 2020); the trial record says it stopped when the study drug expired.
- Mood. A study in 36 healthy volunteers found small changes in emotional processing and no effect on mood (Cerit 2015).
None of the trials ran longer than 12 weeks, and none tested recovery, injury healing or general wellbeing, which is how ARA-290 is usually sold.
Safety
Across these trials the papers report no safety concerns, no serious adverse events in the macular oedema study and no antibodies to the peptide (Heij 2012; Brines 2015; Lois 2020). The total exposure is small, at most a few dozen people per dose for up to 12 weeks, so rare or long-term effects would not show.
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Build your stack, 2 minutesFrequently asked questions
What is the ARA-290 dosage?
There is no approved dose. Trials gave 1, 4 or 8 mg under the skin once a day for 28 days, 4 mg a day for up to 12 weeks, or 2 mg intravenously three times a week for 4 weeks. 4 mg a day is the dose used most often and the only one with a significant result in the largest trial.
How many units is 4 mg of ARA-290?
From a 10 mg vial mixed with 2 mL of bacteriostatic water (5 mg/mL), 4 mg is 0.8 mL, 80 units on a U-100 syringe. From a 16 mg vial in 2 mL (8 mg/mL) it is 50 units.
What is ARA-290 used for?
In trials it was tested for small fibre neuropathy and pain in sarcoidosis, neuropathy and metabolic control in type 2 diabetes, and diabetic macular oedema. It is sold online for recovery and inflammation, which no trial has tested.
Is ARA-290 the same as cibinetide?
Yes. Cibinetide is the drug name for ARA-290, a peptide derived from erythropoietin and developed by Araim Pharmaceuticals.
Is ARA-290 safe?
The published trials, each up to 12 weeks and with at most a few dozen people per dose, report no safety concerns and no antibodies to the peptide. That is too little exposure to rule out rare or long-term effects.
Sources (checked 7 November 2026)
- Heij L et al. Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy: a randomized, double-blind pilot study. Mol Med 2012;18(1):1430-1436. Checked 7 November 2026.
- Culver DA et al. Cibinetide improves corneal nerve fiber abundance in patients with sarcoidosis-associated small nerve fiber loss and neuropathic pain. Invest Ophthalmol Vis Sci 2017;58(6):BIO52-BIO60. Checked 7 November 2026.
- ClinicalTrials.gov NCT02039687 (1, 4 or 8 mg subcutaneously for 28 days, 64 participants). Checked 7 November 2026.
- Brines M et al. ARA 290, a nonerythropoietic peptide engineered from erythropoietin, improves metabolic control and neuropathic symptoms in patients with type 2 diabetes. Mol Med 2015;20(1):658-666. Checked 7 November 2026.
- Lois N et al. A phase 2 clinical trial on the use of cibinetide for the treatment of diabetic macular edema. J Clin Med 2020;9(7):2225. Checked 7 November 2026.
- ClinicalTrials.gov NCT06626971 (4 mg daily for 12 weeks; stopped on expiry of study drug). Checked 7 November 2026.
- Cerit H et al. Testing the antidepressant properties of the peptide ARA290 in a human neuropsychological model of drug action. Eur Neuropsychopharmacol 2015;25(12):2289-2299. Checked 7 November 2026.
ARA-290 is an investigational peptide with no approval; doses are from the trials listed, vial sizes from the Bureau price tracker. Labels and trial records change; the leaflet in your box and your prescriber come first. Educational content, not medical advice.