⚠ Educational reference only — not medical advice.** This article is for research and educational reference. Always consult your own physician before considering any peptide protocol. See the full Disclaimer at the end of this article.

Introduction
ARA-290 (cibinetide) is an 11-amino-acid peptide derived from the helix-B surface of erythropoietin. It was developed to preserve EPO’s tissue-protective effects while eliminating its hematopoietic activity, which carries cardiovascular risk at supraphysiologic doses. Investigational in the United States.

Mechanism of Action
ARA-290 binds the Innate Repair Receptor (IRR), a heteromeric complex of the EPO receptor and the common β-chain (βcR). IRR engagement drives anti-inflammatory and tissue-reparative signaling without stimulating erythropoiesis.

Research Indications
The largest programs evaluate diabetic peripheral neuropathy and sarcoidosis-related small-fiber neuropathy, with reductions in pain scores and improvements in corneal nerve-fiber density reported in mid-phase trials. Additional research contexts include neuropathic pain, ocular surface disease, and post-surgical recovery.

Reconstitution
Typical 8 mg lyophilized vial: add **2 mL of bacteriostatic water**, swirl gently until clear. Final concentration **4000 mcg/mL (4 mg/mL)** — each 0.1 mL (10 units on a U-100 insulin syringe) delivers 400 mcg.

Dosing Protocol (research literature)
Published protocols typically dose **1–4 mg subcutaneously once daily**, with 4 mg most common in neuropathy trials. Treatment duration **4–12 weeks**; pain-score and nerve-fiber endpoints are usually reassessed at week 4 and again at end of treatment.

Administration
Subcutaneous injection into abdominal fat, rotating sites. Timing of day does not appear to influence efficacy.

Storage & Handling
Lyophilized: refrigerate (2–8°C). Reconstituted: refrigerate; stable approximately **21–28 days**. Protect from light. Do not freeze reconstituted product.

Side Effects
Predominantly mild injection-site reactions. No significant elevation in hematocrit, hemoglobin, blood pressure, or thromboembolic events in published trials — the principal safety differentiators from EPO.

Contraindications
Active malignancy, pregnancy, lactation, uncontrolled hypertension, history of thromboembolic disease, and prior hypersensitivity.

Monitoring
Baseline CBC, blood pressure, and a validated neuropathy/pain instrument (e.g., NTSS-6, NPSI). Re-measure at 4, 8, and 12 weeks. Hematocrit and blood pressure surveillance remains prudent despite the non-erythropoietic profile.

Disclaimer
**This article is for informational and research-reference purposes only.** Nothing in this document constitutes medical advice, a prescription, or a recommendation from a physician. The reconstitution, dosing, and protocol information above reflects ranges commonly cited in published research and clinician-directed protocols — it is provided as reference material only, not as instructions, an endorsement of off-label use, or a substitute for individualized medical evaluation.

**Customers should do their own research and consult their own physician** before considering any peptide protocol. Whether a given compound is appropriate for an individual — and at what dose, for what duration, and alongside what monitoring — is a decision that only a licensed clinician with knowledge of that individual’s medical history, current medications, and conditions can make.