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Reviewed by MyPeptideMatch Editorial TeamLast reviewed February 2026Updated February 2026

ARA-290 Dosing Protocol: 5 mg Vial — Neuropathic Pain & Anti-Inflammatory Guide

ARA-290 non-erythropoietic EPO analogue dosing guide — INNATE repair receptor activation for sarcoidosis-related neuropathic pain, insulin secretion, and tissue protection.

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Quickstart highlights

ARA-290 (cibinetide, Araim Pharmaceuticals) is a 11-amino acid non-erythropoietic peptide derived from the helix B region of erythropoietin (EPO).

  • Concentration: 2 mg/mL (5 mg vial + 2.5 mL bacteriostatic water).
  • At 2 mg/mL: 4 mg = 200 units (2 mL); Dahan et al. Phase 2 RCT dose.
  • Dahan et al. 2013: 4 mg/day x 28 days: +29% corneal nerve fiber density, -2.1 NRS pain reduction vs. placebo.
  • Does not stimulate erythropoiesis — no hematocrit elevation or WADA concerns.
  • May require 4–6 weeks for neuropathic pain improvement as small fiber nerve repair progresses.

Dosing table

For educational reference only. Your prescribing provider may adjust doses based on your clinical profile and response.

WeekDose (µg)UnitsFrequencyNotes
1-22000100Once daily (morning)2 mg — 100 units; starting dose; assess neuropathic pain response
3-124000200Once daily (morning)4 mg — 200 units (2 mL); dose from Dahan et al. 2013 sarcoidosis RCT; one 5 mg vial provides 1.25 doses at this level

Reconstitution steps

  1. Draw 2.5 mL bacteriostatic water; inject slowly down the vial wall.
  2. Swirl gently until dissolved; do not shake.
  3. Final concentration: 2 mg/mL. At 2 mg/mL: 2 mg = 100 units, 4 mg = 200 units (2 mL).
  4. Label with date; refrigerate at 2–8 °C. Use within 28 days.

Supplies needed

12-week plan

  • 10 vials
  • 84 syringes
  • 25 mL bac water
  • 84 alcohol swabs
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Protocol overview & cycle notes

Reduce small fiber neuropathy pain, decrease systemic inflammation, and enhance tissue repair through ARA-290 subcutaneous injections activating the INNATE repair receptor (beta common receptor/CD131) without erythropoietic side effects.

Cycle length: 12 weeks on.

Off-cycle: 8 weeks off; reassess neuropathic pain scores before resuming.

Storage & handling

Lyophilized: store at -20 °C for maximum stability. Reconstituted at 2 mg/mL: refrigerate 2–8 °C; use within 14 days (ARA-290 has limited aqueous stability). Protect from light.

Injection & tracking tips

  • Inject subcutaneously (abdomen or thigh) in the morning — ARA-290 does not cause sedation and can be taken before daily activities.
  • ARA-290 does not stimulate erythropoiesis or increase hematocrit — it is specifically engineered to activate tissue-protective (INNATE) receptors without erythropoietic effect.
  • For neuropathic pain: may take 4–6 weeks to show significant pain reduction as nerve repair mechanisms require time for structural changes.

Tracking

Logging helps you and your provider spot patterns and adjust dose or timing.

  • Rate neuropathic pain using NRS (numeric rating scale 0–10) or DN4 neuropathic pain questionnaire weekly.
  • Track small fiber nerve function (corneal confocal microscopy if available, or quantitative sensory testing) at baseline and 12 weeks.
  • Monitor HbA1c if diabetic — ARA-290 enhances insulin secretion and may require diabetes medication adjustment.
Log your cycle in the calculator →

How this works & references

ARA-290 (cibinetide, Araim Pharmaceuticals) is a 11-amino acid non-erythropoietic peptide derived from the helix B region of erythropoietin (EPO). While standard EPO binds the homodimeric EPOR to drive erythropoiesis, ARA-290 specifically binds the heterodimeric INNATE repair receptor (IRR, composed of beta common receptor/CD131 + EPOR). IRR activation drives anti-inflammatory, anti-apoptotic, and tissue repair signaling without stimulating red blood cell production. Dahan et al. (2013, Mol Med) demonstrated: in a Phase 2 RCT of sarcoidosis-related small fiber neuropathy (n=40), ARA-290 4 mg daily for 28 days significantly improved corneal nerve fiber density (+29%), reduced neuropathic pain (NRS -2.1 vs. -0.3 placebo), and improved sleep. ARA-290 also enhances pancreatic beta-cell insulin secretion via IRR on islets.

Sources

Frequently asked questions

Is ARA-290 safe compared to EPO?
ARA-290 is specifically designed to avoid the risks of erythropoiesis-stimulating agents (ESAs like EPO): (1) No increase in hematocrit or thrombosis risk; (2) No stimulation of tumor growth via EPOR homodimer (controversial for EPO); (3) No blood doping potential. ARA-290 activates only the heterodimeric INNATE repair receptor, not the classical EPOR homodimer.
What types of neuropathic pain respond to ARA-290?
Dahan et al. demonstrated efficacy specifically in sarcoidosis-associated small fiber neuropathy (burning, numbness, tingling in extremities). ARA-290 is also being studied for: (1) Diabetic peripheral neuropathy; (2) Chemotherapy-induced neuropathy; (3) Multiple sclerosis neuropathic pain. All share small fiber nerve damage as a common pathology.
How does ARA-290 improve insulin secretion?
Pancreatic beta cells express the INNATE repair receptor (beta common receptor/CD131). ARA-290 binding to beta-cell IRR activates insulin secretion pathways via PI3K-Akt signaling, independent of glucose. In mouse diabetes models, ARA-290 protected islet survival and enhanced glucose-stimulated insulin secretion. Clinical implications for type 1 (islet preservation) and type 2 diabetes are under investigation.
What is the Phase 2 corneal confocal finding significance?
Corneal confocal microscopy measures the density of small corneal nerve fibers (unmyelinated C-fibers) — a validated surrogate for systemic small fiber nerve density. The +29% increase in corneal nerve fiber density after 28 days of ARA-290 (Dahan et al.) represents measurable nerve fiber regeneration — not just pain relief but actual structural nerve repair.
Is ARA-290 on the WADA prohibited list?
ARA-290 does not stimulate erythropoiesis, so it does not carry EPO-class doping concerns. It is not currently on the WADA Prohibited List (2026 edition). Athletes should verify with their national anti-doping organization as novel peptides may be monitored or added as awareness grows.

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This content is for informational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any peptide therapy. Dosing and protocols may vary by formulation and prescriber.

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