ARA-290 Dosage: 4mg/Day Trial Protocol

Published Phase 2 trials used 4 mg of ARA-290 subcutaneously once daily for 28 days — the dose that produced the strongest small-nerve-fiber response in a dose-ranging study comparing 1 mg, 4 mg, and 8 mg. Below is the reconstitution math, syringe-unit conversions, and where the 4 mg figure comes from.

Research-context information only. ARA-290 (cibinetide) is an investigational drug not approved by the FDA. Protocols, doses, and reactions reported below come from published clinical trials and self-reported community sources. This article reports what has been documented, not what should be done. Possession or use of investigational drugs outside an authorized clinical trial may be illegal in your jurisdiction. Consult a licensed physician for personal medical decisions.

ARA-290 is an 11-amino-acid, EPO-derived peptide that activates the innate repair receptor to drive anti-inflammatory and tissue-protective signaling. Below: the trial-documented dose, reconstitution math, and the dose-ranging evidence that singled out 4 mg.

Quick Reference: Trial Protocol

The 4 mg/day figure is the dose used in the Phase 2 sarcoidosis and type 2 diabetes trials. For the full ARA-290 profile and vendor pricing, see our ARA-290 peptide page.

Cycling Details

The published trials ran ARA 290 as a single 28-day daily course rather than an on/off cycle. In the sarcoidosis study, investigators continued measuring symptom and corneal-nerve outcomes through 16 weeks after the start of dosing, and reported that several improvements persisted after the 28-day course ended (Dahan et al., 2013). There is no established long-term maintenance schedule in the trial literature.

Routes of Administration

Subcutaneous injection is the only route described in the ARA-290 trial literature.

• Sites: Trial protocols used abdominal and thigh subcutaneous fat; community sources also describe upper-arm placement.
• Volume: At the 10 mg/mL standard dilution, the 4 mg trial dose draws as 0.4 mL.
• Rotation: Trial protocols describe rotating injection sites

Reconstitution Quick Reference

Math: 10 mg / 1 mL = 10 mg/mL. For 4 mg: 4 / 10 = 0.4 mL = 40 units on a 100-unit insulin syringe.

Published handling protocols describe gentle swirling (not shaking). Refrigeration at 2–8 °C and use within 28 days is standard per the trial product-handling literature. For the full step-by-step walkthrough and vial-size comparisons, see the ARA-290 Reconstitution Guide.

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Where These Numbers Come From

The 4 mg/day dose is not a community estimate — it is the dose carried through the published Phase 2 program.

Dose-ranging sarcoidosis trial: A double-blind, placebo-controlled study compared 1 mg, 4 mg, and 8 mg daily subcutaneous cibinetide for 28 days in patients with painful sarcoid small-fiber neuropathy. The 4 mg dose produced the largest placebo-corrected increase in corneal nerve fiber area, with regenerating skin nerve fibers also increasing significantly at that dose (Culver et al., 2017).

Type 2 diabetes trial: A separate placebo-controlled study administered 4 mg ARA 290 daily for 28 days and reported improvements in HbA1c, lipid profile, and neuropathic symptom scores, with no safety signals (Brines et al., 2015).

Why 4 mg and not 8 mg: In the dose-ranging data, the 4 mg arm — not the higher 8 mg arm — showed the strongest nerve-fiber response, which is why 4 mg is the dose most often referenced for ARA-290.

Stacking Protocols

The ARA-290 trial literature studied the peptide as a single agent, not as part of a stack, so there are no trial-documented combinations.

Community sources occasionally describe pairing ARA-290 with other repair-focused peptides, but no controlled data supports any specific combination.

Side Effects & Safety

• Injection-site reactions — the most commonly noted event in trials (mild redness or irritation)
• No significant safety issues were reported for any treatment group across the Phase 2 sarcoidosis and diabetes trials
• No change in hematocrit — ARA-290 was engineered to skip EPO's red-blood-cell-stimulating effect, and trials reported no meaningful rise in red cell mass
• Limited long-term data — published exposure is largely confined to 28-day courses

mg to Units Conversion

On a standard 100-unit insulin syringe, each "unit" equals 0.01 mL (100 units = 1 mL). The conversion from the 4 mg trial dose to syringe units depends on the chosen dilution.

Reconstitution A: 10 mg vial + 1 mL BAC water (10 mg/mL) — the standard dilution that keeps the 4 mg draw at a measurable 40 units.

Reconstitution B: 10 mg vial + 2 mL BAC water (5 mg/mL) — more dilute, so the same doses draw at larger, easier-to-read volumes; the 4 mg dose lands at 80 units (the full syringe).

These conversions reflect the dilutions documented in published reconstitution math and community sources. They report how the math is described, not a recommended dosing schedule.