ARA-290
Category
Healing & Recovery
Frequency
Daily
Research
Phase 2 Clinical Trials
What is ARA-290
ARA-290 (also known as Cibinetide) is a cyclic peptide derived from the innate repair receptor-binding region of erythropoietin (EPO). It is designed to activate the tissue-protective receptor (innate repair receptor) without the erythropoiesis (red blood cell production) effects of full EPO — capturing EPO's protective benefits without the risk of blood thickening. Browse the full peptide library for related healing compounds.
ARA-290 was developed specifically for neuropathic pain and peripheral nerve repair. For general tissue healing, consider combining with BPC-157. Phase 2 clinical trials in patients with sarcoidosis-related neuropathy demonstrated significant reductions in neuropathic pain and improvements in nerve fiber density — meaning it actually regenerated damaged nerve fibers.
This makes ARA-290 unique — it is one of the only compounds with clinical evidence for actual peripheral nerve regeneration, not just pain management. It's used by users with diabetic neuropathy, chemotherapy-induced neuropathy, nerve injuries, and chronic neuropathic pain conditions.
How it works
Innate Repair Receptor Activation: ARA-290 binds to the tissue-protective (innate repair) receptor, which is separate from the EPO receptor responsible for red blood cell production. This activates repair and anti-inflammatory pathways in neurons and other tissues.
Neurotrophic Factor Upregulation: ARA-290 increases expression of BDNF, NGF, and other neurotrophic factors that support nerve survival and regeneration.
Anti-Apoptotic Signaling: ARA-290 activates JAK2/STAT3 and PI3K/Akt pathways, which protect neurons from programmed cell death.
On the ground in the Philippines
ARA-290 (cibinetide) was developed by Araim Pharmaceuticals and is not registered with FDA Philippines. There is no licensed prescribing pathway here. The clinical evidence base — Brines and Cerami's sarcoidosis neuropathy trials, Heij and Niesters at Leiden — supports use for small fiber neuropathy and diabetic neuropathic pain, which is why it surfaces in BGC chronic-pain and diabetic-management circles even though it sits well outside the standard Manila neurology toolkit.
The Philippines has a real diabetic neuropathy burden — Department of Health diabetes prevalence sits around 6–7% nationally with significant under-diagnosis, and a meaningful subset of those patients carry small fiber neuropathy that gabapentin and pregabalin only partially manage. ARA-290 is not a substitute for endocrine care at Makati Med or St. Luke's BGC, but I've heard it discussed in BGC biohacker circles as an adjunct for people whose EMG/NCV studies came back normal but whose burning, tingling, and night pain are real.
The 4mg daily dose is large by peptide standards. Reconstitution math matters: a 4mg vial reconstituted in 1mL BAC water gives you 100 units on a U-100 syringe. Storage in Manila heat is critical — refrigerate at 2–8°C, never let it ride at room temperature, and discard at 14 days reconstituted. Skin and Cancer Foundation in Makati and BGC compounding pharmacies can supply the BAC water and the 31g insulin syringes; the peptide itself is research-import only.
Hospitals · prescription routes
- Makati Medical CenterMakatiNeurology, EMG/NCV studies, diabetic foot clinic. No ARA-290 prescribing.
- St. Luke's BGCBGCNeurology and pain medicine; runs small fiber assessment and skin biopsy for nerve fiber density.
- The Medical CityPasigNeurology and endocrine; comprehensive diabetic neuropathy workup.
Pharmacies · branches with confirmed stock
- Mercury DrugNationwideDoes not stock ARA-290. Carries gabapentin and pregabalin (Rx).
- WatsonsNationwideDoes not stock ARA-290. Carries OTC topical capsaicin.
Real PH pricing · observed
- ARA-290 4mg vial (research-grade)₱5,500–7,500$98–134International peptide suppliers, shipped to Manila
- BAC water 30mL₱350–500$6–9Manila compounding pharmacies
- Insulin syringes 31g (box of 100)₱650–900$12–16Mercury Drug, Watsons
- EMG/NCV study (per limb)₱4,500–6,500$80–116Makati Med, St. Luke's BGC
- HbA1c lab₱650–950$12–17Hi-Precision, Makati Med outpatient
Customs · Import reality
ARA-290 ships into Manila as research peptide under personal-import volumes. Single-vial parcels through Singapore or Hong Kong forwarders typically clear BOC without intervention. The 4mg dose burns through vials fast, so most users on a Brines-protocol-style 28-day course budget 1 vial per day with a small reserve — that's a real cold-chain logistics problem in Manila summer, not a regulatory one.
Reported benefits
- 01Peripheral nerve regeneration (clinical evidence)
- 02Significant neuropathic pain reduction
- 03Diabetic neuropathy treatment
- 04Systemic anti-inflammatory effects
- 05Organ protection (heart, kidney)
- 06Improved insulin sensitivity
- 07Metabolic benefits in diabetic models
Dosing protocol
| Phase | Dose | Frequency | Duration |
|---|---|---|---|
| Neuropathy Protocol | 4mg | Once daily SC | 4–8 weeks |
| Pain Management | 2–4mg | Once daily | Ongoing as needed |
Always start at the lowest effective dose and titrate up gradually.
Side effects
Common
- Injection site reactions
- Mild headache
- Fatigue in first week
Rare
- ·Dizziness
- ·Elevated blood pressure (monitor)
Who should not use ARA-290
What to expect
Week 1–2
Some users report early pain reduction. Nerve regeneration begins but is not yet felt.
Week 3–6
Significant pain reduction in most users. Tingling and burning sensations decrease.
Month 2–3
Clinical trials showed maximum nerve fiber density improvements at 8 weeks. Sustained pain relief.
Month 3+
Long-term maintenance dosing may be needed for chronic conditions. Nerve regeneration continues.
FAQ
Is ARA-290 the same as EPO (erythropoietin)?
No. ARA-290 is derived from a small region of the EPO molecule and specifically activates only the tissue-protective receptor. It does NOT stimulate red blood cell production or carry EPO's blood-thickening risks.
Can ARA-290 help with diabetic neuropathy?
Yes — this is one of its primary studied applications. Phase 2 trials showed significant improvements in both small fiber neuropathy symptoms and actual nerve fiber density in diabetic patients. Source from the community-verified supplier list.
Where to get ARA-290 in the Philippines
See our community-verified supplier list with COA verification and cold-chain shipping to the Philippines.
Primary sources
Citations supporting the clinical claims on this page. Each entry links to the primary record.
- [01]
Tissue-protective EPO-derived peptides — Brines 2008
MechanismBrines M, Patel NSA, Villa P, et al. "Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin." PNAS 2008;105(31):10925–10930.
DOI: 10.1073/pnas.0805594105 - [02]
Sarcoidosis small-fiber neuropathy trial — Heij 2012
TrialHeij L, Niesters M, Swartjes M, et al. "Safety and efficacy of ARA 290 in sarcoidosis patients with symptoms of small fiber neuropathy." Mol Med 2012;18(1):1430–1436.
DOI: 10.2119/molmed.2012.00332 - [03]
Type 2 diabetes neuropathy trial — Brines 2015
TrialBrines M, Dunne AN, van Velzen 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.
DOI: 10.2119/molmed.2014.00215 - [04]
ARA-290 in sarcoidosis-induced chronic neuropathic pain — Niesters 2013
ReviewNiesters M, Swartjes M, Heij L, et al. "The erythropoietin analog ARA 290 for treatment of sarcoidosis-induced chronic neuropathic pain." Expert Opin Orphan Drugs 2013;1(1):77–87.
DOI: 10.1517/21678707.2013.719289 - [05]
FDA Philippines drug registry — ARA-290 not listed
ReferenceFDA Philippines Registered Drug Products Database. Verified 2026-05-07: ARA-290 / cibinetide has no Philippine drug registration; available only as research-grade peptide.
Source
Risk · Disclosure · Editorial Status
This page is editorial information for adults researching peptide therapy. It is not medical advice, not a prescription, and not an endorsement of any specific product, supplier, or protocol. Side effects can be serious and individual response varies. Talk to a licensed physician — ideally one with peptide-specific clinical experience — before starting any compound, adjusting a dose, or discontinuing therapy.
In the Philippines, GLP-1 medications are prescription-only under FDA Philippines regulation. Research-grade peptides occupy a regulatory gray area: import for personal research use is generally tolerated, but the Bureau of Customs reserves the right to inspect and detain shipments. Do not import for resale.
Editorial Status
Independent · Non-clinical
Affiliation
Not a clinic · Not a pharmacy
Last Updated
May 7, 2026
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