How much water do I add to a 16 mg ARA-290 (Cibinetide) vial?

There is no single correct amount: water changes how many units a dose is, not how many doses the vial holds. With 1 mL the vial is 16 mg/mL and 4.5 mg is 28 units (0.28 mL) on a U-100 insulin syringe. The units table gives 1, 2, 3 mL.

How many doses are in a 16 mg ARA-290 (Cibinetide) vial?

16 doses at 1 mg, 3 doses at 4.5 mg, 2 doses at 8 mg.

How long does a 16 mg ARA-290 (Cibinetide) vial last?

At 4.5 mg a dose and twice weekly to once daily, about 0.4-1.5 weeks. How long a mixed vial keeps is a separate limit; see storage below.

How many 16 mg vials do I need for a cycle?

1 vial at 1 mg 2 times a week for 4 weeks; 21 vials at 8 mg 7 times a week for 6 weeks.

What does 1 unit equal in a 16 mg ARA-290 (Cibinetide) vial?

160 mcg with 1 mL, 80 mcg with 2 mL, 53.33 mcg with 3 mL of bacteriostatic water, on a U-100 syringe.

Research use only · common protocol

ARA-290 (Cibinetide) 16 mg vial dosage

A 16 mg ARA-290 (Cibinetide) vial mixed with 1 mL of bacteriostatic water gives 16 mg/mL, so 4.5 mg is 28 units (0.28 mL) on a U-100 insulin syringe. At 4.5 mg a dose, one vial holds 3 doses.

Email me this plan, with a reminder before the vial's 28-day mark →

The common ARA-290 (Cibinetide) protocol is 1-8 mg, twice weekly to once daily, subcutaneous - a compounding pharmacy protocol titrates 2 mg toward 4 mg twice weekly, while the published phase 2b trial dosed 1, 4 or 8 mg once daily - common practice, not a dose established in trials. Evidence, side effects and legal status are on the full ARA-290 (Cibinetide) dosing page.

ARA-290 (Cibinetide) 16 mg vial at a glance

Vial: 16 mg of ARA-290 (Cibinetide) per vial
Common dose: 1-8 mg
How often: twice weekly to once daily, subcutaneous - a compounding pharmacy protocol titrates 2 mg toward 4 mg twice weekly, while the published phase 2b trial dosed 1, 4 or 8 mg once daily
Mixing example: 1 mL bacteriostatic water = 16 mg/mL; 1 unit = 160 mcg
Doses per vial: 16 at 1 mg · 3 at 4.5 mg · 2 at 8 mg
Cycle: 4-6 weeks

What ARA-290 (Cibinetide) is

Class:: Synthetic 11-amino-acid peptide, derived from erythropoietin Helix B
Also called:: Cibinetide, ARA290
Used for:: An investigational peptide developed by Araim Pharmaceuticals for neuropathic pain and inflammation-related conditions. Never reached FDA approval for any indication; now sold to consumers as a research chemical.
Human evidence:: Moderate human evidence. PubMed indexes cibinetide/ARA-290 under three publications tagged as the randomised-controlled-trial publication type, and four under the clinical-trial publication type generally (NCBI E-utilities query, run 24 September 2026). That confirms multiple published human randomised trials exist, and all four are now in my citation registry. In a 2012 double-blind pilot in 22 people with sarcoidosis and small-fibre neuropathy, neuropathy symptom scores improved more on ARA-290 than placebo, while pain-intensity and fatigue scores improved equally in both groups (Heij 2012). A 2013 placebo-controlled trial in sarcoidosis reported improved neuropathic symptoms and higher corneal nerve fibre density after 28 days of daily injections (Dahan 2013). A phase 2 trial in type 2 diabetes with painful neuropathy reported improved HbA1c, blood lipids and neuropathic symptoms after 28 days (Brines 2015). In a 2017 phase 2b trial of 64 people, only the 4 mg daily dose significantly increased corneal nerve fibre area, the primary endpoint, and pain improved in all groups, including placebo (Culver 2017). All four trials are small and short, and every patient trial traces to the same sponsor, Araim Pharmaceuticals, across a narrow set of orphan-designated indications, and none led to FDA approval or a marketed product.
US status:: Research use only. Not FDA-approved for any indication. The FDA Orphan Drug Product designation database (sponsor "Araim Pharmaceuticals, Inc.") lists four orphan designations for this undecapeptide, granted 2009-2016, covering neuropathic pain in sarcoidosis, sarcoidosis treatment generally, prevention of delayed graft function after renal transplant, and improved pancreatic islet survival after transplantation. Each carries an FDA Orphan Approval Status of "Not FDA Approved for Orphan Indication." Orphan designation is a development incentive, not an efficacy or safety finding. Cibinetide does not appear on FDA's list of bulk drug substances nominated for 503A/503B compounding, in either the category-2 or the withdrawn table, so FDA has not published the kind of safety-risk evaluation it has issued for peptides such as BPC-157 or KPV.

The full picture, with every study: ARA-290 (Cibinetide) guide.

Units per dose: ARA-290 (Cibinetide) 16 mg vial

Water added	Concentration	1 unit =	1 mg	4.5 mg	8 mg
1 mL	16 mg/mL	160 mcg	6.5 units	28 units	50 units
2 mL	8 mg/mL	80 mcg	12.5 units	56.5 units	100 units
3 mL	5.33 mg/mL	53.33 mcg	19 units	84.5 units	over 100 units

U-100 insulin syringe (100 units = 1 mL), to the nearest half unit. Water volumes are examples. Other numbers: dosage calculator.

Every dose from 1 mg to 8 mg, in units

With 1 mL of water in a 16 mg vial (16 mg/mL). Every dose across the common range, so you can read off any dose. The sources give a range, not a week-by-week schedule.

Dose	Draw on a U-100 syringe	Volume	Doses per vial
1 mg	6.5 units	0.065 mL	16
2 mg	12.5 units	0.125 mL	8
3 mg	19 units	0.19 mL	5
4 mg	25 units	0.25 mL	4
5 mg	31.5 units	0.315 mL	3
6 mg	37.5 units	0.375 mL	2
7 mg	44 units	0.44 mL	2
8 mg	50 units	0.5 mL	2

How many doses a 16 mg vial holds

Dose	Doses per vial	Weeks per vial
1 mg	16	2.3-8
4.5 mg	3	0.4-1.5
8 mg	2	0.3-1

Weeks per vial at the common frequency (twice weekly to once daily, subcutaneous - a compounding pharmacy protocol titrates 2 mg toward 4 mg twice weekly, while the published phase 2b trial dosed 1, 4 or 8 mg once daily). Doses per vial do not depend on how much water you add.

Email me my ARA-290 (Cibinetide) 16 mg vial plan

Pick your water volume and dose and I will email you the numbers for this vial - units, volume, doses per vial and how long it lasts - plus the mixing and storage steps, and a reminder before the mixed vial reaches 28 days.

The common ARA-290 (Cibinetide) protocol

Dose	1-8 mg per injection
How often	twice weekly to once daily, subcutaneous - a compounding pharmacy protocol titrates 2 mg toward 4 mg twice weekly, while the published phase 2b trial dosed 1, 4 or 8 mg once daily
Timing	Subcutaneous injection; sites rotated between abdomen, thigh and upper arm using insulin syringes, per the compounding pharmacy's protocol.
Route	Subcutaneous injection
Cycle	4-6 weeks
Break	No break length is stated consistently by the sources
Sources agree?	Partly - the sources differ, and the ranges above cover them

Common practice from the vendors and clinics that publish it, not a dose tested in trials. Where it comes from: [1], [2]. I do not give week-by-week titration: none of these sources states one.

Supplies for one cycle with 16 mg vials

Counted for the low and high ends of the common protocol, mixing each vial with 1 mL of water. One new syringe per injection.

Plan	Injections	16 mg vials	Insulin syringes	Bacteriostatic water	Alcohol swabs
1 mg, 2×/week, 4 weeks	8	1	8	1 mL (1 × 10 mL bottle)	18 (1 × 100-pack)
8 mg, 7×/week, 6 weeks	42	21	42	21 mL (3 × 10 mL bottles)	126 (2 × 100-pack)

Arithmetic on the protocol and this vial size. Swabs: two per vial mixed (both stoppers) and two per injection (vial stopper and skin). An opened multi-dose vial has a use-by date (see storage), which on a slow schedule can matter more than the dose count. Plan your own numbers with the protocol builder.

How to mix a 16 mg ARA-290 (Cibinetide) vial

For this vial: 1 mL of bacteriostatic water makes 16 mg/mL, so 4.5 mg is 28 units (0.28 mL) on a U-100 insulin syringe. Pick a different volume from the units table if you want bigger or smaller draws; the number of doses stays the same.

Wipe the rubber stoppers of both the peptide vial and the bacteriostatic water vial with an alcohol swab and let the alcohol dry. ^[3][4]
With a new sterile needle and syringe, draw up the amount of bacteriostatic water you have chosen for the dilution. ^[3][4][5]
Inject the water into the peptide vial by aiming the stream against the inside glass wall, which helps prevent foaming. ^[6]
Swirl or roll the vial gently until the powder has fully dissolved; do not shake it. Do not inject the solution if it is cloudy or has particles in it. ^[3][4][6]
Label the vial with the date and time it was mixed, the amount of water added and how long it can be used after mixing. ^[3]
Store the mixed vial in the refrigerator at 2-8°C (36-46°F) and do not freeze it. ^[6]

Step by step with pictures: how to reconstitute peptides. About the water itself: bacteriostatic water.

Storing ARA-290 (Cibinetide) vials

Freeze-dried (lyophilized) peptide keeps far longer than peptide in solution; peptide suppliers advise storing the powder at -20°C away from bright light. ^[7]
Protect peptide vials from heat and light. ^[7][8]
Avoid repeated freeze-thaw cycles; a prescription peptide label also says not to freeze a vial once it has been mixed. ^[6][7]
Once a multi-dose vial, such as bacteriostatic water, has been opened (needle-punctured), date it and discard it within 28 days unless its manufacturer states another date. ^[9][10]

More detail: peptide storage and shelf life.

Injecting safely

Clean the injection site with an alcohol swab and let the skin dry completely before injecting. ^[11][12]
Pinch up a fold of skin and fat (not muscle) and insert the needle at a 45- to 90-degree angle: 90 degrees where there is enough fatty tissue, 45 degrees where there is little. ^[11][12][13]
Pulling back on the plunger (aspiration) is not necessary for a subcutaneous injection, because the chance of the needle being in a blood vessel is small. ^[11]
Inject slowly, at roughly 10 seconds per mL. ^[11]
Common sites are the belly, the thigh and the upper arm; rotate sites, keeping each injection at least 1 inch (2.5 cm) from the last. ^[6][11][12]

Hygiene and warning signs

Use a new sterile needle and syringe for every injection and every time you enter a vial; never reuse them. ^[5][9][12]
Never share needles, syringes or pens with anyone, even if the needle is changed; unsafe injection practices spread hepatitis B, hepatitis C and HIV. ^[5][8][9]
Put used needles and syringes in a sharps disposal container straight away (FDA-cleared if possible), never loose in the trash, recycling or toilet, and dispose of the container following your community's guidelines. ^[14][15]
Contact a health care provider if the injection site shows signs of infection, such as redness, swelling, red streaks or a fever. ^[12]

Where to inject: subcutaneous injection sites.

How ARA-290 (Cibinetide) works

ARA-290 (cibinetide) is an 11-amino-acid peptide modelled on the three-dimensional shape of one region of erythropoietin (EPO), the helix B surface, which is why it is also called pyroglutamate helix B surface peptide. ^[16]
Its developers describe two EPO receptors: a pair of EPO receptors that drives red blood cell production, and a combined EPO receptor and beta-common receptor, which they call the innate repair receptor, that appears after injury or inflammation and triggers tissue protection. ARA-290 was designed to activate only the second, so it does not stimulate red cell production. ^[16][17]
It clears from blood very quickly, with a plasma half-life of about 2 minutes, yet its developers report effects that last well beyond that in animal models and trials. ^[16]
The receptor model is disputed. An independent 2018 laboratory study found that the outer portions of the EPO receptor and the beta-common receptor did not specifically associate with each other, with or without EPO or ARA-290 present. ^[18]

What the ARA-290 (Cibinetide) research found

Human evidence: moderate human evidence. Each result says what was studied.

Human studyIn a 2012 double-blind pilot, 22 people with sarcoidosis and small-fibre neuropathy received ARA-290 intravenously three times a week or placebo for 4 weeks. Neuropathy symptom scores improved more on ARA-290, while average pain-intensity and fatigue scores improved equally in both groups. ^[19]
Human studyIn a 2013 blinded, placebo-controlled trial in sarcoidosis with small nerve fibre loss, 28 days of daily injections under the skin improved neuropathic symptoms and was linked to higher corneal nerve fibre density and a longer 6-minute walk distance. ^[20]
Human studyIn a 2017 phase 2b trial of 64 people with sarcoidosis-related small nerve fibre loss, only the 4 mg daily dose significantly increased corneal nerve fibre area, the primary endpoint; the 1 mg and 8 mg results were not significant. Pain improved in all groups, including placebo. ^[21]
Human studyIn a phase 2 trial in type 2 diabetes with painful neuropathy, people given 28 days of daily ARA-290 showed improved HbA1c, blood lipids and neuropathic symptom scores. ^[17]
Human studyIn a 2020 phase 2 study of 9 people with diabetic macular oedema taking cibinetide for 12 weeks, there was no improvement in visual acuity, retinal thickness, retinal sensitivity or tear production on average. ^[22]
Human studyIn a randomised, double-blind study of 36 healthy volunteers given ARA-290 or placebo and tested a week later, it had no effect on mood, and its effects on emotional processing did not clearly point to an antidepressant action. ^[23]

ARA-290 (Cibinetide) side effects and risks

The published trials are small and short (4 to 12 weeks), and their abstracts do not list adverse events by type, so these sources do not give a side-effect profile for ARA-290.

Human studyIn the 2012 sarcoidosis pilot (22 people, 4 weeks), clinical and laboratory checks raised no safety concerns. ^[19]
Human studyIn the phase 2 type 2 diabetes trial (28 days of treatment, then a month of follow-up), the authors identified no potential safety issues. ^[17]
Human studyIn the 12-week diabetic macular oedema study, no serious adverse events or reactions occurred and no one developed antibodies against cibinetide. ^[22]

Other things to know

Not FDA-approved for any use. Every patient trial came from a single sponsor's development programme, and none led to a marketed product or an approved orphan indication.
No established human half-life or dosing schedule exists in a source I could verify. A 2015 review co-written by the developer's scientists gives a plasma half-life of about 2 minutes, but its abstract does not say whether that figure was measured in people or animals, and I found no human pharmacokinetic study. Dosing intervals circulating online are not traceable to a source in my registry.
FDA has not evaluated cibinetide on its bulk drug substances safety-risk list, so none of the immunogenicity, impurity or characterisation findings published for other research peptides on this site exist for this one either way - absence of a finding is not a clean bill of health.
Sold as a research chemical outside any pharmacy or prescriber pathway, the same grey-market channel FDA has repeatedly warned carries dosing errors, counterfeit product and quality problems for other unapproved peptides.

Reported side effects and what the studies measured: ARA-290 (Cibinetide) side effects.

Where this vial size comes from

ARA-290 (Cibinetide) is sold as a 16 mg vial by the pages below, each checked on the date shown. I list them as evidence that this size exists, not as a recommendation to buy from them.

Next Level PharmvendorLists it as: Size dropdown options: 10mg / 16mg · checked 2026-09-28
SwissChemsvendorLists it as: "Cibinitide ARA-290 16mg" - 16mg per 1 vial · checked 2026-09-28

The doses come from the sourced common protocol on the ARA-290 (Cibinetide) dosing page, and every number on this page is arithmetic on those doses and this vial size.

Other ARA-290 (Cibinetide) vial sizes

10 mg vial
16 mg

Where to buy ARA-290 (Cibinetide) for research

Sold for research use only. Listed by Next Level Pharm and BioEdge Research Labs; compare them on my vendors page or see the listing on the ARA-290 (Cibinetide) page.

Questions

How much water do I add to a 16 mg ARA-290 (Cibinetide) vial?: There is no single correct amount: water changes how many units a dose is, not how many doses the vial holds. With 1 mL the vial is 16 mg/mL and 4.5 mg is 28 units (0.28 mL) on a U-100 insulin syringe. The units table gives 1, 2, 3 mL.
How many doses are in a 16 mg ARA-290 (Cibinetide) vial?: 16 doses at 1 mg, 3 doses at 4.5 mg, 2 doses at 8 mg.
How long does a 16 mg ARA-290 (Cibinetide) vial last?: At 4.5 mg a dose and twice weekly to once daily, about 0.4-1.5 weeks. How long a mixed vial keeps is a separate limit; see storage below.
How many 16 mg vials do I need for a cycle?: 1 vial at 1 mg 2 times a week for 4 weeks; 21 vials at 8 mg 7 times a week for 6 weeks.
What does 1 unit equal in a 16 mg ARA-290 (Cibinetide) vial?: 160 mcg with 1 mL, 80 mcg with 2 mL, 53.33 mcg with 3 mL of bacteriostatic water, on a U-100 syringe.

References (23 sources)

[1] Investigative Ophthalmology & Visual Science (ARVO Journals): Phase 2b RCT, cibinetide 1, 4 or 8 mg SC once daily for 28 days in sarcoid small-nerve-fiber-loss patients; 4 mg arm significant vs placebo for corneal nerve fiber area (publication, checked 2026-09-27)
[2] American Wellness Pharmacy: Licensed 503A compounding pharmacy protocol: SC 2 mg twice weekly (may escalate to 4 mg twice weekly), 10 mg vial reconstituted to 10 mg/mL, 4-6 weeks before reassessment, sites rotated abdomen/thigh/upper arm (clinic, checked 2026-09-27)
[3] OpenStax, Rice University: 12.3 Preparing Unit-Dose Packaged Medications - Clinical Nursing Skills
[4] East Carolina University College of Nursing: Reconstitution of Medication
[5] Centers for Disease Control and Prevention: Considerations for Blood Glucose Monitoring and Insulin Administration
[6] DailyMed, National Library of Medicine: SEROSTIM (somatropin) for injection - prescribing information and instructions for use
[7] GenScript: Peptide Storage and Handling Guidelines
[8] DailyMed, National Library of Medicine: OZEMPIC (semaglutide) injection - prescribing information
[9] Centers for Disease Control and Prevention: Preventing Unsafe Injection Practices
[10] Pfizer: Bacteriostatic Water for Injection, USP - prescribing information
[11] OpenStax, Rice University: 12.5 Administering Subcutaneous Injections - Clinical Nursing Skills
[12] MedlinePlus, National Library of Medicine: Subcutaneous (SQ) injections
[13] Centers for Disease Control and Prevention: Chapter 6: Vaccine Administration - Pink Book
[14] US Food and Drug Administration: Best Way to Get Rid of Used Needles and Other Sharps
[15] US Food and Drug Administration: DOs and DON'Ts of Proper Sharps Disposal
[16] Collino M, Thiemermann C, Cerami A et al. Flipping the molecular switch for innate protection and repair of tissues: Long-lasting effects of a non-erythropoietic small peptide engineered from erythropoietin. Pharmacol Ther. 2015;151:32-40.
[17] Brines 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):658-66.
[18] Cheung Tung Shing KS, Broughton SE, Nero TL et al. EPO does not promote interaction between the erythropoietin and beta-common receptors. Sci Rep. 2018;8(1):12457.
[19] Heij L, Niesters M, Swartjes M 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):1430-6.
[20] Dahan A, Dunne A, Swartjes M et al. ARA 290 improves symptoms in patients with sarcoidosis-associated small nerve fiber loss and increases corneal nerve fiber density. Mol Med. 2013;19(1):334-45.
[21] Culver DA, Dahan A, Bajorunas D 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.
[22] Lois N, Gardner E, McFarland M 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).
[23] Cerit H, Veer IM, Dahan A et al. Testing the antidepressant properties of the peptide ARA290 in a human neuropsychological model of drug action. Eur Neuropsychopharmacol. 2015;25(12):2289-99.