Recovery · Reference
How to Get ARA-290 Prescribed Online: The Steps, What the Intake Asks, and What Arrives
If you are still deciding which provider to use, best place to get ARA-290 online has the checklist. This page is the process itself, from the first question to the first refill.
Treatments mentioned
To get ARA-290 prescribed online, you complete a medical intake with a telehealth provider, a physician licensed in your state reviews it, and if ARA-290 is appropriate a licensed US 503A compounding pharmacy prepares the vial in your name and ships it refrigerated. At Pepti that starts with the free assessment, physician review usually happens within 24 hours, and the price is $219 a month all-in for a 5 mL vial holding 10 mg at 2 mg/mL. There is no in-person visit, and bloodwork is not required. Compounded ARA-290 is not FDA approved.
If you are still deciding which provider to use, best place to get ARA-290 online has the checklist. This page is the process itself, from the first question to the first refill.
How to Get ARA-290 Prescribed Online
The short answer
| Step | What happens | Typical timing |
|---|---|---|
| 1. Assessment | Free questions about what you are looking for | A few minutes |
| 2. Medical intake and checkout | Health history, medications, allergies and symptoms, plus checkout at the all-in price | Several minutes |
| 3. Physician review | A physician licensed in your state reads your file and may ask follow-up questions | Usually within 24 hours |
| 4. Prescription | If appropriate, written for your vial with your directions | After review |
| 5. Compounding | A PCAB-accredited, FDA-registered US 503A pharmacy prepares it | After the prescription |
| 6. Shipping | Refrigerated, with ice packs, syringes and alcohol prep pads | Ships after compounding |
| 7. Refills | Every 28 days, one vial per fill, until you cancel | Ongoing |
If ARA-290 is not right for you, your physician will tell you, and the consultation is refunded.
How to Get ARA-290 Prescribed Online
Before you start: is ARA-290 the right conversation?
ARA-290, also called cibinetide, is an eleven-amino-acid peptide built from the surface of erythropoietin. It was designed to keep the part described as tissue-protective and leave out the part that raises red blood cell counts. Its human trials were in two groups: people with sarcoidosis and small-fibre neuropathy, and people with type 2 diabetes and painful neuropathy. Those trials ran for four weeks and reported changes in neuropathy symptom questionnaires and corneal nerve fibre measures; pain-intensity scores did not clearly separate from placebo.
That shapes what the intake is for. A physician is weighing whether a peptide studied in nerve-fibre loss fits what you describe. Some honest cases where a different conversation may come first:
| If your situation is | A physician may first discuss |
|---|---|
| Neuropathy that has not been looked into | Testable causes such as B12, thyroid and glucose |
| A tendon, ligament or muscle injury | BPC-157 or the BPC-157 + TB-500 preparation |
| Systemic inflammation without nerve symptoms | KPV |
| Glucose and weight as the main drivers | Semaglutide or tirzepatide |
More on how ARA-290 compares is in KPV vs ARA-290 and thymosin alpha-1 vs ARA-290.
How to Get ARA-290 Prescribed Online
Step by step
Step 1: the free assessment
The assessment asks what you want help with. It is free and it goes to a physician licensed in your state. It is not a prescription, and finishing it does not commit you to anything.
Step 2: the medical intake
The intake is the step that makes this a prescription rather than a purchase. For ARA-290 expect questions about:
- Your nerve symptoms: where, what they feel like, how long, and whether they have been diagnosed.
- What has already been looked into, and what you have tried.
- Every medication you take. This matters more than usual for ARA-290: the 2015 diabetes trial reported changes in haemoglobin A1c, so anyone on insulin or other glucose-lowering medication should say so. That is a precaution drawn from trial data, not an established interaction.
- Allergies and existing conditions.
- Pregnancy or breastfeeding, where ARA-290 is not used because safety data is absent.
- Whether you are a tested athlete. ARA-290 is specifically named as a prohibited peptide in the anti-doping literature.
Checkout is one all-in price. There is no separate fee for the review, the pharmacy or shipping, and if the physician declines, the consultation is refunded.
Step 3: physician review
A physician licensed in your state reads your intake, usually within 24 hours. They may message you through your account with follow-up questions. If ARA-290 is not the right tool for what you described, they will tell you, and the consultation is refunded. A review that never says no is not a review.
Bloodwork is not required for any Pepti treatment. If your physician wants labs for your care, they'll ask through your account.
Step 4: the prescription
If ARA-290 is appropriate, the physician writes a prescription for the vial with your directions. Your physician sets your directions after reviewing your intake, and they are printed on the vial. The typical printed direction for this vial is:
On the label What it means Inject 0.25 mL (25 units) 25 units on a U-100 insulin syringe Subcutaneously Into the fat layer, usually abdomen or thigh, rotating sites Once daily Monday through Friday 20 doses per vial, about four weeks 10 mg / 5 mL, 2 mg/mL 0.25 mL contains 0.5 mg ARA-290 (math only) The weekday schedule is a prescribing pattern, not a trial design. Dosing detail is in ARA-290 dosage.
Step 5: compounding
A PCAB-accredited, FDA-registered US 503A compounding pharmacy prepares the vial to your prescription. A 503A pharmacy compounds for an identified individual patient, which is why your name is on the label. Lot test results are published at lab results.
Step 6: shipping and what is in the box
The vial ships refrigerated in insulated packaging with ice packs. It arrives as a multi-dose solution, ready to use, with directions printed on the vial, along with sterile syringes and alcohol prep pads. Put it in the refrigerator when it arrives. The beyond-use date is on the label and runs from first puncture. See how to store peptides and how to inject peptides safely.
Step 7: after it arrives, and refills
Your care team is reachable through your account for questions about injection technique, side effects or anything that does not look right. What the trials reported about tolerability, and when to message, is in ARA-290 side effects.
Refills run every 28 days, one vial per fill, which matches 20 weekday doses. Treatment is a subscription that continues until you cancel it. Pepti does not ship stockpiles of vials.
How to Get ARA-290 Prescribed Online
What it costs
| Line item | Included in $219 a month |
|---|---|
| ARA-290, 5 mL vial, 10 mg at 2 mg/mL | Yes |
| Physician review and prescription | Yes |
| Compounding by a licensed 503A pharmacy | Yes |
| Syringes and alcohol prep pads | Yes |
| Refrigerated shipping | Yes |
| Refill management and messaging your care team | Yes |
| Membership fee | None |
Pepti is cash-pay and does not bill insurance. Current details are on the ARA-290 product page.
How to Get ARA-290 Prescribed Online
Where ARA-290 stands legally
ARA-290 is a prescription drug. It has never been approved by the FDA as a finished drug. For compounding, cibinetide (ARA-290) sits in Category 3 of the FDA's list of substances nominated for the 503A bulks list, as of the 14 May 2026 update: the nomination did not include enough supporting information for the FDA to evaluate it. It is not on the Category 2 list of substances with identified safety concerns and was not reviewed by the Pharmacy Compounding Advisory Committee in July 2026. It is prescribed by physicians and compounded by licensed pharmacies to those prescriptions. Wider background is in are peptides legal in the US.
References
What this is based on.
References
- 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) · PMID 24136731
- 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) · PMID 23168581
- Brines M, Patel NS, Villa P et al.. Nonerythropoietic, tissue-protective peptides derived from the tertiary structure of erythropoietin · Proc Natl Acad Sci U S A (2008) · PMID 18676614
- Swartjes M, Morariu A, Niesters M et al.. ARA290, a peptide derived from the tertiary structure of erythropoietin, produces long-term relief of neuropathic pain: an experimental study in rats and β-common receptor knockout mice · Anesthesiology (2011) · PMID 21873879
- Swartjes M, van Velzen M, Niesters M et al.. ARA 290, a peptide derived from the tertiary structure of erythropoietin, produces long-term relief of neuropathic pain coupled with suppression of the spinal microglia response · Mol Pain (2014) · PMID 24529189
- van Velzen M, Heij L, Niesters M et al.. ARA 290 for treatment of small fiber neuropathy in sarcoidosis · Expert Opin Investig Drugs (2014) · PMID 24555851
- 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) · PMID 25387363
- 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) · PMID 26431906
- Dahan A, Brines M, Niesters M et al.. Targeting the innate repair receptor to treat neuropathy · Pain Rep (2016) · PMID 29392190
- 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) · PMID 28475703
- Thomas A, Knoop A, Schänzer W et al.. Characterization of in vitro generated metabolites of selected peptides <2 kDa prohibited in sports · Drug Test Anal (2017) · PMID 28941172
- Brines M, Culver DA, Ferdousi M et al.. Corneal nerve fiber size adds utility to the diagnosis and assessment of therapeutic response in patients with small fiber neuropathy · Sci Rep (2018) · PMID 29549285
Citations are provided for educational purposes. They do not constitute medical advice. Always discuss any peptide protocol with your prescribing physician.
Common questions
How to Get ARA-290 Prescribed Online, answered.
Complete a telehealth medical intake, have a physician licensed in your state review it, and if appropriate a licensed 503A pharmacy compounds and ships the vial. At Pepti, start with the free assessment.
At Pepti, physician review usually happens within 24 hours of a completed intake. Compounding and refrigerated shipping follow.
No. The review is done by a physician licensed in your state through telehealth.
Bloodwork is not required for any Pepti treatment. If your physician wants labs for your care, they'll ask through your account.
Everything the intake asks, especially every medication you take. If you use insulin or other glucose-lowering medication, say so, because one ARA-290 trial reported changes in haemoglobin A1c.
At Pepti, $219 a month all-in, covering medication, physician review, refill management and shipping. No membership fee, no insurance billing.
A refrigerated 5 mL multi-dose vial of ARA-290 at 2 mg/mL with your directions printed on it, sterile syringes and alcohol prep pads, packed with ice packs.
Every 28 days, one vial per fill, until you cancel.
If ARA-290 is not the right fit for what you describe, your physician will tell you. A declined consultation is refunded.
Pepti prescribes ARA-290 in every state except Oklahoma, plus DC.
No. Compounded medications are not FDA approved, and ARA-290 has not been approved by any regulator. The free assessment goes to a physician licensed in your state. A consultation does not guarantee a prescription.
Next step
See what a physician recommends for you.
A licensed physician in your state reviews your intake and decides what is appropriate. A consultation does not guarantee a prescription.