“I noticed fewer of those sharp twinges in my foot after starting ARA-290.”

ARA-290 (Injectable)
Nerve & neuropathy support
All-in monthly price
No membership fee · this is the full price · free shipping · avg 4-week supply
Add in-depth bloodwork
Optional — add a physician-reviewed at-home blood panel to your plan.
Your sex-hormone baseline plus the safety markers that matter on therapy — blood counts, liver and kidney function — from one painless upper-arm device. Matched to your sex (PSA for men; progesterone & FSH for women). No needle, no clinic, physician-reviewed.
This treatment requires licensed provider review and approval. Treatment is not guaranteed. If prescribed, medication is fulfilled by a licensed U.S. pharmacy where permitted by law. Compounded medications are not FDA-approved or FDA-cleared.

Reviewed by Dr. Gene, MD · Board-certified Family Medicine
Every Pepti prescription is reviewed by a licensed U.S. physician before it's dispensed — and only provided if clinically appropriate.
FDA status: Compounded medication, not FDA-approved. No FDA-approved drug contains it. Status of every medication
What patients say about ARA-290
“I made it through my shift without taking as many breaks to sit down.”
“My evening walks started feeling doable again.”
“Getting out of bed felt easier, especially on colder mornings.”
ARA-290 (Injectable)
ARA-290 is a peptide made from a fragment of erythropoietin, the hormone that protects tissue, and is studied for burning, tingling and numbness from damaged small nerve fibers. It works on the body's repair pathway rather than dulling pain. Compounded; not FDA-approved.
About a 4-week supply supply at the standard prescribed dose — your physician confirms exact dosing.
A licensed US physician reviews your intake and prescribes when appropriate.
Compounded fresh at a US pharmacy and shipped cold-chain to your door.
Every order ships free — medication, physician care and refills, one all-in price.
Amounts shown are per unit. Compounded fresh at a US FDA-registered pharmacy.
Every batch independently tested
Every medication batch dispensed through Pepti is independently tested by a qualified third-party laboratory for applicable quality and safety standards before the pharmacy releases it. Batches are tested to the same standard used by 503B outsourcing facilities.
Confirms the finished preparation is free of viable microorganisms.
Screens for endotoxins that can cause fever or inflammatory reactions.
Verifies the labeled concentration of the active peptide is what is in the vial.
- Lot 110226-ARA-2
Tested 2026-11-04 · Biolink Life Sciences Carolinas
Sterility
Sterile
Endotoxin
<2 EU/mL
Potency
98.4%
- Lot 102626-ARA-2
Tested 2026-10-28 · Biolink Life Sciences Carolinas
Sterility
Sterile
Endotoxin
<2 EU/mL
Potency
98.3%
- Lot 101926-ARA-2
Tested 2026-10-21 · Biolink Life Sciences Carolinas
Sterility
Sterile
Endotoxin
<2 EU/mL
Potency
98.7%
How ARA-290 is prescribed.
- Adults with burning, tingling or numb feet and hands their physician has evaluated
- People with nerve symptoms tied to diabetes, prediabetes or an autoimmune condition
- Patients who want a repair-focused option instead of, or alongside, pain medication
- Someone who tried standard nerve medications and did not tolerate the side effects
Your physician decides whether ARA-290 is appropriate for you after reviewing your intake and labs.
Inject 0.25 mL (25 units) subcutaneously once daily Monday through Friday.
- Licensed physician review of your intake, history, and labs
- Medication compounded to your prescription by a PCAB-accredited, FDA-registered pharmacy
- Every batch independently tested before release
- Sterile syringes and alcohol prep pads for injectables
- Tracked delivery to your door, refills on schedule
- Message your physician anytime; dose changes without an appointment
- Store refrigerated (36–46°F / 2–8°C) at all times, including before first use.
- One vial is your monthly supply. A fresh vial ships every 28 days on your refill schedule, so you're always well inside the beyond-use date on your label.
- Protect from light. Wipe the stopper with an alcohol pad before every draw.
- Dispose of syringes in the sharps container per the included instructions.
A typical course of ARA-290.
Everything published
about ARA-290.
How it is described to work, pathway by pathway. What the research shows and what it does not. Where it stands with the FDA, dated and sourced.
Read the referencepeer-reviewed, each verified on PubMed
mechanism, evidence, dosing, safety, FAQ
2026 · checked against fda.gov, not memory
How ARA-290 works, and what the research shows.
ARA-290 switches on the body's tissue-repair receptor, the same one erythropoietin uses to protect cells after injury.
Unlike erythropoietin it does not raise red blood cell counts, so it is studied purely for repair, especially of the small nerve fibers behind burning and tingling pain.
Two mid-stage trials in people with small-fiber nerve damage from sarcoidosis reported less neuropathic pain and regrowth of nerve fibers measured in the eye.
Heij and colleagues 2012, Dahan and colleagues 2013Larger late-stage trials have not been completed.
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
- 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) · PMID 32674280
- Muller C, Yassin K, Li LS et al.. ARA290 Improves Insulin Release and Glucose Tolerance in Type 2 Diabetic Goto-Kakizaki Rats · Mol Med (2016) · PMID 26736179
Citations are provided for educational purposes. They do not constitute medical advice. Always discuss any peptide protocol with your prescribing physician.
Important safety information
+
Possible side effects
Do not use if you have
If you experience severe side effects, call 911 or go to your nearest emergency room.
vial — Ara-290 10mg/5mL 2mg/mL (5mL)
Frequently asked
about ARA-290 (Injectable).
ARA-290 is a peptide made from a fragment of erythropoietin, the hormone that protects tissue, and is studied for burning, tingling and numbness from damaged small nerve fibers. It works on the body's repair pathway rather than dulling pain. Compounded; not FDA-approved. ARA-290 is prescription-only at Pepti: a licensed physician reviews your assessment and, if appropriate, prescribes it to be compounded by a state-licensed, FDA-registered pharmacy.
ARA-290 is $219 per month at Pepti. That is all-in: medication, physician review and ongoing care, shipping, and messaging. No membership, consult, or visit fees, and the price is the same in every state.
ARA-290 is commonly prescribed for: Adults with burning, tingling or numb feet and hands their physician has evaluated; People with nerve symptoms tied to diabetes, prediabetes or an autoimmune condition; Patients who want a repair-focused option instead of, or alongside, pain medication; Someone who tried standard nerve medications and did not tolerate the side effects. Whether it is appropriate for you is decided by the reviewing physician from your history, medications, and labs where required.
Yes. ARA-290 is prescription-only. The free online assessment takes about five minutes, a physician licensed in your state reviews it within 4 hours, and if approved the prescription goes to the pharmacy. If not approved, the medication charge is refunded.
No. ARA-290 can be prescribed from the assessment alone. If your physician wants labs for your care, they'll ask through your account; upload a recent lab report from any lab at no charge, or order Pepti's at-home panel.
ARA-290 is a subcutaneous injection into the abdomen or thigh with a small insulin syringe. Your kit ships with sterile syringes and alcohol prep pads, and the exact dose and schedule are printed on the pharmacy label. Dosing videos are in your account.
33 more questions about Pepti, answered.Show fewer
One vial is your monthly supply at the dose your physician prescribes. A fresh vial ships about every 28 days, and the date moves if your physician changes your dose. Store it as the pharmacy label directs, refrigerated.
Once per fill, $219 each time, when the next vial ships. It renews until you cancel, which you can do anytime from your account with no cancellation fee.
The compounded ARA-290 with sterile syringes and alcohol prep pads, free tracked shipping in an unbranded box with insulated packaging, the physician review, ongoing physician care and dose adjustments, and unlimited messaging.
Reported side effects of ARA-290 are usually mild: mild redness or swelling at injection site; temporary fatigue or headache; mild nausea (uncommon). The physician screens your history, medications, and allergies before prescribing, the medication-specific consent lists the known risks, and you can message your physician about anything you notice. Seek emergency care for severe symptoms.
Response varies by person, goal, and dose, and ARA-290 is prescribed for ongoing use rather than a short trial. Your physician sets expectations at approval, tracks how you respond through your account, and adjusts the dose without an appointment.
Yes. Request it from your account or the app; your physician approves or declines. If approved you pay for the additional medication at the pharmacy's cost and the new dose applies to your next shipment.
Yes. Add ARA-290 to a plan with another treatment and both go through one assessment and one physician review, shipping together on one schedule. Each keeps its own catalog price. The physician reviews the combination and can adjust it.
No. Compounded ARA-290 is not FDA-approved. It is prepared to your physician's prescription by a state-licensed, FDA-registered 503A pharmacy and every batch is independently tested before release.
Yes, when prescribed by a licensed physician and dispensed by a licensed pharmacy, which is how Pepti provides it in every state it serves. Research-use-only ARA-290 sold without a prescription is labeled not for human use and is a different product.
ARA-290 switches on the body's tissue-repair receptor, the same one erythropoietin uses to protect cells after injury. At Pepti it is prescribed to support studied for nerve pain and tingling, supports the body's own repair signal, not an opioid, not a sedative, daily injection, monday to friday. Individual response varies, and your physician sets expectations at approval.
ARA-290 switches on the body's tissue-repair receptor, the same one erythropoietin uses to protect cells after injury. Unlike erythropoietin it does not raise red blood cell counts, so it is studied purely for repair, especially of the small nerve fibers behind burning and tingling pain. Compounded ARA-290 is not FDA-approved; it is prescribed off-label by a licensed physician after reviewing your assessment.
ARA-290 is prescribed for studied for nerve pain and tingling, supports the body's own repair signal, not an opioid, not a sedative, daily injection, monday to friday. It is commonly requested by adults with burning, tingling or numb feet and hands their physician has evaluated; people with nerve symptoms tied to diabetes, prediabetes or an autoimmune condition; patients who want a repair-focused option instead of, or alongside, pain medication; Someone who tried standard nerve medications and did not tolerate the side effects. Whether it is appropriate for you is the reviewing physician's decision.
ARA-290 is studied for studied for nerve pain and tingling, supports the body's own repair signal, not an opioid, not a sedative, daily injection, monday to friday. Those are the goals it is prescribed to support at Pepti; results vary by person, dose, and consistency, and no outcome is guaranteed. Your physician tracks how you respond through your account.
Two mid-stage trials in people with small-fiber nerve damage from sarcoidosis (Heij and colleagues 2012, Dahan and colleagues 2013) reported less neuropathic pain and regrowth of nerve fibers measured in the eye. Larger late-stage trials have not been completed. References are listed on this page.
ARA-290 is generally not prescribed with: active cancer or history of cancer (unless approved by oncologist); pregnancy or breastfeeding; severe kidney or liver disease; known allergy to the peptide or excipients. The physician screens for these in your intake, and anything that rules ARA-290 out means it is not prescribed and is refunded.
At Pepti. Complete the free assessment, a physician licensed in your state reviews it within 4 hours, and if appropriate ARA-290 is compounded by a state-licensed, FDA-registered pharmacy and shipped free to your door for $219 per month, all-in. Not prescribed means refunded.
Injectable vial: 5 mL at 2 mg/mL, containing 10 mg ARA-290. One vial is your monthly supply at the prescribed dose, and a fresh one ships about every 28 days.
Not currently. ARA-290 ships as a multi-dose vial with sterile syringes and prep pads. The pepti Pen is available for 24 other treatments.
$219 per month covers the compounded ARA-290, the physician review, ongoing physician care including dose adjustments and refill review, unlimited messaging, and free tracked shipping. There is no membership, consult, visit, or refill fee; the only separate charges are optional at-home lab panels and a physician-approved dose increase billed at pharmacy cost.
Yes. ARA-290 is on Pepti's live catalog, which lists only treatments a partner pharmacy can compound and ship today. If a physician prescribes it, it ships; if it ever cannot be dispensed, the charge is refunded.
ARA-290 ships to 49 states and Washington, D.C, free and tracked, in insulated unbranded packaging. Eligibility is confirmed during the assessment from your shipping address.
$219 per month at Pepti. That includes the compounded ARA-290, the physician review and ongoing care, free tracked shipping, and messaging, with no membership, consult, or visit fee. The price is the same in every state and every refill is the same price.
Pepti supplies ARA-290 as a monthly injectable vial with syringes and prep pads included, one vial per month at $219, prescribed by a licensed physician after a free online assessment and shipped free from a state-licensed, FDA-registered pharmacy in insulated packaging.
Yes. Pepti prescribes ARA-290 online in 49 states and Washington, D.C after a free assessment reviewed by a physician licensed in your state. It is compounded by an FDA-registered pharmacy and shipped free, $219 per month all-in. Not prescribed means refunded.
Yes. At Pepti the entire process is telehealth: a five-minute online assessment, physician review within 4 hours, then ARA-290 ships from the pharmacy. No clinic visit and no video appointment in most cases. $219 per month, all-in.
Yes, for the real thing. ARA-290 sold without a prescription is research-use-only product labeled not for human use, with no physician, no pharmacy, and no verified testing. Pepti's ARA-290 is physician-prescribed, pharmacy-compounded, batch-tested, and $219 per month including the physician and shipping.
Pepti does, in 49 states and Washington, D.C, with named board-certified physicians, a state-licensed FDA-registered compounding pharmacy, independent batch testing, and one published all-in price of $219 per month with no membership or consult fee. Refunded if the physician does not prescribe.
It is legal to be prescribed ARA-290 online by a licensed physician and have it dispensed by a licensed pharmacy, which is how Pepti provides it. Buying it as a research chemical without a prescription is a different product and is not for human use. Compounded ARA-290 is not FDA-approved.
$219 per month at Pepti, including the medication, the physician, and shipping. Refills are the same price and there is no membership fee.
Yes. Pepti has no clinics: the assessment, physician review, messaging, dose changes, and refills all happen online, and ARA-290 ships free from the pharmacy to your door in 49 states and Washington, D.C.
Start the free assessment at hellopepti.com, choose ARA-290, and answer the health questions. A physician licensed in your state reviews it within 4 hours. If approved, ARA-290 ships the next business day and arrives overnight; if not, the $219 is refunded.
No. ARA-290 can be prescribed from the assessment alone at Pepti. If your physician wants labs for your care, they'll ask through your account; upload a lab report from any lab, or order a Pepti at-home panel from $129.
Pepti ships ARA-290 to 49 states and Washington, D.C, free and tracked, refrigerated in insulated packaging, directly from the pharmacy. It ships the next business day and arrives overnight.
Questions people ask
about ARA-290 (Injectable).
- ARA-290: What It Is, Where to Get It Prescribed, and What It CostsARA-290 — vial — Ara-290 10mg/5mL 2mg/mL (5mL). Specification, mechanism, dosing, formats, state availability and how to get it prescribed.
- ARA-290 Dosage: How Pepti Prescribes the Peptide, in Units, mL and mgThe ARA-290 (cibinetide) dosage Pepti prescribes: 0.25 mL (25 units on a U-100 insulin syringe) under the skin once daily Monday through Friday, 0.5 mg per dose, 20 doses per vial. Includes a units to mL to mg chart, how long a vial lasts, how the published trials were dosed and why that is not your dose, what changes the directions, and side effects.
- ARA-290 Side Effects: What the Cibinetide Trials Reported and What to Watch ForA practical reference to ARA-290 (cibinetide) side effects: what the phase 2 trials in sarcoidosis and type 2 diabetes reported, why it does not carry erythropoietin's blood-thickening risk, what prescribers see with the injection, the blood sugar precaution, when to get emergency care, and who should not take it.
- ARA-290 Benefits: What the Research Actually ShowsThe benefits claimed for the ARA-290 peptide (cibinetide), one at a time: small nerve fibre regrowth, neuropathy symptoms, pain, metabolic markers, inflammation, recovery and the eye, with what kind of study sits behind each, how strong it is, the side effects, FDA status and how Pepti supplies it.
- Can You Take ARA-290 With Tirzepatide or Semaglutide?ARA-290 (cibinetide) and tirzepatide act through unrelated receptors and no interaction is described, but nobody has studied them together. The blood sugar precaution that matters most, why glucose control comes first in diabetic neuropathy, the eye question, how the schedules fit, and what not to combine.
- How Long Does ARA-290 Take to Work? What the Trials Measured, and WhenThe ARA-290 (cibinetide) human trials measured outcomes at 28 days, with one twelve-week study and one single-dose study. This page sets out what each trial measured and over what period, why nothing was measured in the first weeks, why nerve fibre regrowth is slow, and why no trial gives a personal timeline.
- Do You Need a Prescription for ARA-290? Is It Legal to Buy Online?Yes: ARA-290 (cibinetide) for human use is a prescription medication in the US. What FDA Category 3 means and does not mean, why research ARA-290 is a different product, the anti-doping position, and what a lawful prescription looks like.
- Best Place to Get ARA-290 Online: How to Choose a Provider, and What Pepti OffersWhere to get ARA-290 (cibinetide) prescribed online: a checklist for choosing a provider, the red flags specific to this peptide, and exactly what Pepti's ARA-290 prescription includes and costs.
- How to Get ARA-290 Prescribed Online: The Steps, What the Intake Asks, and What ArrivesThe step-by-step route to an ARA-290 (cibinetide) prescription through telehealth: the assessment, the medical intake, physician review, compounding, refrigerated shipping, refills and cost.
- ARA-290 for Women: What the Research Has Looked At, and What It Is NotWhat research has studied about ARA-290 (cibinetide) and what it means for women: small phase 2 trials in sarcoidosis and type 2 diabetes neuropathy that did not report women separately, pregnancy, breastfeeding and conception, the testable causes of nerve symptoms to check first, hormone therapy, side effects, and how to get it prescribed.
- ARA-290 for Men: What the Research Has Looked At, and What It Is NotWhat research has studied about ARA-290 (cibinetide) and what it means for men: small phase 2 trials in sarcoidosis and type 2 diabetes neuropathy that did not report men separately, why it is not EPO, not a testosterone booster and not a recovery peptide, using it alongside TRT, tested sport, what men should rule out first, and how to get it prescribed.
- Is ARA-290 Banned in Sports? Anti-Doping Status, the EPO Question and Drug TestsARA-290 (cibinetide) is named as a prohibited peptide in the anti-doping literature and detection methods have been published. Why it is prohibited even though it does not raise red cell counts, how the S0 catch-all and the NCAA's related-substance rule work, why a prescription does not help, and why a workplace drug screen does not look for it.
- Peptides for Healing: What Is Actually Prescribed, How Each One Works, and What It CostsA complete guide to the peptides used for healing and recovery: what each contains, what it does at which stage of repair, how they are dosed, what they cost, and when a peptide is the wrong tool.
- How Much Do Peptides Cost? Real Monthly Prices and What Drives ThemWhat prescription peptides actually cost per month, why single molecules price differently from four-peptide blends, which costs providers hide behind a low headline, and how to compare.
- Where to Get Peptides for Injury Recovery Online: How to Choose a ProviderBPC-157, TB-500 and the repair blends are prescription-only. Where to get them online, what an injury-specific provider should screen for before prescribing, the checklist for choosing one, and what Pepti offers.
- How Much Does ARA-290 Cost?ARA-290 cost in 2026: $219 per month all-in at Pepti — compounded medication, physician review, and shipping included. No membership or consult fees.
- Best Peptides for Recovery and HealingGHK-Cu for recovery and tissue repair — how it works, dosing, and what the evidence shows. Doctor-prescribed protocols for tendon, ligament, gut, and soft-tissue repair.
Read more about ARA-290 (Injectable).
Best Place to Get ARA-290 Online: How to Choose a Provider, and What Pepti Offers
Where to get ARA-290 (cibinetide) prescribed online: a checklist for choosing a provider, the red flags specific to this peptide, and exactly what Pepti's ARA-290 prescription includes and costs.
ARA-290: What It Is, Where to Get It Prescribed, and What It Costs
ARA-290 — vial — Ara-290 10mg/5mL 2mg/mL (5mL). Specification, mechanism, dosing, formats, state availability and how to get it prescribed.
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