1. Draw 1.6 mL bacteriostatic water with a sterile syringe.
2. Inject slowly down the vial wall; avoid foaming.
3. Label with reconstitution date and refrigerate at 2 to 8 °C, protected from light. At 10 mg/mL, 1 unit =
4. 0.01 mL = 80 mcg on a U-100 insulin syringe.

Ara-290 (cibinetide) binds to the innate repair receptor (IRR), a heterodimer of EPOR and CD131 (bc subunit), which is distinct from the classical erythropoietin receptor. This selective binding triggers anti-apoptotic and anti-inflammatory signaling cascades that protect tissues and promote repair without stimulating erythropoiesis. Preclinical research demonstrates that Ara-290 can reprogram a pro-inflammatory, tissue-damaging environment into one favoring healing and regeneration. Additionally, analgesic effects have been observed through immunomodulation and direct inhibition of TRPV1 ion channels activated by capsaicin.

• Neuroprotection: Clinical trials in diabetic neuropathy showed improvements in HbA1c, lipid profiles,
  and neuropathic pain scores with 4 mg daily dosing.
• Nerve regeneration: In sarcoidosis-associated small-fiber neuropathy, treatment led to significant
  increases in corneal nerve fiber density and improved symptoms compared to placebo.
• Tissue protection: Anti-inflammatory and anti-apoptotic effects observed across multiple organ systems in preclinical models.
• No erythropoietic effects: Unlike full EPO, Ara-290 does not stimulate red blood cell production,
  avoiding related side effects.
• Tolerability: Well tolerated in clinical studies; occasional mild injection-site reactions (redness, transient discomfort) may occur with subcutaneous administration.