KirkleyCare • Clinician-Directed Client Guide

ARA-290 Protocol

A four-week stepped protocol followed by a four-week break.

This guide is specifically built around a 10 mg vial of ARA-290 / Cibinetide reconstituted with 1 mL of bacteriostatic water and administered subcutaneously according to the individualized KirkleyCare protocol below.

10 mg ARA-290 Vial
1 mL BAC Water
4 Weeks Active Phase
3 Vials Complete Course

Protocol Overview

Four weeks on • Four weeks off
Weeks 1–4

Active Phase

30 mg Total

Begin with two 1 mg doses, progress to 2 mg three times weekly, then transition to 2 mg Monday through Friday.

Weeks 5–8

Break Phase

4 Weeks Off

No scheduled ARA-290 during this phase. Response and ongoing treatment goals can be reassessed before another course is considered.

Reconstitution

One concentration throughout the entire protocol
10 mg ARA-290
+
1 mL BAC Water
=
10 mg/mL Final Concentration
The Number to Remember
1 syringe unit = 0.1 mg ARA-290
Initial Dose
1 mg Used for the first two doses Draw to 10 units
Protocol Dose
2 mg Used for the remainder of the active phase Draw to 20 units

Week-by-Week Schedule

Follow the progression shown below

Week 1 • Introduction

4 mg total
Monday 1 mg 10 units
Tuesday OFF
Wednesday 1 mg 10 units
Thursday OFF
Friday 2 mg 20 units

Week 2 • M / W / F

6 mg total
Monday 2 mg 20 units
Tuesday OFF
Wednesday 2 mg 20 units
Thursday OFF
Friday 2 mg 20 units

Week 3 • Monday–Friday

10 mg total
Monday 2 mg 20 units
Tuesday 2 mg 20 units
Wednesday 2 mg 20 units
Thursday 2 mg 20 units
Friday 2 mg 20 units

Week 4 • Monday–Friday

10 mg total
Monday 2 mg 20 units
Tuesday 2 mg 20 units
Wednesday 2 mg 20 units
Thursday 2 mg 20 units
Friday 2 mg 20 units

Three-Vial Course

The protocol uses exactly 30 mg of ARA-290
1
Vial One Weeks 1 + 2
4 mg + 6 mg = 10 mg
2
Vial Two Week 3
10 mg total
3
Vial Three Week 4
10 mg total
16 Total Injections
30 mg Total ARA-290
3 10 mg Vials
4 Weeks Active Treatment

Weeks 5–8

Planned break following the four-week active phase
Protocol Break

Four Weeks Off

No routine ARA-290 doses are scheduled during Weeks 5–8. This creates a defined reassessment period following the initial four-week active course.

ARA-290 Dose Calculator

For a 10 mg vial reconstituted with exactly 1 mL of bacteriostatic water.

mg
Protocol Quick Select
20 Syringe Units
0.20 mL to Draw
5 Doses per 10 mg Vial
U-100 Syringe Visual — First 20 Units
Draw to 20 units
0 5 10 15 20 units
Calculator note: this calculator performs concentration math for this specific formulation. It assumes a 10 mg vial, exactly 1 mL of diluent, and a U-100 insulin syringe.

How to Use This Guide

Keep the concentration consistent
1

Confirm Vial

This page is designed specifically for a 10 mg ARA-290 vial.

2

Add 1 mL

The calculations assume exactly 1 mL of bacteriostatic water.

3

Follow the Week

Use the calendar above to identify the clinician-directed dose for that treatment day.

4

Take the Break

The four-week active phase is followed by a planned four-week break.

Client education: ARA-290 / cibinetide remains investigational. This page explains a clinician-directed KirkleyCare protocol and concentration calculation. It should not be used to independently select a dose, alter the prescribed schedule, or substitute for individualized clinical guidance.

Research Context

Why ARA-290 is being investigated

Human Subcutaneous Research Exists

ARA-290, also called cibinetide, has undergone human clinical investigation for neuropathic conditions. Controlled studies have evaluated daily subcutaneous administration, including 1 mg, 4 mg, and 8 mg treatment arms over 28 days.

Another Phase 2 study evaluated 4 mg subcutaneously once daily for 28 days in people with type 2 diabetes and painful neuropathy.

Those clinical trials provide useful human research context but are not the same dosing schedule as the stepped KirkleyCare protocol shown on this page.

ClinicalTrials.gov — ARA-290 Study →

PubMed — Phase 2 ARA-290 Study →