Neural Β· RegenerativeTier 2 β€” Good human studies

Cerebrolysin

FPF-1070 Β· Cere Β· EVER Neuro Pharma

Standardised mixture of low-molecular-weight neuropeptides and free amino acids derived from porcine brain. The most clinically validated neuroregenerative peptide mixture, with RCT data in stroke, vascular dementia, and Alzheimer's disease.

πŸ’‰ IV infusion / IM injection🧊 Ampoules: room temperature, protect from light; do not freeze. Opened ampoule: use immediately.

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Mechanism of Action

Multi-target: (1) Neurotrophic factor mimicry β€” activates BDNF, NGF, IGF-1, and CNTF receptor pathways β†’ neuronal survival and synaptic plasticity; (2) Neurogenesis β€” promotes neural stem cell proliferation and differentiation in the hippocampus; (3) Anti-apoptotic β€” reduces excitotoxicity and mitochondrial dysfunction in injured neurons; (4) Metabolic β€” improves neuronal glucose utilisation and ATP production; (5) Anti-amyloid β€” reduces AΞ²42 aggregation and tau hyperphosphorylation in Alzheimer models.

Clinical Applications

  • βœ“Acute ischemic stroke β€” improves functional outcomes when started within 72 h (CEREBROLYSIN trial data)
  • βœ“Vascular dementia β€” slows progression, improves MMSE and ADAS-cog in RCTs
  • βœ“Alzheimer's disease β€” modest cognitive stabilisation; best evidence as adjunct to AChEIs
  • βœ“Traumatic brain injury β€” accelerates neurological recovery
  • βœ“Post-stroke rehabilitation β€” extends neuroplasticity window
  • βœ“Age-related cognitive decline β€” off-label use for cognitive longevity

Dosing Protocol

Recommended Dosing

IV or IM only β€” not suitable for SC due to local tissue irritation. Acute neurological (stroke/TBI): 10–30 mL IV daily for 10–21 days. Cognitive decline/dementia: 5–10 mL IM or IV daily for 10–20 days, 2–4 courses per year. Must be diluted in 100 mL normal saline for IV infusion over 30–60 min. IM: undiluted or diluted, 5 mL max per injection site.

Safety & Contraindications

Possible Side Effects

  • ⚠Fever and flu-like symptoms (most common β€” immune activation, especially first doses)
  • ⚠Agitation, insomnia, or dizziness (CNS activation β€” dose-dependent)
  • ⚠Nausea and GI discomfort
  • ⚠Injection site pain with IM administration
  • ⚠Rare: seizure (in patients with epilepsy or post-stroke β€” monitor closely)
  • ⚠Allergic reactions β€” porcine-derived product; caution in pork allergy

Contraindications

  • βœ•Epilepsy or active seizure disorder β€” risk of lowering seizure threshold
  • βœ•Pork allergy
  • βœ•Severe renal impairment (amino acid load)
  • βœ•Pregnancy
  • βœ•Status epilepticus

Combinations & Synergies

πŸ”— Semaxsynergistic BDNF upregulation β€” Semax intranasal + Cerebrolysin IV creates a broad neurotrophic protocol
πŸ”— SelankCerebrolysin for neuroregeneration + Selank for anxiety/mood normalisation post-stroke
πŸ”— Thymosin Alpha-1immune support during Cerebrolysin course β€” especially in immunocompromised patients
πŸ”— Do not combine with MAO inhibitors β€” risk of serotonin-related interactions