New to peptides? Start with the foundations ->
The plain-English version
Standard protocol is 10 to 30 milliliters (a small IV push or slow infusion) daily for 10 to 21 days, repeated every 3 to 6 months. Sourcing in the US is the real challenge - it is not FDA-approved here. Always with a doctor, ideally a neurologist or longevity-clinic prescriber.
Route: intravenous infusion, intramuscular injection. Evidence tier for the dose: Strong clinical. Multiple human studies support the dosing protocol; not yet FDA-labeled for this exact indication but close.
The dose at a glance
| What's typical | What's the max in research |
|---|---|
| Starting dose: 5 to 10 mL IV (intravenous, into a vein) on day 1 to test tolerance, then escalate to the full protocol dose. | Max observed in research: 60 mL daily was used in some severe-stroke trials (CARS) without serious safety signals, but 30 mL is the practical ceiling for most protocols. |
| Maintenance dose: 10 to 30 mL IV daily during the 10 to 21-day cycle. Stroke and TBI protocols use the higher end (20-30 mL); longevity protocols stay at 10-15 mL. | |
| Frequency: Daily during the active cycle. Cycle repeated every 3 to 6 months. | Half-life: The product is a mix of peptides and amino acids - half-life varies by component. Tissue effects are believed to last weeks beyond plasma clearance. |
Titration (how to ramp the dose)
Test dose of 5-10 mL on day 1, full dose from day 2 onward.
Cycle length and time off
On cycle: 10 to 21 days of daily infusion. Stroke acute care often runs 21 days; maintenance protocols run 10 days.
Off cycle: 3 to 6 months between cycles.
Timing notes: Morning infusion is standard, partly because the patient (or caregiver) needs to be alert to monitor for reactions. IM (intramuscular, into a muscle) injections can be done at home; IV typically requires clinic.
What's commonly prescribed (per published protocols and clinical write-ups)
Cerebrolysin ships as ready-to-inject ampoules (small sealed glass vials of liquid) at 215.2 mg/mL concentration, in 1, 5, 10, or 20 mL sizes. Brand name is Cerebrolysin (manufacturer Ever Pharma, Austria). Not FDA-approved in the US - most patients source through international pharmacies (Mexico, Eastern Europe) under a longevity-clinic prescription. Quality varies wildly - always ask for a COA (Certificate of Analysis, the lab purity test result).
Source: prescribing labels, published protocols, and clinical write-ups. We have not independently tested each prescriber pattern.
Reconstitution (mixing the vial)
Cerebrolysin ships pre-mixed (already liquid) - no reconstitution required. Shelf life is multi-year unrefrigerated until opened. Once an ampoule is opened, use immediately. If your pharmacy filled the vial with a different concentration, recalculate from the mg/mL printed on your vial label - not from this page.
Reconstitution = mixing freeze-dried (lyophilized) powder with bacteriostatic water (sterile water with preservative) so you can draw a dose into a syringe.
Drug interactions to watch
- MAOI antidepressants - theoretical interaction with neurotransmitter modulation; coordinate with prescriber.
- Lithium - one report of seizure when combined; rare but documented.
- Stimulant medications - additive effects possible; start low.
Who should not take this (contraindications)
- Severe kidney failure (the product is processed by the kidneys).
- Status epilepticus (uncontrolled seizures).
- Pregnancy and breastfeeding (no safety data).
- Known allergy to porcine (pig-derived) products.
Common side effects
- Burning sensation at injection site (especially IM).
- Headache or dizziness in the first few infusions.
- Mild nausea.
- Anxiety or restlessness in some patients.
Serious side effects (call a doctor)
- Allergic reaction including anaphylaxis - rare but documented; first dose should be in a clinical setting.
- Seizure (very rare; almost always in patients with seizure history).
- Severe headache that does not resolve - call your doctor.
What to monitor while you're on it
- Cognitive testing (MMSE or MoCA) at baseline and end of each cycle.
- Blood pressure during the first 3 infusions.
- Liver and kidney panel at baseline and after the first cycle.
- Watch for injection-site reactions across the cycle.
How to stop
Just stop at the end of the cycle. No taper needed.
Where this dosing comes from
- CARS-1 and CARS-2 trials (Stroke, 2017-2018)
- Alvarez et al., Alzheimer's RCT (2011)
- CAPTAIN TBI trials (2010s)
- Ever Pharma prescribing information (Austria, EU)
- International longevity clinic protocols (varies by clinic)
Where these doses come from
These doses come from human trials and prescribing protocols used by clinicians. Not FDA-approved at this exact dose, but well-supported by published data.
Always work with a real prescriber. Don't self-prescribe.
Safety reminder: None of this replaces a doctor. Peptides are gray-market in the US for most uses. Talk to a real prescriber before you change anything.
Where to go next
- Full Cerebrolysin directory entry - status, sourcing, studies, what to skip
- Cerebrolysin for stroke recovery
- Cerebrolysin for Alzheimer's support
- Cerebrolysin for traumatic brain injury recovery
- Cerebrolysin for age-related cognitive decline
- What are peptides - if you skipped the foundation
- How peptides actually work - mechanism in plain English
- Subscribe to the dispatch
Subscribe to the dispatch
The weekly Protocol One dispatch covers what's moving in peptides, GLP-1s, and longevity protocols. Free. 5-min read. Broken down for normal humans.
Last reviewed · 2026-05-07 · Page generated by Protocol One matrix engine. None of this replaces a doctor. Peptides are gray-market in the US for most uses. Talk to a real prescriber before you change anything.