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Cognition

Cerebrolysin

A complex mixture of neurotrophic peptide fractions. Used exclusively as a cycle, never as a continuous treatment.

4 min read 10 sources

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Cerebrolysin vial with white powder and the black TPD label on a white podium with a glowing light blue ring, glass spheres and lab glassware behind it in a bright lab
In use in several countries · mainly in Russia, Eastern Europe and China

Summary

At a glance

Sources checked on 26 Oct 2026

Largest stroke trial
1,070 participants

CASTA in Asia, primary endpoint no different from placebo1

Mortality in severe stroke
10.5 %

after 90 days, placebo 20.2%, only in a post hoc analysis1

Response in vascular dementia
2.69 -fold

Cochrane review, two trials, very low certainty evidence2

Non-fatal serious adverse events
2.39 -fold

Cochrane review on stroke, three trials, moderate certainty evidence3

  • Cerebrolysin is not a single compound but a mixture of small peptides and free amino acids from pig brain. It is meant to act like the body's own nerve growth factors.34
  • In the largest stroke trial (CASTA, 1,070 participants) there was no difference from placebo on the primary endpoint. In severely affected patients a post hoc analysis showed fewer deaths.1
  • In vascular dementia a Cochrane review found a benefit for thinking and overall condition, with very low certainty evidence and high risk of bias.2
  • The Cochrane review on stroke found no effect on mortality but more non-fatal serious adverse events than on placebo.3
  • Cerebrolysin is in use in several countries, mainly Russia, Eastern Europe and China. The trials gave it as an infusion into a vein. Everything here is the state of research, not a recommendation.32
Profile

Updated May 2026

Class
Neurotrophic peptide mixture

brain extract

Route
Subcutaneous or intramuscular

not IV bolus

Mode
Cycle only

no maintenance

Form
Lyophilisate, 60mg/vial

6-pack = 360mg

Sizes
60mg/6vials

1 size in the shop

Contents 16 sections
  1. At a glance
  2. What is Cerebrolysin?
  3. How it works
  4. What you need
  5. Reconstitution
  6. Use
  7. Dosing (cycle only)
  8. What the research shows
  9. Research status
  10. Side effects
  11. Practice
  12. Storage
  13. Related compounds
  14. FAQ
  15. Glossary
  16. Sources

What is Cerebrolysin?

Cerebrolysin is not a single substance but a complex mixture of small neurotrophic peptides and amino acids. It is known for mimicking the action of the body's own nerve growth factors. In several countries it is used clinically around stroke, dementia and brain injuries.

This product is the freeze-dried powder form (60mg per vial, 6-pack = 360mg total), not the official liquid form. That is why it is dosed in milligrams. Important up front: Cerebrolysin is used exclusively as a cycle, never as a continuous or maintenance treatment.

Comparison

Other peptides for the brain

Targets as stated in the TPD lexicon. Tap a card to open its entry.

Peptide mixture from pig brain Cerebrolysin Neuropeptide
ACTH(4-7) analogue Semax ACTH Tuftsin analogue Selank Tuftsin CNTF derivative P21 CNTF

Cerebrolysin is a mixture from animal tissue. The others are single, synthetically made peptides. 4

How it works

The peptide fractions in Cerebrolysin act similarly to the body's own neurotrophic factors. In a research context they are credited with protective and regenerative effects on nerve cells: supporting the cells' energy supply, protecting against damage and triggering repair processes.

Unlike a metabolic or hormone peptide with one clear single receptor, Cerebrolysin is a mixture with a broad action profile. That is also why it is run in cycles rather than continuously.

Where it acts

Where Cerebrolysin was studied

Tap the card. Cerebrolysin is a mixture, there is no single receptor.

  1. Brain

    Studied in stroke, dementia and brain injury, benefit documented to different degrees depending on the area3

    Observed in trials
Glass network of nerve cells with branches, fine chains of glass beads along the branches and warmly glowing points of light between two cell bodies
Symbolic image.

What you need

For use you need:

Supplies

5 things, numbered as in the picture

Tick off what you already have. Vial and BAC water are our real shop photos at the same size.

Cerebrolysin vial and bacteriostatic water at the same size with the black TPD label, next to two U-100 insulin syringes, two alcohol swabs and a sharps container with a blue lid

  1. Cerebrolysin vial

    The Cerebrolysin vial with the freeze-dried powder

    In the shop

  2. Bacteriostatic water

    Bacteriostatic water to dissolve it (3ml per 60mg vial gives 20mg/ml)

    In the shop

  3. Syringes

    Syringes for the application (subcutaneous or intramuscular)

  4. Alcohol swabs

    Alcohol swabs for the vial cap and the skin

    Amazon (opens a new tab)

  5. Sharps container

    A sealable sharps container for used needles

As an Amazon associate we earn from qualifying purchases. Links open Amazon - no extra cost for you.

Reconstitution

About 3ml of bacteriostatic water is used per 60mg vial, giving a concentration of 20mg/ml. At 20mg/ml, 20mg/day is exactly 1ml, 32mg is about 1.6ml.

Use the peptide calculator to see concentration and units. Because the daily doses are relatively large, depending on the dose you exceed the volume of a single insulin syringe, which is why doses above 20mg are split into two applications per day.

When dissolving, just add the bac water, it does not matter if it hits the powder directly. Then swirl or shake until everything has dissolved, both are fine. The reconstituted solution keeps for at least 4 to 6 months refrigerated.

Step by step

Dissolving the powder

Four steps, the same for every vial size.

  1. 1Wipe the cap

    Clean the rubber stopper with an alcohol swab.

  2. 2Add BAC water

    Just add it, it does not matter if it hits the powder directly.

  3. 3Swirl or shake

    Until everything has dissolved, both are fine.

  4. 4Draw up

    With the U-100 insulin syringe.

Less water higher concentration fewer units on the syringe Example: 60 mg + 3 ml = 20 mg/ml

Use

Dosing. Loading the dosing information …

Dosing (cycle only)

Dosing

Dosing, titration and syringe

Loading the dosing information …

  • Getting started and stepping up, drawn as a staircase
  • Units on the U-100 syringe for every step
  • How long one vial lasts

What the research shows

For a neurotrophic agent, Cerebrolysin is relatively well studied. In a large randomised stroke trial (CASTA, 2012) the primary endpoint was overall neutral, but a favourable trend showed in more severely affected patients. A Cochrane review (2019) found a statistically significant benefit for general cognitive and global function in vascular dementia. So the evidence is mixed and varies in strength by indication. That belongs in the picture honestly.

The studies with links are in the source block below.

Study results

What the trials measured

Interactive: switch tabs, tap points, show or hide arms. Arms are named relative to each other, no dosing advice.

Mortality after 90 days in severe stroke1

Share in percent, subgroup with severe deficits

Severely affected participants1 Acute stroke, given for 10 days
Placebo 20%
Cerebrolysin 11%

Post hoc analysis of a subgroup, the trial itself was neutral on its primary endpoint. The authors call for a separate trial to confirm it.

Response after 24 weeks6

Share of participants in percent, 242 people with vascular dementia

Thinking clearly better6 At least 4 points on the ADAS-cog+ test
Placebo 52%
Cerebrolysin 82%
Overall condition improved6 Rating by clinicians with caregivers (CIBIC+)
Placebo 37%
Cerebrolysin 75%
Both together6
Placebo 27%
Cerebrolysin 68%

Values from the abstract of a manufacturer-supported trial. The Cochrane review rates the vascular dementia trials overall as very uncertain and at high risk of bias.

Relative risk compared with placebo23

1 means no difference, above 1 means more often than on placebo

Response, vascular dementia2 2 trials, 379 participants, very low certainty
Placebo 1.00-fold
Cerebrolysin 2.69-fold
Deaths, acute stroke3 6 trials, 1,689 participants, moderate certainty
Placebo 1.00-fold
Cerebrolysin 0.96-fold
Non-fatal serious adverse events3 3 trials, 1,335 participants, moderate certainty
Placebo 1.00-fold
Cerebrolysin 2.39-fold

The placebo bar stands for the reference value 1. The stroke review also includes one trial with a similar mixture from cattle brain.

Bright desk by a window with a frosted glass brain model and a pot of fresh green shoots, shelves and a city behind it
Symbolic image.

Research status

Where the research stands

Cerebrolysin has been used in several countries for decades, so many manufacturer trials are phase 4. Here are all registered trials with a phase and known status, mostly given as an infusion into a vein. As of 26 Oct 2026. 10

  1. Preclinical Nerve protection in cell and animal models
  2. Phase 1 1 trial, 1 completed
  3. Phase 2 7 trials, 4 completed, 1 stopped early
  4. Phase 3 5 trials, 5 completed
  5. Approval mainly in Russia, Eastern Europe and China
419 participants in phase 3 In use in several countries, mainly Russia, Eastern Europe and China. There is no approval for this powder as a research product, the trials used the ready-made liquid solution as an infusion.3
Show all 20 phase 2, 3 and 4 trials on a timelineHide timeline 14 completed 4 running 2 stopped early 4 with results
Phase 2
Phase 3
Phase 4

Bar: start to primary endpoint (planned for running trials). Green = completed, blue = progress until 26 Oct 2026, grey = stopped early. Phase 1: 1 trial on safety and pharmacokinetics, not shown as bars.

Side effects

Cerebrolysin is considered well tolerated in the studies. Mostly mild things are reported: injection-site reactions, occasionally dizziness, restlessness or headache, especially when titrated up too fast. That is exactly what the slow ramp at the start of the cycle is for. The cycle structure with a long break is itself a safety element.

Tolerability

Frequency in an Alzheimer's trial

Out of 100 participants per group, how many had the event in an Alzheimer's trial over 28 weeks (values from the trial registry).

14 of 100 Cerebrolysin
4 of 100 Donepezil (comparison)
6 of 100 Cerebrolysin plus donepezil
Event CerebrolysinDonepezil (comparison)Cerebrolysin plus donepezil
Agitation9 14%4%6%
Dizziness9 9%3%10%
Headache9 6%3%8%
Insomnia9 8%4%5%
Nausea9 2%9%8%

Shares calculated from the participant numbers on the registry (65 on Cerebrolysin, 68 on donepezil, 67 on both), without a placebo group. The Cochrane review on stroke found more non-fatal serious adverse events than on placebo.93

Practice

A few things that matter:

  1. Think of it as a cycle, not a continuous peptide

    At most 30 days, then at least 6 months off.

  2. Titrate up slowly, especially in the first days.

  3. Keep the reconstituted solution refrigerated, it keeps for at least 4 to 6 months with barely any loss.

  4. No more than once or twice per year.

Light blue notebook with an elastic band, a glass of water and a green plant on a white table by a window

Storage

The undissolved powder should be kept cool and dark. The reconstituted solution goes into the fridge (2 to 8 degrees), is protected from light and stays stable for at least 4 to 6 months with barely any loss of potency.

Shelf life

How long it keeps

Undissolved (powder) Cool and dark

As the entry describes: keep the undissolved powder cool and away from light.

Dissolved (mixed) Fridge, 2 to 8 degrees, away from light

Stable for at least 4 to 6 months with barely any loss.

  • Keep it dark
  • Dissolved: 2 to 8 degrees
  • Note the mixing date on the vial
Nine vials with white powder and blue caps in the door shelf of a bright fridge
Powder cool and dark, once dissolved into the fridge (2 to 8 degrees), stable there for at least 4 to 6 months. Symbolic image.

Related

Related compounds

A different path: all in the TPD lexicon.

Cerebrolysin
Semax ACTH(4-7) analogue, nasal or subcutaneous Selank Tuftsin analogue, nasal or subcutaneous P21 Tetrapeptide from CNTF Dihexa Angiotensin IV analogue, as a tablet Pinealon Short Khavinson peptide for the brain

FAQ

Common questions about Cerebrolysin

Short answers, each backed by the sources below.

Is Cerebrolysin approved?

A Cochrane review describes Cerebrolysin as widely used for stroke in Russia, Eastern Europe, China and other Asian countries. Many of the manufacturer's trials are registered as phase 4. This powder is a research product, the trials used the ready-made liquid solution.310

What is in Cerebrolysin?

A mixture made in a standardised process from small peptides under 10 kDa and free amino acids from pig brain. It has no single receptor but is meant to act like the body's own nerve growth factors.43

What did the large stroke trial CASTA show?

1,070 people with acute stroke received Cerebrolysin or saline for 10 days. There was no difference on the primary endpoint. In severely affected patients a post hoc analysis showed 10.5 percent deaths with Cerebrolysin and 20.2 percent with placebo. The authors see this as a signal that still needs confirmation.1

What is known in vascular dementia?

A Cochrane review with six trials and 597 participants found a benefit for thinking and overall condition. The evidence is very low certainty though, the trials are at high risk of bias and, where known, were supported by the manufacturer. The authors think the effect may be too small to matter in daily life.26

Does it help recovery after stroke or brain injury?

In the CARS trial with rehab over 21 days arm function after 90 days was clearly better than on placebo, but the trial was small and exploratory. After moderate to severe brain injury CAPTAIN II found a small to medium advantage across many measures. Both need to be confirmed in larger trials.45

Which side effects are known?

In acute stroke Cerebrolysin changed neither mortality nor the number of all serious adverse events according to the Cochrane review, but non-fatal serious adverse events were more common than on placebo (relative risk 2.39). In an Alzheimer's trial agitation, dizziness and headache were common.39

Do the trials transfer to this product?

Only to a limited extent. In the trials the ready-made liquid solution was given as an infusion into a vein, over some days to weeks. This product is a freeze-dried powder that the entry describes for subcutaneous or intramuscular use. There are no data on this form.12

Glossary

Terms explained briefly

Dotted words in the text open these explanations directly.

Cochrane review
Systematic review that collects, rates and pools all suitable trials on a question. Considered particularly reliable.
Infusion
Slow delivery of a liquid directly into a vein, usually by drip.
Intramuscular
Into a muscle, for example the buttock, deltoid or outer thigh.
Ischaemic stroke
A blood clot blocks a vessel in the brain and part of the brain no longer gets oxygen.
Lyophilisate
Freeze-dried powder. Without water the contents stay stable much longer.
Neurotrophic
Supports growth and survival of nerve cells. The body makes its own growth factors for this, such as BDNF.
Placebo
Dummy preparation without active substance, here usually saline. Comparing against it shows what is due to the substance itself.
Post hoc analysis
Analysis decided only after the trial ended. It gives hints but no proof.
Relative risk
How much more often an event occurs with the compound than without. 1 means equally often, 2 means twice as often.
Subcutaneous
Into the fat layer just under the skin.
Vascular dementia
Decline of memory and thinking due to poor blood flow in the brain, the second most common form of dementia.

Evidence

Sources

Show all 10 sourcesHide sources 8 Studies2 Trial registry checked 26 Oct 2026

Studies

  1. Large placebo-controlled trial CASTA in acute stroke in Asia

    Heiss et al., Stroke, 2012

    DOI 10.1161/STROKEAHA.111.628537 PMID 22282884 NCT00868283
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  2. Cochrane review on vascular dementia

    Cui et al., Cochrane Database of Systematic Reviews, 2019

    DOI 10.1002/14651858.CD008900.pub3 PMID 31710397
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed, PMC (Volltext)
  3. Cochrane review on acute ischaemic stroke

    Ziganshina et al., Cochrane Database of Systematic Reviews, 2023

    DOI 10.1002/14651858.CD007026.pub7 PMID 37818733
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed, PMC (Volltext)
  4. CARS trial: recovery after stroke with rehab

    Muresanu et al., Stroke, 2016

    DOI 10.1161/STROKEAHA.115.009416 PMID 26564102
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed, PMC (Volltext)
  5. CAPTAIN II trial after brain injury

    Muresanu et al., Neurological Sciences, 2020

    DOI 10.1007/s10072-019-04181-y PMID 31897941
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  6. Placebo-controlled trial in vascular dementia over 24 weeks

    Guekht et al., Journal of Stroke and Cerebrovascular Diseases, 2011

    DOI 10.1016/j.jstrokecerebrovasdis.2010.01.012 PMID 20656516 NCT00947531
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  7. Alzheimer's: Cerebrolysin, donepezil and both together

    Alvarez et al., Current Alzheimer Research, 2011

    DOI 10.2174/156720511796391863 PMID 21679156 NCT00911807
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed
  8. Stroke: Cerebrolysin together with clot-dissolving drug

    Lang et al., International Journal of Stroke, 2013

    DOI 10.1111/j.1747-4949.2012.00901.x PMID 23009193 NCT00840671
    Checked 26 Oct 2026 via doi.org, Crossref, PubMed

Trial registry

  1. Adverse events of the Alzheimer's trial on the registry

    ClinicalTrials.gov, NCT00911807

    NCT00911807
    Checked 26 Oct 2026 via ClinicalTrials.gov API v2
  2. All trials on ClinicalTrials.gov

    ClinicalTrials.gov, U.S. National Library of Medicine

    Checked 26 Oct 2026 via ClinicalTrials.gov API v2

In the shop

Cerebrolysin in the catalog

Sizes, prices and shipping times are on the product page.

To the product