Cerebrolysin

What Cerebrolysin does

Cerebrolysin is an injectable mix of pig brain peptides and amino acids, with mixed recovery results and uncertain healthy-person benefits and long-term safety. Cochrane found no survival benefit after acute stroke and a possible rise in serious nonfatal harms. Some stroke and brain-injury trials report gains. National approvals exist in parts of Europe and Asia, but no FDA approval.

• In Austria, doctors use it for patients after a stroke or head injury and for some kinds of dementia; it is not FDA approved. (Studied in a trial)
• In stroke rehab trials, people's arm recovery was better with it, though the gain was smaller when trials were pooled. (Studied in a trial)
• After brain injury, a trial found a small gain in daily function and thinking, but the evidence rests on two small trials. (Studied in a trial)
• People report better mood, memory or sleep and less anxiety, though these goals lack strong clinical evidence. (Reported by users)

Uses in the sources

• Nationally approved in Austria for support after stroke and head injury, and for Alzheimer-type or vascular dementia. (Clinician-published) (source)
• Studied alongside stroke rehabilitation and standard TBI care; results differ across trials. (Studied in a trial) (source)
• Reported online for memory, mood and recovery from past substance use; these goals lack convincing clinical evidence. (Reported by users) (source)

Cerebrolysin dosage

Typical reported dose: 30 mL by IV drip once a day for at least 10 days

• CASTA: 30 mL: 30 mL once daily once daily, into a vein. Studied in a trial. Studied in: Ischemic stroke within 12 hours. (source)
• Alteplase trial: 30 mL: 30 mL once daily once daily, into a vein. Studied in a trial. Studied in: Ischemic stroke receiving alteplase within 3 hours. (source)
• Stroke trial: 50 mL: 50 mL once daily once daily, into a vein. Studied in a trial. Studied in: Acute stroke within 24 hours. (source)
• CARS: 30 mL with rehabilitation: 30 mL once daily once daily, into a vein. Studied in a trial. Studied in: Stroke rehabilitation starting 24–72 hours after onset. (source)
• Subacute stroke: 30 mL: 30 mL once daily once daily, into a vein. Studied in a trial. Studied in: Motor impairment; treatment on stroke days 8–28. (source)
• Extended rehabilitation: 30 mL: 30 mL once daily once daily, into a vein. Studied in a trial. Studied in: Severe arm impairment around 10 days after stroke. (source)

Highest studied: 10 mL/day IM is the highest verified human exposure located, in a small retrospective cohort..

These are doses reported in labels, trials or user reports, not a personal plan. Check the source behind each one.

Work out syringe units with the dosing calculator

How to store Cerebrolysin

Comes as: Licensed amber liquid in glass ampoules or vials; 215.2 mg peptide fraction per mL, Austrian pack sizes: 1, 2, 5, 10, 20, 30 and 50 mL; availability varies.

Mixed with: Already liquid. Austria lists 0.9% saline, Ringer solution or 5% glucose for IV dilution. No powder mixing is needed..

• National prescribing information is represented as clinical-practice here; the schema reserves label for FDA/EMA.
• Ampoules have 48-month shelf life; 20, 30 and 50 mL puncturable vials have 24 months, when stored as specified.
• Austrian limits: up to 5 mL IM, up to 10 mL IV; infusion recommended from 10 mL, over about 15–60 minutes.
• Use only clear amber solution. Sodium hydroxide and water for injection are listed excipients.
• Milligram-labeled powder has no established conversion to the licensed liquid; 215.2 mg/mL does not establish product equivalence.
• This field does not validate community powder mixing or nasal-spray storage.

Before mixing: Austrian national SmPC: below 25°C, protected from light in the original pack. Do not refrigerate or freeze.

After mixing: Single withdrawal only; discard leftovers immediately. Tested 24-hour compatibility does not establish safe storage after opening.

Cerebrolysin side effects and risks

Reported side effects

• Serious nonfatal harms after acute stroke: Cochrane: 20/667 (3.0%) versus 8/668 (1.2%); RR 2.39, 95% CI 1.10–5.23., serious (source)
• Headache: CARS 1: 6/104 (5.8%) versus 3/104 (2.9%) placebo., mild (source)
• Insomnia: CARS 1: 6/104 (5.8%) versus 4/104 (3.8%) placebo., moderate (source)
• Severe allergy or shock: Austrian label: <1/10,000; a life threatening case is published., serious. Stop administration and get emergency care. (source)
• Seizure: Austrian label: <1/10,000. A TBI cohort reported more seizures; exact rates unavailable., serious. Stop and seek urgent care for a new seizure. (source)
• Stomach upset, nausea, diarrhea or constipation: Austrian label: <1/10,000. Label rates differ from all cause trial event rates., mild (source)
• Agitation, confusion or poor sleep: Austrian label: 1/10,000 to <1/1,000., moderate (source)
• Warmth, sweating, itching or dizziness: Austrian label: 1/10,000 to <1/1,000; rapid administration can contribute., mild (source)
• Palpitations or irregular heartbeat: Austrian label: <1/10,000, especially with rapid administration., serious (source)
• Injection-site redness, itching or burning: Austrian label: <1/10,000; community injection pain rates are unknown., mild (source)
• Brain fog, mood changes or flu-like feelings: Community reports; no reliable rate or proven cause., moderate (source)

Stop and get help if

• Trouble breathing, swollen lips or tongue, collapse or widespread hives: Stop administration and call emergency services now.
• New seizure, repeated seizures or not waking normally: Get emergency care now; protect from injury and give no further doses.
• New one-sided weakness, speech loss, sudden severe headache or reduced consciousness: Call emergency services; do not delay stroke care for a peptide dose.
• Chest pain, fainting or sustained irregular heartbeat: Stop administration and seek urgent medical assessment.
• Hot spreading injection-site redness, pus, fever or shaking chills: Seek urgent assessment for infection; retain product and batch details.

Who should avoid it

• pregnant: Human safety is unestablished. Austria allows only necessary clinical treatment.
• breastfeeding: Milk transfer and infant safety are unknown. Austria requires choosing between nursing and treatment.
• tryingToConceive: Precaution: human fertility safety and a preconception stopping interval are unknown.
• under18: Adults-only reference. Austria does not recommend use under 18 because data are insufficient.
• other: An ongoing or repeated seizure emergency is an Austrian label contraindication. Seek emergency care.
• seizureDisorder: Seizure frequency may rise. Some regional labels are stricter; review epilepsy or past post-traumatic seizures.
• other: Severe kidney impairment is an Austrian label contraindication. A safe adjusted dose is unestablished.
• kidneyDisease: Kidney severity must be checked; severe impairment is contraindicated.
• other: Prior hypersensitivity is contraindicated; life-threatening anaphylaxis has been reported.
• other: The Austrian label advises caution with an allergic tendency.
• activeCancer: Precaution: an Alzheimer trial reported IGF-I changes. Active-cancer safety is unknown; this is not a label contraindication.
• heartCondition: Rapid administration can cause palpitations or rhythm changes; review before exposure.
• uncontrolledBloodPressure: High-dose MAO inhibitors with 30–40 mL Cerebrolysin can raise blood pressure.
• psychiatricCondition: Agitation, confusion and insomnia are reported. Unstable mood conditions need review.
• bleedingDisorder: Muscle injection may cause bleeding or a hematoma; assess the route and bleeding risk.
• testedAthlete: No named WADA ruling found. IV volume rules apply even when a drug is not named.

Interactions

• MAO inhibitors: Additive effects; high-dose MAO inhibitors with 30–40 mL Cerebrolysin can raise blood pressure.
• Other antidepressants: Austria warns of additive effects and suggests clinician-led antidepressant dose review. Do not change antidepressants independently.
• Balanced amino-acid infusions: Do not mix in the same infusion; the Austrian label identifies an incompatibility.
• Lipid infusions or same-syringe medicines: Lipid-containing or pH-changing solutions are incompatible. Vitamins and heart medicines should not share the same syringe.
• Blood thinners and antiplatelet drugs: Muscle injections may cause bleeding or bruising. This is a route precaution, not a proven Cerebrolysin drug interaction.
• Donepezil: A randomized combination trial found no significant added cognitive benefit; clinician-managed use was studied.
• Other neuroactive peptide mixtures: Self-use combinations lack controlled human safety evidence. Other brain-derived preparations are not interchangeable.

Product quality risks

• One chemical study identified 638 peptides in an online sample. It did not establish sterility, dose consistency or market-wide authenticity.
• A lab comparison found other mixtures had different composition and activity. It was not a counterfeit-prevalence survey.
• Unregulated injections may be mislabeled, contaminated or nonsterile. No representative Cerebrolysin online-market purity survey was found.
• A powder sold under this name is not established as equivalent to the licensed liquid.

What to expect

National approvals exist, but no FDA approval. Stroke survival benefit is unproven; brain-injury trials are small, and at least 43 human studies were identified.

Key studies

• CASTA: acute stroke: The largest acute-stroke trial missed its primary endpoint. (source)
• CERE-LYSE-1: with alteplase: Early neurological gains did not become a day-90 disability benefit. (source)
• Stroke: 50 mL for 21 days: Main neurological and daily-function outcomes were neutral. (source)
• Stroke dose finding: 10 or 50 mL: A tiny dose-finding study reported MRI changes. (source)
• CARS-1: rehabilitation: Arm recovery favored Cerebrolysin in this exploratory trial. (source)
• CARS-2: replication: The replication contributes to pooled evidence but has limited standalone reporting. (source)

Cerebrolysin FAQ

• Is Cerebrolysin FDA-approved? No FDA-approved product or label found. FDA’s 2020 warning specifically names Cerebrolysin; research labeling does not establish approval.
• How do people take it? Into a vein, once daily. Source: clinician-published.
• What's the difference between Cerebrolysin and Semax? Cerebrolysin: an injectable pig brain mixture with mixed stroke, brain-injury and dementia evidence. Semax: a Russian nasal peptide with limited human evidence for brain and nerve effects. Why people pair them: users alternate or combine cycles seeking recovery and focus; no controlled human combination trial was verified.
• Can I take it with Semax? Users alternate or combine cycles seeking recovery and focus; no controlled human combination trial was verified. Benefits and adverse reactions are hard to attribute. Synergy is unproven. Source: reported by users. Ask a doctor before combining anything.
• Is it banned in sport? It is unclear (WADA 2026). Foreign approval means S0 is not automatic. IV totals >100 mL/12 hours are prohibited outside listed medical exceptions; no compound-specific ruling found. M2.2 separately addresses total IV infusions or injections over 100 mL per 12 hours, except legitimate hospital treatment, surgical procedures or clinical diagnostic investigations.
• How do I store it once opened? Single withdrawal only; discard leftovers immediately. Tested 24-hour compatibility does not establish safe storage after opening.