Lower numbers = closer to natural. Higher numbers = more enhanced.
Why this rating?
Cerebrolysin is a neurotrophic peptide mixture, an experimental preparation of enzymatically-treated low-molecular-weight peptides and amino acids derived from pig (porcine) brain. It is used abroad for stroke, dementia and brain injury, and is of interest in the nootropic community for cognition/recovery. It is not anabolic, not hormonal, and has no muscle-building or athletic-performance effect. It does not move the muscular/physique/athletic-performance ceiling by any path, so it is rated 1, basically natty, with no effect on the natty scale.
Overview
An experimental mixture (code name FPF-1070) of enzymatically-treated peptides and amino acids derived from pig brain, manufactured by Ever Pharma (Austria). It is proposed to have neurotrophic/neuroprotective activity and is used abroad, not in the US, for stroke, dementia, and brain injury. It is given by injection and is popular in nootropic circles for cognition and neuro-recovery, but the clinical evidence is weak and mixed.
Purpose & Use Cases
Stroke (used abroad)
Given as intravenous courses after acute ischemic stroke in several countries. A 2023 Cochrane review found it probably has no beneficial effect on all-cause death and flagged a possible increase in non-fatal serious adverse events at higher doses.
Dementia / Cognitive Decline (used abroad)
Used for vascular dementia and Alzheimer's disease. A 2019 Cochrane review reported improved cognition/general function in vascular dementia but cautioned any benefit may be too small to be clinically meaningful, with high risk of bias.
Brain Injury / Neuro-Recovery
Also used off-label abroad for traumatic brain injury and other neurological conditions, and taken by nootropic users hoping for cognitive/recovery benefits, an unproven, off-label application.
Benefits
- Proposed neurotrophic / neuroprotective activity
- Used clinically abroad for stroke, dementia and brain injury
- Some trial signal for cognitive/general function in vascular dementia (low-quality evidence)
- Not hormonal: does not affect the HPTA
Good to Know
Pig-brain peptides, not FDA-approved
Cerebrolysin is a mixture of peptides and amino acids enzymatically extracted from porcine (pig) brain. It is used clinically in Russia, Eastern Europe, China and Asia for stroke and dementia, but it is NOT an approved drug in the United States.
The evidence is weak and mixed
A 2023 Cochrane review found it probably does not reduce death after ischemic stroke and may raise non-fatal serious adverse events at higher doses. A 2019 Cochrane review found a possible cognitive benefit in vascular dementia, but warned any effect may be too small to be clinically meaningful, with high risk of bias.
Not a performance or muscle compound
Its interest is neurological, cognition and neuro-recovery, not muscle, strength, or fat loss. It is non-hormonal, so there is no HPTA suppression and no PCT.
Dosage Guidelines
| Experience Level | Dosage Range |
|---|---|
| Beginner | 5 – 10 mL/day |
| Intermediate | 10 – 20 mL/day |
| Advanced | 20 – 30 mL/day |
Dosed by ampoule volume (215.2 mg/mL total peptide content), given as IV infusion or IM injection in daily courses, not a loading/maintenance split. Landmark trials used 30 mL/day for 10 days in acute ischemic stroke (CASTA trial) and 30 mL/day for 21 days for post-stroke motor recovery (CARS trial); a vascular dementia trial used 20 mL/day IV across 2 treatment cycles (Guekht et al. 2011). The 2023 Cochrane stroke review found the higher-dose 30 mL/day x 10-day regimen was associated with more non-fatal serious adverse events. Lower daily volumes (5-10 mL) also appear in some clinical/community protocols; these are approximate, not a validated self-use regimen.
Not well characterized for the mixture; its putative neurotrophic components (e.g. BDNF) have half-lives of only minutes in blood.
Side Effects
Injection Reactions
commonNausea, dizziness, headache and sweating around the time of injection.
Slow the infusion; usually transient.
Non-Fatal Serious Adverse Events (higher dose)
uncommonThe 2023 Cochrane stroke review identified a potential increase in non-fatal serious adverse events with Cerebrolysin, particularly at the higher 30 mL/day for 10 days regimen.
Medical supervision; caution with higher-dose regimens.
Sourcing / Purity Risk
uncommonAs a porcine-brain-derived biological not approved in the US, purity, sterility and batch consistency depend entirely on the manufacturer/source.
Use only pharmaceutical-grade product from a legitimate manufacturer; avoid unverified sources.
General Mitigation Strategies
Injection-related effects (nausea, dizziness, headache, sweating) are usually transient. It is not recommended in people with epilepsy, kidney disease, or hypersensitivity to its constituents. Higher-dose regimens carry a possible increase in non-fatal serious adverse events (2023 Cochrane review), so medical supervision is warranted. Because it is a porcine-derived biological and not FDA-approved, product quality is the key practical risk.
Post Cycle Therapy (PCT)
Not hormonal. Does not affect the HPTA. No PCT required.
How It Works
Cerebrolysin is proposed to act through neurotrophic effects that resemble endogenous neurotrophic signaling. The preparation is described as containing or mimicking factors such as BDNF, GDNF, NGF and CNTF. The precise molecular mechanism in humans is not established, and the neurotrophic proteins it is compared to are far too large and short-lived to survive in blood, so the active principle of the low-molecular-weight mixture remains unclear. It has no hormonal or anabolic action.
Fundamentals
Reference on the practices relevant to Cerebrolysin: how they are done and where they go wrong. Not a recommendation to use it.
Legal Status
Not an FDA-approved drug in the United States. Marketed and used clinically in Russia, Eastern Europe, China and parts of Asia.
Legal status varies by country and changes over time. This is a general summary, not legal advice.
WADA Status
Cerebrolysin is not explicitly named on the WADA Prohibited List. However, as a non-approved neurotrophic biological, a tested athlete should treat it cautiously. Non-approved substances can fall under S0. Verify current status before competition. (The WADA list could not be opened directly this session.)
References
- Cerebrolysin - Wikipedia (porcine-brain peptide mixture, neurotrophic, not FDA-approved)
- Ziganshina et al. 2023 - Cerebrolysin for acute ischaemic stroke (Cochrane, PMID 37818733)
- Cui et al. 2019 - Cerebrolysin for vascular dementia (Cochrane, PMID 31710397)
- Heiss et al. 2012 - CASTA trial: Cerebrolysin in acute ischemic stroke in Asia (Stroke, PMID 22282884)
- Muresanu et al. 2016 - CARS trial: Cerebrolysin and Recovery After Stroke (Stroke, PMID 26564102)
- Guekht et al. 2011 - Cerebrolysin in vascular dementia, randomized placebo-controlled trial (PMID 20656516)