Brain & focus
A brain-derived peptide preparation used clinically in Russia to support memory and recovery in stroke and other brain conditions.
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Cortexin is a preparation of small peptides extracted from the brain cortex of cattle, given by intramuscular (into a muscle) injection. It is used clinically in Russia for stroke recovery and memory problems 12, as well as in children's neurology. Human trial evidence is limited, and it is a research compound, not FDA approved.
Cortexin is a mix of brain peptides from cattle that helps protect nerve cells and improve thinking. It works by activating growth factors for brain cells, reducing inflammation, and balancing the brain chemicals that control mood and alertness. It's used in Russia to help people recover from stroke and improve memory 12.
Cortexin's polypeptide components switch on nerve-growth signaling that helps nerve cells survive, by engaging Trk receptors (docking sites for growth signals) and the PI3K/AKT chain (an internal survival signal). The preparation improves the balance between excitatory (glutamate) and inhibitory (GABA) amino acids (brain chemicals that rev nerve cells up or calm them down), 7 protecting nerve cells from death by overstimulation (excitotoxicity) and giving anticonvulsant (anti-seizure) effects. Cortexin blocks brain caspase-8 only in the tissues where it acts. Caspase-8 is a key enzyme that starts the externally triggered cell self-destruct pathway (apoptosis (programmed cell death)), so blocking it prevents the programmed death of stressed nerve cells. 1 Known molecular targets include β5-tubulin (a structural protein that keeps cells in shape), creatine kinase B (an enzyme for energy production) and 14-3-3 α/β proteins (signal-carrying proteins). 1 Its antioxidant effects restore the balance between damaging and protective enzyme systems, 1 reducing brain inflammation by shifting microglia (the brain's immune cells) toward a protective type. The polypeptides cross the blood-brain barrier (the filter that protects the brain) after injection into muscle, allowing direct effects on the brain 3.
Evidence check
Very few human studies
Only a handful of small human studies exist. Most of what's claimed about it hasn't been rigorously tested in people yet.
Every numbered marker on this page links to one of the 8 sources at the bottom.
Brain Recovery
Helps damaged brain tissue heal by turning on natural repair signals and protecting nerve cells from further harm.
Cognitive Function
Supports memory, focus, and thinking ability by balancing brain chemicals and improving how nerve cells communicate.
Brain protection
Acts like a shield for brain cells by fighting harmful molecules and reducing inflammation that can damage neurons.
The most-asked question
The research-reported range is 10 mg, once daily.
Stroke recovery, Traumatic brain injury, Cognitive impairment
10 mg
The standard adult dose per the manufacturer instructions. The 10 mg vial is dissolved in 1-2 mL of saline, water for injection, or 0.5% procaine and injected into a muscle. Children under 20 kg get 0.5 mg/kg. 6
The ceiling: 10 (as determined by your healthcare provider based on individual response and tolerance) 6
Reconstitution, in plain words
Peptides usually arrive as a freeze-dried powder in a small vial. “Reconstitution” just means adding sterile water back in so you can measure a dose. Here's how it works for Cortexin:
Add the recommended volume of bacteriostatic water to the Cortexin vial. Gently swirl (do not shake) until the powder is fully dissolved. The resulting solution should be clear. Calculate your individual dose based on the concentration and your prescribed amount.
Your dose of Cortexin is determined by your healthcare provider. Using an insulin syringe marked in units, draw up the exact amount prescribed. For example, if the reconstituted concentration is 1mg/mL and your dose is 0.5mg, draw up 0.5mL (50 units on an insulin syringe). Always double-check calculations before injection.
Three quick questions — your vial, your water, your dose — and it tells you the exact syringe mark. “Find dose amount” is preloaded with Cortexin's recorded schedule.
Injection sites & technique
Subcutaneous (under the skin) injection (into the fatty tissue just under the skin)—allows for consistent absorption and can be self-administered at home after proper training
Timing
Morning administration is recommended to avoid potential agitation or sleep disturbance. If two injections per day are prescribed, give the second injection no later than mid-afternoon.
Administration is by injection and independent of food intake.
If combining Cortexin with other peptides or supplements, space administrations by at least 15-30 minutes when possible. Consult with a healthcare provider before combining with prescription medications.
The honest list
These show up most often. They usually fade as your body adjusts.
Cortexin is a freeze-dried powder mixed with saline and injected into a muscle. 6 Local injection site reactions (pain, redness, swelling) occur in 8-15% of patients. They are usually mild, stay in the shoulder or buttock where you injected, and clear up on their own within 24-72 hours. Pain at the injection is most common (8-12% of patients), followed by redness or swelling. Reactions become more likely with repeated injections or poor injection technique.
What to do Rotate injection sites systematically between left and right deltoid or gluteal muscles—use different sites for each of 10 consecutive injections. Use proper IM injection technique with fine-gauge needle (25-27 gauge) and inject slowly. Apply warm (not cold) compress to site if soreness persists beyond 2 hours. Topical analgesic cream may help. Massage the area gently after injection. Reactions typically resolve without intervention within 24-72 hours.
Headache is reported in approximately 5-12% of Cortexin patients, usually mild to moderate intensity and occurring during or within 2-4 hours of injection. Characteristically resolves within 2-4 hours without specific treatment. More common in the first few injections of a 10-day course and frequency typically decreases with subsequent injections. Mechanism may relate to rapid BBB penetration of neuropeptide fractions or GABAergic effects on vasculature.
What to do Usually transient and self-resolving within 2-4 hours. Acetaminophen (500-1000 mg) or ibuprofen (400 mg) provides relief if needed. Ensure adequate hydration before and after injection. Headaches on initial injections often improve or disappear by day 3-4 of treatment course. If headache is severe or persistent (>4 hours), dose reduction may be considered.
Dizziness or lightheadedness is reported in 3-8% of Cortexin patients, typically mild and occurring within 30 minutes of IM injection. Episodes are usually brief (20-60 minutes) and self-limited. More common with higher doses (10 mg vs 5 mg) or with afternoon administration. Related to GABAergic modulation or transient hemodynamic effects. True vertigo (sensation of room spinning) is uncommon (<1%).
What to do Rest in a safe location (lying down or seated) until symptoms resolve. Avoid driving or operating machinery for at least 2-4 hours after injection. Ensure adequate hydration and avoid rapid position changes. Administer injections in the morning when possible. Dizziness typically resolves spontaneously within 20-60 minutes without specific treatment.
Nausea occurs in approximately 2-4% of Cortexin patients, usually mild and very brief (15-45 minutes). Gastric effects typically resolve without specific treatment. More common with IM administration than theoretical rectal administration. Usually occurs within 30 minutes of injection. Mechanism likely relates to the polypeptide mixture stimulating GI sensory neurons or GABAergic effects.
What to do Usually brief and self-limiting without specific treatment. Ensure patient is well-hydrated before and after injection. Small frequent meals or light snacks during treatment course may help. Ginger tea may provide symptomatic relief. Antiemetics are rarely needed; nausea resolves spontaneously in the vast majority of cases. Nausea on repeat injections often improves or disappears.
Agitation, nervousness, or restlessness is reported in 1-3% of Cortexin patients, more common at higher doses (10 mg vs 5 mg) or with afternoon/evening administration. Characterized by inability to sit still, nervousness, or mild irritability lasting 30 minutes to 2 hours after injection. Likely relates to GABAergic tone shifts or peptide-mediated cholinergic effects on CNS. More common on initial injections of a course.
What to do More likely at higher doses (10 mg)—patients experiencing agitation may benefit from dose reduction to 5 mg if clinically appropriate. Administer injections in the morning (before 2 PM) to avoid nighttime sleep disruption. Patients should engage in calm, quiet activities for 1-2 hours after injection if agitation occurs. Symptoms typically resolve without specific intervention within 1-3 hours.
Transient blood pressure elevation (systolic BP increase of 5-15 mmHg) occurs in approximately 1-3% of Cortexin patients, characteristically mild and clinically insignificant. More common in hypertensive patients or with higher doses. Effects are transient, typically lasting 30-90 minutes after injection. Diastolic pressure typically increases minimally. Mechanism may relate to neuropeptide stimulation of sympathetic tone.
What to do Monitor blood pressure in hypertensive patients during initial treatment course to establish baseline changes. Changes are typically clinically insignificant and require no intervention. Ensure adequate hydration and avoid sodium loading during treatment. Patients with uncontrolled hypertension should discuss Cortexin use with their physician before starting. BP typically returns to baseline within 1-2 hours after injection.
Worth knowing about, but most people never see these.
Allergic reactions to Cortexin are rare (<1%) but possible due to its bovine (cattle) protein origin. 7 The glycine stabilizer may theoretically contribute to rare reactions. Reactions range from mild (localized rash, mild urticaria) to severe (angioedema, bronchospasm, anaphylaxis). Risk is highest in individuals with known beef/cattle protein allergies or significant atopy. Most reactions occur within 15-30 minutes of injection; delayed reactions (24-48 hours) are rare.
What to do Stop immediately if any sign of allergy appears (rash, hives, facial swelling, deep tissue swelling under the skin, difficulty breathing, wheezing, throat tightness). Have emergency medications, including epinephrine, on hand during Cortexin injections, especially if the patient has had allergies before. Mild local reactions may respond to an oral antihistamine (diphenhydramine 25-50 mg). People with known beef or cattle allergies should avoid Cortexin.
Rare, but if any of these happen, stop and contact a medical professional.
Severe allergic reactions are rare but can be life-threatening in people allergic to products made from cattle. They show up as deep swelling of the face or throat, severe tightening of the airways, collapse of blood pressure and circulation, or severe hives.
What to do Discontinue immediately. Administer epinephrine IM (0.3-0.5 mg of 1:1000 solution). Provide airway management support and IV antihistamines/corticosteroids. Transfer to emergency care. Have emergency resuscitation equipment available before administration in patients with prior allergic history.
Week by week
Is it right for you?
Cortexin should only be started, adjusted, or discontinued under medical supervision. This information is for educational purposes only and does not replace professional medical advice. Never stop a prescribed treatment without consulting your healthcare provider first, as abrupt discontinuation may have consequences.
Monitor closely if combining with Cortexin as interactions may affect bleeding risk or drug metabolism.
No known direct interaction with Cortexin. BPC-157 is sometimes used for its gut-protective properties, which could theoretically help manage GI side effects.
Generally safe to take alongside Cortexin. Space doses apart if taking oral formulations to ensure optimal absorption.
Helpful if experiencing any GI side effects that could lead to dehydration. Safe to combine.
Cortexin is particularly well-suited for individuals focused on cognitive support in chronic cerebral ischemia and cerebrovascular disease. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach 5.
Cortexin is particularly well-suited for individuals focused on neuroprotection (protecting brain cells) and neurorecovery following stroke or traumatic brain injury. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach 7.
Cortexin is particularly well-suited for individuals focused on pediatric neurology including cerebral palsy and developmental delays. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach 78.
Cortexin is a porcine brain-derived polypeptide preparation used in Russian neurology that is not FDA-approved and has no Western rigorous safety data. As an undefined mixture of peptides and proteins extracted from animal brains, batch standardization and quality control are not guaranteed. Concerns include potential transmissible spongiform encephalopathy (TSE/prion) risk from animal CNS tissue, although documented cases have not been reported. Allergic reactions to porcine proteins are possible. No formal human safety assessments, toxicology studies, or clinical trials by modern regulatory standards have been conducted. Use in Western countries is essentially non-existent due to regulatory limitations on animal-derived neurological products.
Evidence is limited to observational clinical use in Russian and post-Soviet medical practice spanning several decades and small open-label clinical studies published predominantly in Russian-language journals. No preclinical (animal or lab studies, not human trials) toxicology, human Phase 1 data, formal safety monitoring, or randomized controlled trials exist. Published reports focus on clinical efficacy claims rather than comprehensive safety characterization.
Keeping it good
Store Cortexin in the refrigerator at 36-46°F (2-8°C) in its original packaging. Protect from light and moisture. Do not freeze. Check the expiration date before use. Some formulations may be stored at room temperature for limited periods—check your specific product labeling.
Once reconstituted, Cortexin should be kept refrigerated at 36-46°F (2-8°C) and used within the timeframe specified on your product labeling (typically 14-28 days). Label the vial with the reconstitution date. Do not use if the solution appears cloudy, discolored, or contains particles.
Not our opinion — the published record
2018
Cortexin works through several protective routes: it balances oxidative stress (cell damage from unstable oxygen molecules) that harms aging brains, turns off destructive inflammatory proteins, and binds directly to key structural proteins in brain cells. This many-sided approach is what makes the peptide complex so effective at protecting nerve tissue from damage.
Gulyaeva NV
2015
Cortexin's brain peptides act like a multi-tool repair kit, protecting neurons at every level from chemical signals between cells all the way up to controlling which genes get turned on in the nucleus. This comprehensive approach means the drug can protect the brain from damage in many different ways simultaneously.
Gomazkov OA
2025
When given to developing animals with brain damage, Cortexin improved motor control and reduced structural brain injury whether injected into muscle or delivered rectally. Scientists proved the peptides actually enter the bloodstream and penetrate the brain's protective barrier using radioactive tracer studies.
Kurkin DV, Bakulin DA, Morkovin EI et al.
2020
Cortexin matched the memory-restoring power of Cerebrolysin in rats with long-lasting stroke-like brain damage, and the benefits lasted for 10 days even after treatment stopped. Both drugs repaired the damaged memory centers in the brain equally well, suggesting Cortexin is a strong alternative for ischemia (brain damage from poor blood flow).
Tyurenkov IN, Kurkin DV, Kalatanova AV et al.
2023
In a study of 801 patients with long-term blood flow problems to the brain (chronic cerebral ischemia), Cortexin combined with another treatment improved mental test scores, eased depression, and cut markers of brain damage in half. This real-world evidence from hundreds of patients supports the drug's brain-protecting power in humans.
Mashin VV, Belova LA, Kotova EY et al.
2020
Standard regimen: 10 mg injected into the muscle (intramuscularly) once daily for 10 days for adults; children under 20 kg receive 0.5 mg/kg, children over 20 kg receive 10 mg, once daily for 10 days. A repeat course may follow in 3-6 months. The vial is mixed (reconstituted) in 1-2 mL of 0.5% procaine (a numbing agent), water for injection, or 0.9% saline (salt water).
2026
Official Russian label: polypeptides from cattle cerebral cortex (the outer layer of the brain), 10 mg per vial with 22 mg glycine as a stabilizer; nootropic (thinking-enhancing), neuroprotective and antioxidant action that adjusts the balance of neurotransmitters (brain chemical messengers). Uses include stroke, traumatic brain injury and its after-effects, encephalopathies (brain disease or damage), cognitive disorders, epilepsy, developmental delays and cerebral palsy, in combination therapy. Do not use with hypersensitivity (allergy), or in pregnancy or breastfeeding, because there is no clinical data.
GEROPHARM; Vidal Russia
2017
84 children aged 1-11 with cerebral palsy and epilepsy received cortexin 5-10 mg by injection into the muscle (IM) added to antiepileptic drugs: seizure frequency more than halved with motor improvement in 36.9%, motor improvement alone in 17.8%, seizure reduction alone in 16.7%; worsening in one patient (1.2%). The authors conclude cortexin was effective and safe as an add-on treatment in this group.
Kholin AA, Zavadenko NN, Il'ina ES, et al.
If this isn't the right fit
Your questions
Both are brain-derived polypeptide preparations, but they differ in several ways. Cortexin is derived specifically from the cerebral cortex of cattle (and young pigs), 67 while Cerebrolysin is derived from whole porcine brain tissue. Cortexin is provided as a lyophilized powder requiring reconstitution and is administered only intramuscularly (up to 10 mg), while Cerebrolysin comes as a ready-to-use solution and can be given both intramuscularly and intravenously in much larger volumes (up to 50 ml). Cortexin is primarily available in Russia and CIS countries from GEROPHARM, 7 while Cerebrolysin (by EVER Pharma, Austria) is approved in over 40 countries. Preclinical (animal or lab studies, not human trials) studies suggest comparable neuroprotective (protecting brain cells) efficacy between the two preparations 4.
Cortexin is approved and widely used in Russia and some CIS (Commonwealth of Independent States) countries. 7 It is not approved by the FDA (United States), EMA (European Union), or most other Western regulatory agencies. It may be available through some international online pharmacies, but procurement and use outside approved markets carries regulatory and safety risks. The majority of clinical research on Cortexin has been published in Russian-language medical journals.
Yes, Cortexin has been used in pediatric neurology in Russia for conditions including cerebral palsy, developmental delays, epilepsy (as adjunctive therapy), and cognitive impairment in children. 7 The pediatric dosage is based on body weight: 5 mg IM daily for children under 20 kg, and 10 mg IM daily for children over 20 kg, given for a 10-day treatment course. 6 Cortexin has demonstrated efficacy and safety as adjunctive therapy in children with cerebral palsy combined with epilepsy in Russian clinical studies 8.
Cortexin is provided as a lyophilized (freeze-dried) white or slightly yellow powder in sealed glass vials. Before use, the powder must be dissolved in 1-2 ml of 0.9% sodium chloride solution (normal saline) or water for injection. 6 The reconstituted solution is then administered by intramuscular (into a muscle) injection, typically into the deltoid or gluteal muscle. The injection should be given in the morning to avoid potential sleep disturbance. The reconstituted solution must be used immediately and cannot be stored.
Animal studies have demonstrated that the neuroprotective (protecting brain cells) and cognitive benefits of Cortexin persist for at least 10 days after the last injection, 4 and clinical experience suggests effects can last for weeks to months. However, for chronic conditions such as cerebrovascular disease and cognitive impairment, repeated treatment courses every 3-6 months 6 are recommended to maintain and build upon therapeutic gains. The multicenter CORNELia study showed sustained cognitive improvements at the 30-day assessment point after treatment initiation 5.
The evidence base for Cortexin includes multicenter observational studies (such as the CORNELia study with 801 patients), 5 comparative animal studies, 4 and extensive Russian clinical experience. However, it lacks large-scale, randomized, double-blind, placebo-controlled trials published in major international peer-reviewed journals. Most research has been published in Russian medical journals (primarily Zhurnal Nevrologii i Psikhiatrii). While the Russian clinical evidence is substantial, the limited availability of English-language studies and the absence of Western regulatory approval mean that Cortexin's evidence base is not considered strong by international standards.
8 sources
Every numbered marker on this page points to one of these. Same sources, same numbering as the Cortexin research profile on Peptide Initiative.
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Every claim on this page traces back to the research database behind Peptide Initiative — studies, citations, clinical trial data, and the technical detail we deliberately left out here.
Open the research profileThis guide is education, not medical advice. Talk to a clinician before taking anything.
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