Cerebrolysin

How a course is commonly described

1. 1
   Days 1-10Community-reported

   Community courses start at 5 mL intramuscularly each morning with no titration, and guides place the first subjective change around days 4-10. The acute stroke trials delivered their whole course in this window, 30 mL a day by infusion for 10 days.

2. 2
   Days 10-21Clinical

   Community courses end at 10-20 days. The CARS rehabilitation trials ran 30 mL a day for the full 21 days alongside daily rehabilitation, and the CAPTAIN trials followed a 10-day 50 mL phase with two more 10-day cycles at 10 mL.

3. 3
   Weeks 1-4 (dementia cycle)Clinical

   The labelled dementia regimen is 10-30 mL a day, five days a week, for four weeks. The 2006 dose-ranging trial extended this with twice-weekly infusions for a further eight weeks and found the lowest dose, 10 mL, the only one that improved cognition at week 24.

4. 4
   BreakCommunity-reported

   Community guides describe a 1-2 month break and 2-3 courses a year; the label describes 2-4 dementia cycles a year. Guides frame the gap as the period in which effects keep developing, pointing to trials whose endpoints were measured at day 90 or later.

5. 5
   Day 90 assessmentClinical

   Every major trial measured its primary endpoint 90 days after the first dose, long after the last injection: CASTA was neutral at that point, CARS and CAPTAIN II reported small-to-medium or large effects on function, and the Alzheimer's trials saw global change two months after the course ended.

• The trials gave 30-50 mL a day by intravenous infusion to hospital patients with stroke, brain injury or dementia. The 5-10 mL intramuscular courses described by the nootropic community deliver a third to a tenth of that volume to healthy people, a use no trial has examined.
• The 2023 Cochrane review found no reduction in death after acute stroke and more non-fatal serious adverse events, most pronounced with the 30 mL for 10 days regimen, while manufacturer-supported trials report functional benefit; the two readings of the same literature have not been reconciled, and the Cochrane review of vascular dementia rated its positive findings very low quality.
• Cerebrolysin is not approved in the United States or the United Kingdom and the FDA orphan designations for frontotemporal dementia and CADASIL are not approvals. The label lists epilepsy, severe renal impairment and hypersensitivity as contraindications, and because it is a porcine protein hydrolysate its batch composition cannot be reduced to a single molecule.