Cerebrolysin

A prescription injectable made from purified pig brain protein, a mixture of low molecular weight peptides and free amino acids. It is registered in Austria and studied in human stroke and dementia trials, and labelled by its maker for brain injury, though the pooled evidence stays mixed and is often graded very low to moderate quality.

Last updated: September 2026

What is Cerebrolysin?

Cerebrolysin is a prescription injectable medicine, not an oral supplement. It is a mixture of low molecular weight peptides and free amino acids, described in one trial paper as roughly 85% free amino acids and 15% biologically active peptides, produced by controlled enzymatic breakdown of purified pig brain protein (PMID 29155000; Vietnamese label, Long Chau). The concentrate is supplied as a solution for injection at 215.2 mg per ml, and it sits apart from the research compounds in our peptide library because it is a registered medicine with a named marketing authorisation holder.

The manufacturer, EVER Neuro Pharma of Austria, describes it as a multi-modal neuropeptide drug that improves the ability of the brain to self-repair, and lists it for cerebrovascular disorders, specifically senile dementia of the Alzheimer type, vascular dementia, stroke and craniocerebral trauma (manufacturer label, EVER Pharma). That is the manufacturer position, not an independent finding. It is a registered prescription medicine in Austria and is listed by the licensed pharmacy chain Long Chau in Vietnam, while two openFDA API queries returned a genuine no-match, meaning no FDA-approved cerebrolysin product was found in the United States (openFDA).

Outside Austria it is widely used for acute ischaemic stroke in Russia, Eastern Europe, China and other Asian and post-Soviet countries, though wide use is not the same as broad regulatory approval. The independent evidence is mixed: the current Cochrane review of seven randomized trials, one of a cerebrolysin-like agent (Cortexin), found probably little to no effect on survival after stroke, a separate 2017 meta-analysis found no significant superiority on functional scales, and the vascular dementia evidence, while showing a signal, was graded very low quality with an evidence base Cochrane calls weak (PMID 37818733, 28656143, 31710397). Industry funding of several of the pivotal trials is documented inside the reviews themselves. See our peptide FAQ for how research grades are read.

How It Works

Neurotrophic mimicry: trial papers describe cerebrolysin as acting like the body's own neurotrophic factors, said to promote neurogenesis and neuronal plasticity. This is the proposed mechanism, not a proven clinical effect (PMID 33935111, 29155000).

Composition: it is a defined mixture, described as roughly 85% free amino acids and 15% low molecular weight peptides, made by a standardised, controlled enzymatic breakdown of purified pig brain protein, and the finished solution is stated to contain no protein, lipid or antigenic compounds (PMID 29155000; Vietnamese label, Long Chau).

Blood brain barrier crossing: an animal distribution study reproduced in the Vietnamese label injected radiolabelled cerebrolysin into rats and reported the components reaching brain tissue (animal study, rat, intravenous tail vein, n=8, Vietnamese label). The label draws a blood brain barrier crossing conclusion from it, but its own summary range of 170 to 390 ng per gram does not match the higher figures in its tissue table on the same page, an inconsistency that is in the source.

Onset framing: the manufacturer positions it as a fast onset agent (manufacturer label), and the Vietnamese label states neurotrophic activity can be detected in plasma 24 hours after injection (Vietnamese label, Long Chau). These are label statements, not independent trial endpoints.

What Trials and Reviews Report

Stroke rehabilitation: in the CARS randomized trial, cerebrolysin at 30 mL per day showed a large effect size on the Action Research Arm Test at day 90 (Mann-Whitney estimator 0.71, 95% CI 0.63 to 0.79), but the authors called the study exploratory and small and asked for a large-scale trial to confirm it (PMID 26564102).
Acute stroke, pooled: the current Cochrane review of seven RCTs (1773 participants, one a trial of the cerebrolysin-like agent Cortexin) found probably little to no difference in all-cause death (RR 0.96, 95% CI 0.65 to 1.41), and a separate 2017 meta-analysis of seven studies (1779 patients) found no significant superiority on the modified Rankin Scale or Barthel Index (PMID 37818733, 28656143).
Alzheimer type dementia: one RCT (192 enrolled) reported more responders on a global change scale at week 12 (76% versus 57%), though the authors noted a baseline imbalance between the groups (PMID 12111446).
Vascular dementia, pooled: six RCTs (597 participants) showed a beneficial signal on cognition and global function, but Cochrane graded the evidence very low quality and described the supporting base as weak (PMID 31710397).
Haemorrhagic transformation: the CEREHETIS pilot reported a lower symptomatic haemorrhagic transformation rate with cerebrolysin added to alteplase (OR 0.248, 95% CI 0.072 to 0.851), but no difference in the day 90 modified Rankin Scale (PMID 36973684).
Thrombectomy add-on: a 2025 open label study with propensity-matched historical controls reported higher rates of mRS 0 to 2 at 90 days (68% versus 44%), and the authors themselves called for randomized trials to validate it (PMID 40325343).
Cervical myelopathy: two randomized trials reported greater neurological improvement with cerebrolysin, one in conservatively treated cervical spondylotic myelopathy (192 patients) and one after surgery for degenerative cervical myelopathy (90 patients), with the dose not stated in either abstract (PMID 29155000, 36730671).
Preterm infant motor development: an RCT reported fewer infants with failed gross motor development at 12 months when cerebrolysin was added to an early intervention program, 33% versus 70%, with the total n not stated in the abstract (PMID 33935111).

Dosing Described in Research and Labels

Phase	Dose	Frequency	Duration
Alzheimer type dementia (RCT)	30 mL per day (trial dose, not a recommendation, PMID 12111446)	Intravenous, 5 days a week	4 weeks; 192 enrolled (95 placebo, 97 cerebrolysin)
Subacute stroke rehabilitation, CARS (RCT)	30 mL per day (trial dose, not a recommendation, PMID 26564102)	Once daily, 24 to 72 hours after onset, with rehabilitation	21 days; day 90 endpoint (n not stated in the abstract)
Acute ischaemic stroke, dose ranging (RCT)	10 mL vs 50 mL per day (trial doses, not a recommendation, PMID 15559222)	Daily, within 12 hours of onset, ages 45 to 85	10 days; n=36 (12 placebo, 12 per dose arm)
Thrombolysis add-on, CEREHETIS (RCT)	30 mL per day (trial dose, not a recommendation, PMID 36973684)	Alongside alteplase 0.9 mg/kg	14 days; 126 treated, 215 controls
Thrombectomy add-on (open label, historical controls)	30 mL intravenous (trial dose, not a recommendation, PMID 40325343)	Within 8 hours of onset, plus a second cycle on days 69 to 90	To day 21; 50 treated vs 50 matched historical controls
High risk preterm infants (RCT)	0.1 mL per kg body weight (trial dose, not a recommendation, PMID 33935111)	Weekly injection, adjuvant to early intervention	3 months (total n not stated in the abstract)
Other stroke and cervical myelopathy RCTs	Dose not stated in the abstract (trial reports, PMID 26934986, 34214867, 29155000, 36730671)	Intravenous or injection add-on	10 days to 4 weeks by trial; one duration not stated
Manufacturer label, stroke	20 to 50 mL per day (manufacturer label, not a recommendation, EVER Pharma)	Intravenous or infusion, as soon as possible	10 to 21 days
Manufacturer label, traumatic brain injury	20 to 50 mL per day (manufacturer label, not a recommendation, EVER Pharma)	As soon as possible	7 to 30 days
Manufacturer label, cognition and Alzheimer type	10 to 30 mL per day (manufacturer label, not a recommendation, EVER Pharma)	5 days weekly over 4 weeks	2 to 4 cycles per year

These figures summarise what published research and approved labels describe. They are educational, not a recommendation or a personal protocol. Any dose, schedule, or decision to use a compound belongs with a licensed prescriber.

Side Effects

Common

⚠Sensation of heat if the injection is given too quickly (Vietnamese label, Long Chau).
⚠In the Alzheimer trial the named events were headache, dizziness, weight loss and anxiety, and the overall event rate was higher on placebo than on cerebrolysin, 73% versus 64% (PMID 12111446).
⚠In vascular dementia trials there was no difference in adverse event rates versus placebo, on very low quality evidence (PMID 31710397).
⚠Pooled acute stroke trials show an increase in non-fatal serious adverse events (RR 2.39, 95% CI 1.10 to 5.23), and the signal was stronger in the 30 mL for 10 days schedule (RR 2.87, 95% CI 1.24 to 6.69) (PMID 37818733).
⚠Across the pooled analyses, total adverse events, total serious adverse events and all-cause mortality did not differ from placebo (PMID 37818733).

Rare

•Rarely, hypersensitivity may present as tremor, headache or a mild rise in body temperature (Vietnamese label, Long Chau).

Who Should NOT Use Cerebrolysin

✕Hypersensitivity to any component of the drug (manufacturer label).
✕Epilepsy: the label names status epilepticus or grand mal seizures, or epilepsy with increasing seizure frequency (manufacturer and Vietnamese label).
✕Severe renal impairment (manufacturer label).
✕Pregnancy has no clinical safety data, and the label advises against use during breastfeeding unless the expected benefit outweighs the possible harm (Vietnamese label, Long Chau).
✕Caution with antidepressants or MAO inhibitors: the label says combined use may increase drug accumulation and that the dose of the other drug should be reduced (Vietnamese label, Long Chau).

How Courses Are Structured in Research and Labels

Per injection

Doses up to 5 mL may be given intramuscularly; above 5 mL the label uses intravenous injection or a slow infusion, run over at least 20 to 60 minutes in a standard diluent (Vietnamese label, Long Chau).

A course

The Vietnamese label defines a course as at least 10 to 20 daily injections; the manufacturer label lists 10 to 21 days for stroke and 7 to 30 days for traumatic brain injury (labels, EVER Pharma and Long Chau).

Cyclic use

For cognition and Alzheimer type indications the manufacturer label describes 5 days weekly over 4 weeks, repeated 2 to 4 cycles per year (manufacturer label, EVER Pharma).

Trial endpoints

Trials measured outcomes at fixed points rather than by feel, for example day 90 after stroke, or weeks 4, 12 and 24 in the Alzheimer trial (PMID 26564102, 12111446).

Notes from Ho Chi Minh City

In Ho Chi Minh City cerebrolysin sits on the prescription side of the counter, not the grey market. Long Chau lists the EVER Neuro Pharma ampoule boxes, the 5 mL and the 10 mL, both marked prescription-only with the price left blank and a line telling you to ask a pharmacist. That matches how it is used here, as an intravenous or infusion drug that medical staff administer over a course, running the line slowly, rather than something anyone reconstitutes at home. It is Austrian made and registered, a world away from the powder and bacteriostatic water peptides most of this library covers. Whether it belongs in any given case, and at what dose, is a decision for a licensed prescriber, not a self-administered one.

Sourcing in Vietnam

The licensed pharmacy chain Long Chau lists two EVER Neuro Pharma packs, a 5 mL box and a 10 mL box, each a blister of five ampoules and each marked prescription-only (fetched 2026-09-06). No price is published: every price field on the listing is blank and the page tells you to consult a pharmacist. The only price figure anywhere on the page, 555.000đ, appears in a customer comment thread and was disputed there by another customer saying an extra zero was typed, so it is not a listed price. The page also prints a Vietnamese registration number, QLSP-845-15, but that is the retailer rendering of the number and was not confirmed against the Drug Administration of Vietnam database, which could not be queried. Country of origin is given as Austria, maker EVER Neuro Pharma GmbH.

FAQ

Q: Is cerebrolysin approved by the FDA?

A: No. Two openFDA API queries, one for the brand name and one for the substance name, each returned a genuine no-match, so no FDA-approved cerebrolysin product or FDA drug label was found in the United States. It is a registered prescription medicine in Austria and is listed by a licensed pharmacy chain in Vietnam.

Q: What doses were used in cerebrolysin trials?

A: The most common trial dose was 30 mL per day, used in an Alzheimer trial (given intravenously), the CARS stroke rehabilitation trial and the CEREHETIS thrombolysis pilot. A dose ranging stroke trial compared 10 mL with 50 mL per day, and a preterm infant trial used 0.1 mL per kg weekly. These are trial doses, not recommendations, and several other trials did not state a dose or route in the abstract.

Q: Does cerebrolysin work for stroke?

A: The evidence is mixed. The current Cochrane review of seven randomized trials, one of a cerebrolysin-like agent (Cortexin), found probably little to no effect on survival, and a 2017 meta-analysis found no significant superiority on functional scales, although some individual trials reported positive signals on specific measures. Cochrane also flagged an increase in non-fatal serious adverse events. Any use is a decision for a licensed physician.

Q: What are the side effects of cerebrolysin?

A: The label lists a sensation of heat if the injection is given too fast and, rarely, hypersensitivity with tremor, headache or a mild rise in body temperature. Pooled stroke trials show an increase in non-fatal serious adverse events, which was more prominent at 30 mL for 10 days, while total serious events and mortality did not differ from placebo.

Q: Is cerebrolysin a nootropic or a supplement?

A: Neither in the usual sense. It is a prescription-only injectable medicine derived from purified pig brain protein, not an oral supplement, and every human dose in the sources reviewed is injected, intramuscular, intravenous or infused. It also does not appear in the WHO ATC index nootropics subgroup N06BX on the page checked, though a full ATC search across all groups was not run.

Q: How much does cerebrolysin cost in Vietnam?

A: No price is published. The licensed pharmacy chain Long Chau lists a 5 mL and a 10 mL EVER Neuro Pharma pack, both prescription-only, with every price field blank and a note to consult a pharmacist (fetched 2026-09-06). A single pharmacist comment mentioning 555.000đ was disputed in the same thread by a customer saying an extra zero was typed, so it is not a listed price.

Availability in Vietnam

Cerebrolysin is a prescription-only injectable, not a research or grey market peptide. In Vietnam it is dispensed through licensed pharmacies on a prescription and given by medical staff. See the Sourcing in Vietnam note for the current pharmacy listing, and the peptide library for how it compares with other compounds.

Back to Peptide Library

Peptide Library Peptide FAQ Peptide Legality in Vietnam

Research & Sources

Cerebrolysin for acute ischaemic stroke · Cochrane Database of Systematic Reviews (2023) (PMID: 37818733)
Current version (pub7). Seven RCTs, 1773 participants, one of a cerebrolysin-like agent (Cortexin). Probably no effect on all-cause death; a potential increase in non-fatal serious adverse events, more prominent at 30 mL for 10 days.
Cerebrolysin for vascular dementia · Cochrane Database of Systematic Reviews (2019) (PMID: 31710397)
Six RCTs, 597 participants. A beneficial signal on cognition and global function, all graded very low quality; the review calls the supporting evidence base weak.
Efficacy and Safety of Cerebrolysin for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials · BioMed Research International (2017) (PMID: 28656143)
Seven studies, 1779 patients. No significant superiority on the modified Rankin Scale or Barthel Index; neutral safety outcomes versus placebo.
Cerebrolysin in Alzheimer's disease: a randomized, double-blind, placebo-controlled trial with a neurotrophic agent · Journal of Neural Transmission (2002) (PMID: 12111446)
Intravenous 30 mL, 5 days a week for 4 weeks. 192 enrolled (95 placebo, 97 cerebrolysin). More CIBIC+ responders at week 12; a baseline imbalance is noted in the abstract.
Cerebrolysin and Recovery After Stroke (CARS): A Randomized, Placebo-Controlled, Double-Blind, Multicenter Trial · Stroke (2016) (PMID: 26564102)
30 mL per day for 21 days, starting 24 to 72 hours after onset. Large effect size on the Action Research Arm Test at day 90; the authors describe it as exploratory and small.
[A randomized, double-blind, placebo-controlled study of Cerebrolysin safety and efficacy in the treatment of acute ischemic stroke] · Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova (2004) (PMID: 15559222)
Article in Russian. Dose ranging: placebo (n=12) versus 10 mL per day (n=12) versus 50 mL per day (n=12) for 10 days.
Cerebrolysin as an Early Add-on to Reperfusion Therapy: Risk of Hemorrhagic Transformation after Ischemic Stroke (CEREHETIS), a prospective, randomized, multicenter pilot study · BMC Neurology (2023) (PMID: 36973684)
30 mL per day over 14 days with alteplase 0.9 mg/kg, 126 treated versus 215 controls. Lower symptomatic haemorrhagic transformation; no difference in day 90 modified Rankin Scale.
Efficacy of Cerebrolysin Treatment as an Add-On Therapy to Mechanical Thrombectomy in Patients with Acute Ischemic Stroke Due to Large Vessel Occlusion in Anterior Circulation: Results of a 3-Month Follow-up of a Prospective, Open Label, Single-Center Study · Translational Stroke Research (2025) (PMID: 40325343)
Open label, single arm, 30 mL intravenous within 8 hours to day 21 plus a second cycle on days 69 to 90, versus 50 propensity-matched historical controls. Authors call for randomized trials.
Effect of cerebrolysin on neurodevelopmental outcome of high risk preterm infants: A randomized controlled trial · Journal of Neonatal-Perinatal Medicine (2022) (PMID: 33935111)
0.1 mL per kg body weight weekly for 3 months as an adjuvant. Fewer infants with failed gross motor development at 12 months; total n not stated in the abstract.
Cerebrolysin combined with rehabilitation promotes motor recovery in patients with severe motor impairment after stroke · BMC Neurology (2016) (PMID: 26934986)
Phase IV RCT, 70 patients, 21 day course. No difference in the whole group; a subgroup with severe impairment improved more. Dose not stated in the abstract.
Efficacy and safety of Cerebrolysin after futile recanalisation therapy in patients with severe stroke · Clinical Neurology and Neurosurgery (2021) (PMID: 34214867)
Intravenous add-on after recanalisation. No difference on the modified Rankin scale; a difference in haemorrhagic transition and mortality in favour of cerebrolysin. Dose and n not stated in the abstract.
Role of Cerebrolysin in cervical spondylotic myelopathy patients: a prospective randomized study · The Spine Journal (2018) (PMID: 29155000)
192 patients over 4 weeks, both arms on celecoxib. Greater myelopathy improvement with cerebrolysin. Source of the 85% amino acid, 15% peptide composition figure. Dose and route not stated in the abstract.
Prospective Randomized Control Trial to Compare the Role of Injection Cerebrolysin for 10 Days Duration Against Placebo in Operated Cases of Degenerative Cervical Myelopathy · Spine (2023) (PMID: 36730671)
90 operated cases, 60 cerebrolysin for 10 days versus 30 placebo. Higher mJOA scores at one year. Dose volume not stated; route stated only as injection.
Cerebrolysin, manufacturer product and prescribing information (EVER Neuro Pharma) · everpharma.com and cerebrolysin.com (2026) Link
Manufacturer pages: solution for injection, strength 215.2 mg/ml, labelled indications, contraindications, and the label dosage table (stroke and TBI 20 to 50 mL per day; cognition and Alzheimer type 10 to 30 mL per day). Accessed 2026-09-06.
Cerebrolysin 10ml, Vietnamese pharmacy product listing (Nha Thuoc Long Chau) · nhathuoclongchau.com.vn (2026) Link
Licensed pharmacy listing carrying the Vietnamese label text (route thresholds, course length, contraindications, undesirable effects, the rat distribution study) and the registration number QLSP-845-15 as printed by the retailer. No price displayed. Accessed 2026-09-06.
openFDA Drugs@FDA and drug label API queries for cerebrolysin · api.fda.gov (2026) Link
Both the brand name and substance name queries returned a genuine no-match, indicating no FDA-approved cerebrolysin product or FDA drug label was found. Accessed 2026-09-06.
WHO Collaborating Centre for Drug Statistics Methodology, ATC/DDD Index, group N06BX · atcddd.fhi.no (2026) Link
Cerebrolysin does not appear in the N06BX other psychostimulants and nootropics group on this page. A full ATC search across all groups was not run. Accessed 2026-09-06.

Important Disclaimer

Educational content only. This is not medical advice. Cerebrolysin is a prescription-only injectable medicine, not a supplement, and any decision to use it, including any dose, route or course, belongs with a licensed physician. It is a registered prescription medicine in Austria and is listed by a licensed pharmacy chain in Vietnam under a registration number printed by the retailer, QLSP-845-15, which was not confirmed against the Drug Administration of Vietnam database. Two openFDA API queries found no FDA-approved cerebrolysin product in the United States. Consult a licensed physician before any use.