Peptide

Semax

Synthetic heptapeptide derived from ACTH(4-10), developed in Russia; intranasal use for neuroprotection, stroke, and cognitive disorders. Upregulates BDNF, dopamine, and serotonin.

Regulatory status

Not approved

FDA (U.S.): Not approved. The FDA noted possible immunogenicity and insufficient safety data when evaluating it for compounding (proposal withdrawn).

EMA (EU): Not approved. It is used as a medicine only in Russia (it has been on the Russian list of essential medicines since 2011, e.g., for stroke).

How to take it

Typical intranasal regimen: 250-1000 µg/day for 10-14 days in cycles. Only approved in Russia.

Safety

Well tolerated in Russian trials; no long-term safety data in the West. Not approved by the FDA/EMA.

Effect by goal · level of evidence

Ischemic stroke (recovery)

improves Moderate clinical trial (A)

Improvement in Russian trials

Russian clinical study in the acute phase of hemispheric ischemic stroke: patients treated with Semax showed better neurological and electrophysiological recovery. Limited methodological quality and no independent replication.

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Neuropathy and cognition

improves (modest) Low-moderate review (A)

Preliminary data

2025 review of its possible use in Alzheimer-type cognitive impairment: the data come mostly from experimental models. Rigorous clinical trials in people are lacking.

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BDNF and neurotransmitters

improves Low preclinical (A)

Preclinical mechanism

In rats, Semax increases BDNF and its receptor in the hippocampus, a mechanism that could explain its cognitive effects. Animal study.

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Information, not medical advice. Scientific evidence reflects the quality of the studies.