Semax
Cognitive · Russian peptide
Tier C+
Bottom line
Read Off Label grades Semax as C+ (5.7/10) based on weak evidence, variable benefit magnitude, and a low-risk safety profile.
Used in Russia for stroke, ADHD, cognitive support.
Studied, labeled, or reported-use context: 200-600 mcg intranasal daily in cycles — Research chemical (Russia Rx); PCAC voted 8-5 in favour of adding Semax to the 503A bulks list, for cerebral ischaemia, migraine, and trigeminal neuralgia (Jul 23-24, 2026) — advisory only, not an FDA approval or a final compounding decision; not individualized guidance.
Frontier potential — editorial judgment, not evidence
This is a separate axis from the grade above. It asks a different question: if this worked in humans, how much would it matter? It is our judgment, it is not part of the composite score, and it cannot raise a grade. A high number here is a statement about the idea, not about whether it works or whether anyone should take it.
What the ceiling rests on
An ACTH(4-10) analogue with a coherent mechanism — it raises BDNF and NGF expression in animal models — and decades of Russian clinical use in stroke and cognitive indications, including registration as a medicine there.
Why it may not get there
The clinical literature is almost entirely Russian-language, with trial designs and reporting standards that have not been independently verified, and Western replication is essentially absent. Intranasal peptide delivery to the brain is itself contested. This is a case where the volume of use is high and the quality of evidence supporting it is low.
What would change this An independent Western trial with a validated cognitive endpoint.
What the evidence says
Used in Russia for stroke, ADHD, cognitive support. Very limited peer-reviewed Western data. Popular in DIY nootropic communities. Some users report focus/mood improvement; others nothing. The FDA Pharmacy Compounding Advisory Committee (PCAC) met Jul 23-24, 2026 and voted on seven peptides for the 503A bulk drug substances list. Committee votes are advisory: the FDA is not bound by them, adding a substance to the 503A list would follow notice-and-comment rulemaking, and inclusion would permit compounding — it would not constitute FDA approval, an efficacy finding, or a safety determination. FDA's own review staff had recommended against the four Jul 23 peptides, citing poor characterization, weak human efficacy and safety evidence, and unassessed immunogenicity; press coverage also noted committee members' financial ties to the peptide industry. The underlying human evidence base for these compounds is unchanged by the vote. On this compound the committee voted 8-5 in favour of adding Semax to the 503A bulks list, for cerebral ischaemia, migraine, and trigeminal neuralgia.
Mechanism
Synthetic ACTH(4-10) analog; BDNF/NGF upregulation; dopaminergic/serotonergic modulation; neuroprotective via HPA modulation
Studied, labeled, or reported dose & route
200-600 mcg intranasal daily in cycles
This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.
Citations
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Common questions
- What does the evidence show about Semax's effects?
- Read Off Label rates the evidence for Semax as Weak and the benefit magnitude as variable, producing an overall grade of C+ (5.7/10). Used in Russia for stroke, ADHD, cognitive support.
- What safety findings are reported for Semax?
- Semax has a low risk profile in the database. Low (reported; limited Western safety data) Legal status: Research chemical (Russia Rx); PCAC voted 8-5 in favour of adding Semax to the 503A bulks list, for cerebral ischaemia, migraine, and trigeminal neuralgia (Jul 23-24, 2026) — advisory only, not an FDA approval or a final compounding decision.
- What doses or routes are reported for Semax?
- 200-600 mcg intranasal daily in cycles This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
- How does Semax work?
- Synthetic ACTH(4-10) analog; BDNF/NGF upregulation; dopaminergic/serotonergic modulation; neuroprotective via HPA modulation
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.