Semax
ACTH(4-10) Analog
Semax is a peptide people usually talk about for Cerebral ischemia / stroke recovery and Trigeminal neuralgia. It is still in the FDA review process, so people are watching both the research and the access question closely.
Why does this matter?
Semax matters because a lot of people hear about it online without a clear sense of what it may actually help with. This page gives you the plain-English version first, then shows where the research is strongest, what is still uncertain, and where the peptide stands in the FDA review process.
Molecular weight
813.97 g/mol
Molecular formula
C₃₉H₅₁N₉O₁₀S
Amino acid count
7
Review date
July 23-24, 2026
Sequence / structure
Met-Glu-His-Phe-Pro-Gly-Pro (ACTH 4-7 + PGP)
Other names
Semax, ACTH(4-7)-PGP, Heptapeptide Semax, NA-Semax (N-acetyl Semax — enhanced version), NA-Semax-Amidate (further modified version)
Status
Under FDA review for cerebral ischemia and trigeminal neuralgia
Semax is a brain-focused peptide best known for sharper thinking, better memory, and stronger neuroprotection. It has a real-world track record too, with prescription use in Russia and Ukraine for more than two decades in settings that include stroke recovery and cognitive support. That combination of everyday mental-performance interest and longer clinical experience is what keeps Semax in the spotlight.
The quick version before the deep dive
- •People usually talk about Semax for Cerebral ischemia / stroke recovery and Trigeminal neuralgia.
- •Trigeminal neuralgia.
- •Potently increases Brain-Derived Neurotrophic Factor expression (up to 3-4x in animal models).
- •Increases Nerve Growth Factor and other neurotrophins (NT-3, NT-4).
Deep Dive: Mechanism of Action +
BDNF Upregulation — Potently increases Brain-Derived Neurotrophic Factor expression (up to 3-4x in animal models)
NGF Enhancement — Increases Nerve Growth Factor and other neurotrophins (NT-3, NT-4)
Melanocortin System — Acts on MC3/MC4 receptors (without adrenal stimulation)
Neuroplasticity — Enhances synaptic plasticity and long-term potentiation
Anti-oxidative — Reduces oxidative stress in neural tissue
Anti-inflammatory (CNS) — Modulates neuroinflammation
Dopaminergic Modulation — Influences dopamine and serotonin turnover
Gene Expression — Modulates expression of 24+ genes related to immune and vascular function in brain
NO System — Does NOT affect adrenal cortisol (unlike full ACTH)
Where people usually see it discussed
Neurological (FDA Review Indications) +
- Cerebral ischemia / stroke recovery
- Trigeminal neuralgia
Cognitive (Approved in Russia) +
- Cognitive impairment
- Memory enhancement
- ADHD (pediatric, approved in Russia)
- Learning disabilities
- Age-related cognitive decline
Neuroprotective +
- Stroke prevention and recovery
- Traumatic brain injury
- Optic nerve atrophy (approved in Russia)
- Neurodegenerative diseases (research)
Mental Health +
- Depression (adjunctive)
- Anxiety
- PTSD
- Chronic fatigue
Formal evidence and study snapshots
Deep Dive: Clinical Trials +
Russian Phase III (multiple)
Human clinicalIschemic stroke
Improved neurological outcomes, reduced disability
Eremin et al. 2004
Human clinicalOptic nerve
Improved visual function in optic atrophy
Kaplan et al. 1996
Human clinicalCognitive
Enhanced memory and attention in healthy subjects
Russian pediatric trials
Human clinicalADHD
Improved attention and behavior in children
Dolotov et al.
PreclinicalBDNF
3-4x increase in BDNF mRNA in rat brain
What the current safety discussion looks like
- ✓20+ years of clinical use in Russia without significant safety signals
- ✓Approved prescription medication in Russia (0.1% nasal drops)
- ✓No hormonal effects — does not stimulate adrenal cortex (unlike ACTH)
- ✓No addiction/tolerance reported
- ✓No sedation (unlike many cognitive-enhancing drugs)
- ✓Side effects (rare): Mild nasal irritation (intranasal), occasional headache
- ✓No hepatotoxicity, cardiotoxicity, or nephrotoxicity reported
- ✓Safe in pediatric populations (approved for ADHD in children in Russia)
- ✓No withdrawal effects
How the status timeline currently reads
1996
Approved prescription medication in Russia
2001
Additional approvals (optic nerve, ADHD)
2011
Added to Russian Essential Drug List
Pre-2023 (US)
Category 1 — eligible for 503A compounding
September 2023
Moved to Category 2 in US
July 23-24, 2026
FDA advisory committee review for cerebral ischemia and trigeminal neuralgia
How dosing is usually described
Intranasal (Primary route — as approved in Russia)
Standard: 200-600 mcg/day divided into 2-3 doses Acute stroke: 1200-1800 mcg/day (clinical setting) Cognitive enhancement: 200-400 mcg/day Duration: 10-14 day courses, repeatable
Subcutaneous (Research)
200-400 mcg/day
Administration
0.1% solution (1 mg/mL) is the standard Russian formulation 1-2 drops per nostril, 2-3x daily Course duration: 10-14 days (can repeat after 2-4 week break)
Research protocols only. Not medical advice.
The citations behind the page
Deep Dive: Key Research Papers +
- 1
Ashmarin IP, et al.*. "Regulatory peptides in cognitive processes." Neuroscience and Behavioral Physiology 2007.
- 2
Dolotov OV, et al.*. "Semax, an analogue of ACTH(4-10) with cognitive effects, regulates BDNF and trkB expression in the rat hippocampus." Brain Research 2006.
- 3
Filippenkov IB, et al.*. "Effects of Semax on the transcriptome of the rat brain during ischemia." Molecular Biology 2019.
- 4
Myasoedov NF, et al.*. "Mechanisms of action of Semax and its analogs." Molecular Genetics, Microbiology and Virology 2015.
- 5
Eremin KO, et al.*. "Semax (ACTH 4-10 analogue) in the treatment of optic nerve atrophy." European Journal of Ophthalmology 2004.
- 6
Levitskaya NG, et al.*. "Nootropic and analgesic effects of Semax following different routes of administration." Neuroscience and Behavioral Physiology 2008.
- 7
Grivennikov IA, et al.*. "Neuroprotective effects of Semax in conditions modeling ischemic infarction." Bulletin of Experimental Biology and Medicine 2008.
Common questions about Semax
What is Semax? +
Semax is ACTH(4-10) Analog, one of the peptides currently under review in connection with cerebral ischemia and trigeminal neuralgia.
What is Semax being reviewed for? +
The current advisory review focuses on cerebral ischemia and trigeminal neuralgia, with a listed review date of July 23-24, 2026.
Which category does Semax belong to? +
Semax is grouped in this library under Cognitive.
How many amino acids are in Semax? +
Semax is presented here as a 7-amino-acid peptide or peptide analog based on the source research and naming conventions.
What is the sequence or structure note for Semax? +
Met-Glu-His-Phe-Pro-Gly-Pro (ACTH 4-7 + PGP).
What research applications are most associated with Semax? +
Cerebral ischemia / stroke recovery, Trigeminal neuralgia, Cognitive impairment, and Memory enhancement
How is Semax described as working in the current research? +
Potently increases Brain-Derived Neurotrophic Factor expression (up to 3-4x in animal models). Increases Nerve Growth Factor and other neurotrophins (NT-3, NT-4).
How is Semax usually discussed in protocols or treatment plans? +
Semax is most often described with intranasal and subcutaneous protocols in the source material.
What does the safety discussion say about Semax? +
20+ years of clinical use in Russia without significant safety signals Approved prescription medication in Russia (0.1% nasal drops)
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