This is a working overview of intranasal route, written for readers who want more than a one-paragraph summary but less than a textbook.
Reviewed 2026-06-08. Anything still debated is marked as such rather than presented as settled.
Semax is a synthetic heptapeptide with the sequence Met-Glu-His-Phe-Pro-Gly-Pro. It is described in the literature as an analogue of the ACTH(4–10) fragment, a short N-terminal portion of adrenocorticotropic hormone that retains some neurotropic activity without the full hormonal effects of the parent peptide. The molecule carries a methionine residue at the N-terminus and two proline residues near the C-terminus, features that shape both its interactions with receptor systems and its chemical stability. The free peptide corresponds to the formula C37H51N9O10S and a molecular mass near 813.9 Da.
The compound was developed in the 1980s at the Institute of Molecular Genetics in Moscow, where it emerged from research on short ACTH fragments and their effects on the central nervous system. Russian pharmaceutical listings describe it as a nootropic and neuroprotective agent, most often formulated as nasal drops. It is not a marketed medicine in the United States or the European Union, and no pharmacopoeial monograph covers it. Consequently, most published clinical experience with the substance originates from a small number of research centres, mainly in Russia and neighbouring countries.
Pharmacological accounts link semax to melanocortin signalling and to modulation of neurotrophic factor expression, particularly brain-derived neurotrophic factor and nerve growth factor. Much of this evidence comes from rodent studies using intranasal delivery, a route chosen because it allows peptides to reach the central nervous system with limited systemic exposure. Whether the same mechanisms operate in humans at comparable magnitude remains an open question. The precise receptor or receptors responsible for the reported behavioural and neuroprotective effects have not been conclusively identified.
Semax binds to melanocortin receptors and is thought to influence neuronal survival and plasticity rather than to act through the adrenal axis. Laboratory work has shown increased expression of brain-derived neurotrophic factor and nerve growth factor in treated tissue. Changes in c-Fos, a marker of neuronal activation, have also been reported. Because the peptide is rapidly degraded by peptidases, its effects are generally attributed to downstream signaling cascades rather than to sustained receptor occupancy.
Published studies are dominated by animal models of stroke, ischemia, and cognitive impairment, with a smaller number of human trials conducted in Russia. Many of the human reports are small, single-center, and published in Russian-language journals, which limits independent scrutiny. Outcome measures vary between studies and often rely on clinician-rated scales rather than objective biomarkers. Systematic reviews have noted the methodological weaknesses and called for larger, preregistered trials before firm conclusions can be drawn.
Claims about enhanced focus, memory, or mood in healthy people rest mostly on anecdotal reports and community discussion rather than on controlled data. It remains unclear whether any cognitive benefit observed in patients recovering from brain injury would extend to uninjured users. Dose-response relationships, long-term safety, and interactions with other drugs are not well characterized in the peer-reviewed literature. Questions about optimal route of administration and treatment duration likewise remain open.
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C37H51N9O10S | Free acid form of the heptapeptide; depends on terminal groups |
| Molecular mass | About 813.9 g/mol | Average mass used for mass spectrometry confirmation |
| Appearance | White to off-white solid | Supplied as a lyophilised powder; hygroscopic |
| Solubility class | Freely soluble in aqueous media | Water, saline, and phosphate buffers; limited organic solubility |
| Typical storage temperature | -20 degrees Celsius | Long term and dry; short working periods may use 2 to 8 degrees Celsius |
Semax is a synthetic seven-amino-acid peptide whose sequence extends the ACTH(4-10) fragment with a C-terminal proline-glycine-proline tripeptide. The commonly cited sequence is Met-Glu-His-Phe-Pro-Gly-Pro, giving a molecular formula near C37H51N9O10S and a molecular weight close to 813.9 g/mol. It belongs to the broader class of synthetic ACTH fragments studied for central nervous system effects rather than for adrenal steroid stimulation. In practice the material appears as a lyophilized white powder for laboratory work or as a dilute saline solution in clinical settings.
Development is attributed to researchers at the Institute of Molecular Genetics in Moscow during the early 1980s, building on earlier Soviet work with ACTH fragments. Russian regulatory approval followed for intranasal use, and the compound has remained commercially available there for decades. Most published human data originate from Russian and, later, some Eastern European clinical reports, which are not always accessible in English translation. Outside that region the material is generally handled as a research chemical rather than a licensed medicine.
Identity and purity of semax are established with reversed-phase high-performance liquid chromatography coupled to ultraviolet detection, usually at 214 nanometres. Mass spectrometry, most often electrospray ionisation in positive mode, confirms the molecular mass and reveals truncated sequences. Amino acid analysis and peptide mapping after enzymatic digestion provide additional structural confirmation. Laboratories typically report purity as the percentage area of the main peak, a figure that does not capture isomeric or oxidised variants unless the method resolves them.
The peptide is prone to several degradation pathways. Oxidation of the methionine residue produces a sulfoxide that elutes close to the parent peak in many chromatographic systems. Hydrolysis of peptide bonds and deamidation of susceptible residues in related sequences also reduce purity over time. Lyophilised material kept dry at minus twenty degrees Celsius and shielded from light is the most stable form commonly described in laboratory practice.
Note: For purposes of this table, genes are defined as orphan genes (when species-specific) or TRGs (when limited to a closely related group of species) when the mechanism of origination has not been investigated, and as de novo genes when de novo origination has been inferred, irrespective of method of inference. The designation of de novo genes as "candidates" or "proto-genes" reflects the language used by the authors of the respective studies.
==== Systemic sickness ==== Since the 1990s, reviews of studies for causal relations between silicone-gel prosthetic breasts and systemic disease reported no causal relation to the occurrences of either systemic or autoimmune diseases; nonetheless, many women reported suffering neurological and rheumatological illnesses caused by failures of their prosthetic breasts. The study Long-term Health Status of Danish Women with Silicone Breast Implants (2004), reported that in relation to women of the general population, women with prosthetic breasts did not have a greater rate of incidence and diagnosis of autoimmune disease; that their rate of incidence for musculoskeletal disease was lower than the rate of incidence among women who had undergone other types of cosmetic surgery.
=== Prenatal and newborn screening === Checking for sickle cell disease begins during pregnancy, with a prenatal screening questionnaire that includes, among other things, a consideration of health issues in the child's parents and close relatives. During pregnancy, genetic testing can be done on either a blood sample from the foetus or a sample of amniotic fluid. During the first trimester of pregnancy, chorionic villus sampling (CVS) is a technique used for prenatal diagnosis of sickle cell disease. A routine heel prick test, in which a small sample of blood is collected a few days after birth, is used to check conclusively for sickle cell disease as well as other inherited conditions.
Sources: en.wikipedia.org
=== Other uses === CPA is useful in the treatment of hot flashes, for instance due to androgen deprivation therapy for prostate cancer. CPA is useful for suppressing the testosterone flare at the initiation of GnRH agonist therapy. It has been used successfully both alone and in combination with estrogens such as diethylstilbestrol for this purpose.
=== Vascular malformations === Sirolimus is used to treat vascular malformations. Treatment with sirolimus can decrease pain and the fullness of vascular malformations, improve coagulation levels, and slow the growth of abnormal lymphatic vessels. Sirolimus is a relatively new medical therapy for the treatment of vascular malformations in recent years, sirolimus has emerged as a new medical treatment option for both vascular tumors and vascular malformations, as a mammalian target of rapamycin (mTOR), capable of integrating signals from the PI3K/AKT pathway to coordinate proper cell growth and proliferation. Hence, sirolimus is ideal for "proliferative" vascular tumors through the control of tissue overgrowth disorders caused by inappropriate activation of the PI3K/AKT/mTOR pathway as an antiproliferative agent.
Hormone replacement therapy (HRT) is primarily concerned with alleviating gender dysphoria in transgender people. Hormone therapy targets the secondary sex characteristics. Trans women typically use feminizing therapy, the goal of which is to develop female characteristics while suppressing male characteristics. Trans men typically use masculinizing therapy, which has the opposite goal – to develop male characteristics while suppressing female characteristics. Trans women are usually treated with estrogen and complementary anti-androgenic therapy. According to UCSF Transgender Care, "The primary class of estrogen used for feminizing therapy is 17-beta estradiol, which is a 'bioidentical' hormone in that it is chemically identical to that from a human ovary." The anti-adrogenic medications include spironolactone and the 5-alpha reductase inhibitors, finasteride and dutasteride. This therapy induces breast formation, reduces male hair pattern growth, and changes fat distribution, also leading to a decreased testicular size and erectile function. Trans men are normally treated with exogenous testosterone. Several formulations of testosterone exist, and in the U.S., all formulations are "bioidentical" to endogenous testosterone of testicular origin. Masculinizing therapy is expected to cease menses, to increase facial and body hair, to cause changes in skin and in fat distribution, and to increase muscle mass and libido.
Sources: en.wikipedia.org
It is described as a synthetic analogue of the ACTH(4–10) fragment, a short segment of adrenocorticotropic hormone. Its sequence differs from that fragment and includes two proline residues, which influence stability and behaviour in solution.
It appears in Russian pharmaceutical listings as a nasal formulation, but it is not an authorised medicine in the United States or the European Union. Outside those markets it is normally encountered as a research chemical rather than a prescription product.
Laboratory and animal work points to melanocortin signalling and changes in neurotrophic factor levels, especially brain-derived neurotrophic factor. The exact receptor targets and the degree to which these findings transfer to humans are still unresolved.
It is associated with the melanocortin receptor family, particularly subtypes found in the central nervous system. This interaction is separate from the adrenal pathway activated by full-length ACTH.