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Chronic Pain Peptides 2026 Update: Evidence Comparison
BPC-157 NMDA modulation, VEGF upregulation, substance P reduction Neuropathic (post-herpetic neuralgia, diabetic neuropathy, CIPN) Intranasal 250–500mcg daily OR subcutaneous 250–500mcg twice daily Phase II trials. Moderate evidence (2025–2026 publications) 4–
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- BPC-157
- NMDA modulation, VEGF upregulation, substance P reduction
- Neuropathic (post-herpetic neuralgia, diabetic neuropathy, CIPN)
- Intranasal 250–500mcg daily OR subcutaneous 250–500mcg twice daily
- Phase II trials. Moderate evidence (2025–2026 publications)
- 4–8 weeks for sustained reduction
- Most robust evidence for neuropathic pain; intranasal route bypasses hepatic metabolism
- TB-500
- Actin polymerisation, VEGF and MGF upregulation, anti-inflammatory cytokine modulation
- Musculoskeletal with neuropathic overlap (CRPS, fibromyalgia, ischemic neuropathy)
- Subcutaneous 2–5mg twice weekly
- Preclinical + case series. Limited human RCT data
- 2–6 weeks
- Best for pain with vascular insufficiency component; less direct evidence for pure neuropathic pain
- KPV
- NF-κB inhibition, IL-10 upregulation, mast cell stabilisation
- Inflammatory visceral pain (IBD-related), localized inflammatory pain
- Oral 500mcg–1mg daily OR topical compounded cream
- Early-phase trials (2024–2026). Emerging evidence
- 2–4 weeks
- Promising for gut-mediated pain; systemic absorption variability limits broader use
- Selank
- Anxiolytic via BDNF and NGF modulation, GABAergic enhancement
- Chronic pain with anxiety comorbidity, central sensitization
- Intranasal 300–600mcg 2–3× daily
- Phase II evidence in anxiety; extrapolated for pain-anxiety interface
- 1–3 weeks
- Indirect pain benefit via anxiety reduction and central sensitization dampening