Dosing Guide

FOXO4-DRI Dosage Chart & Schedule Guide.

FOXO4-DRI (Proxofim) is a D-retro-inverso senolytic peptide that selectively clears senescent "zombie" cells by disrupting the FOXO4-p53 survival interaction. Based on the landmark Baar et al. (Cell, 2017) study, it is used in pulse cycles to restore tissue homeostasis.

⏱️
Half-lifeNo PK data · in-cell ≥72 h
💉
RouteIV/IP in studies · subQ in practice
📅
Best timingDays 1, 3, 5, then stop
🧊
StorageDry: freezer · Mixed: fridge, ~4 weeks
The short answer

Three injections, every other day: days 1, 3 and 5, then stop. Roughly 1–3.3 mg per dose subcutaneously, which is 20–66 units on a U-100 syringe from a 10 mg vial mixed with 2 mL of bacteriostatic water. Then at least three months off.

Dosage Protocols

Syringe units below assume a 10 mg vial in 2 mL bacteriostatic water (5 mg/mL = 5,000 mcg/mL). Different setup? Use the calculator. None of these milligram figures come from a trial; they are what people inject.

Conservative
1 mgper injection · 20 units
FrequencyDays 1, 3 and 5
Course total3 mg total
Cycle length3 doses, then 3–6 months off

The usual entry point for a compound with zero human safety data, and under a third of a vial.

Why this dose+

Using under a third of a 10 mg vial leaves room to abort the course after dose one if you react badly. It is also only about 1/28 (roughly 3.5%) of the body-surface-area-scaled equivalent of the mouse dose, so a null result tells you very little.

MOST REPORTEDStandard
2.5 mgper injection · 50 units
FrequencyDays 1, 3 and 5
Course total7.5 mg total
Cycle length3 doses, then 3–6 months off

Where most self-experimenters and telehealth protocols land: roughly three-quarters of a 10 mg vial.

Why this dose+

The every-other-day spacing is the part of this protocol with actual data behind it. The 2.5 mg figure is not: nothing validates it, and it is a price-driven convention rather than a studied dose. Cost, not evidence, set where the community landed.

Full vial
3.3 mgper injection · 66 units
FrequencyDays 1, 3 and 5
Course total9.9 mg (full 10 mg vial)
Cycle lengthOne vial = one course; 6 months off

Splits a whole 10 mg vial evenly across the three published dosing days, the way vendors package a cycle.

Why this dose+

Higher is not known to work better, and no human dose-response curve exists to justify going past this. Giving the full 10 mg as one shot to save injections collapses the three-dose spacing that the selectivity data rests on.

Three small doses beat one big one: the spacing IS the safety mechanism
  • In Baar's supplementary data, the whole amount as one dose scored a selectivity index of 5.24.
  • Split into three doses of one-third each, that same total hit 9.41: nearly twice as selective.
  • So days 1, 3 and 5 is the design, not tradition or a way to stretch a vial.
  • Consolidating the three doses into one, or running it daily like BPC-157, discards that selectivity.
There is a hard ceiling, and it is set by how many senescent cells you have
  • It kills a finite population of cells and then has nothing left to act on.
  • In mice, adding it on top of genetic clearance "did not further enhance these effects."
  • The in-vitro window between killing senescent and healthy cells is about 11-fold at best.
  • The authors ruled out chronic use: "permanent FOXO4 inhibition is not advisable."

Course Schedule

The whole protocol is one week long. Three injections on days 1, 3 and 5, then months of nothing; the washout is part of the design, not a pause between cycles.

Dosing week (all tiers)
1
2
3
4
5
6
7
Weeks 2–12: washout
1
2
3
4
5
6
7
Repeat course (≥3–6 months later)
1
2
3
4
5
6
7
Inject
No injection
Optional repeat course

Missed a dose? Shift it by a day and keep the every-other-day gap intact: days 1, 3, 6 is fine, days 1, 2, 3 is not. More than a week late, treat the course as finished.

FOXO4-DRI Reconstitution Calculator

Enter your vial size, how much water you added, and the dose you want; we'll tell you exactly how much to draw. A 10 mg vial with 2 mL of bacteriostatic water gives 5 mg/mL, which puts a 2.5 mg dose at 50 units on a U-100 syringe.

mg

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mL

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mg

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Your syringe

Mid-size, most popular for peptides

Concentration

3.33 mg/mL

1 unit = 33 mcg

Draw volume

0.075 mL

= 0.25 mg ÷ 3.33 mg/mL

Units to draw (0.5 mL syringe)

7.5 units

0.5 mL Syringe

7.5 IU
01020304050 IU

From Vial to Injection in 6 Steps

1
Wipe both vial tops

Alcohol swab the FOXO4-DRI vial and the bacteriostatic water vial, and let both air-dry before you pierce them.

2
Add 2 mL slowly

Run the bacteriostatic water down the inside wall of the 10 mg vial rather than squirting it onto the powder cake.

3
Swirl, don't shake

Roll the vial gently until it turns completely clear. Shaking a peptide this size damages it.

4
Draw your dose

Use a fresh U-100 insulin syringe and the calculator. At 5 mg/mL, 1 mg is 20 units, 2.5 mg is 50 units and 3.3 mg is 66 units.

5
Inject and rotate

People inject subcutaneously into the abdomen or thigh, rotating sites between the three doses. Note that no published study has ever used the subQ route.

6
Fridge, then finish

Keep unopened powder in the freezer. Once mixed, refrigerate at 2–8 °C and use within about 4 weeks. Needles go in a sharps container.

A full course is three injections across five days, so one mixed vial covers it. Every published in-vivo dose was given intravenously or intraperitoneally, and nobody has measured how much of a subcutaneous dose reaches circulation.

What to Expect

Nothing about the dosing week is meant to feel dramatic. In the animal work, every endpoint that moved was read three to four weeks after the first injection, not in the first few days.

First 2–4 hoursIt gets inside cells, and you feel nothing

Baar's team tracked the peptide with an anti-TAT antibody and saw intracellular uptake within 2 to 4 hours of dosing, with it still detectable at 72 hours. There is no acute effect to feel.

24–72 hoursSenescent cells commit to apoptosis

Real-time cell-density imaging showed senescent cells beginning to die 24 to 36 hours after exposure. This is the window in which self-experimenters describe mild flu-like malaise, achiness or an energy dip. No trial has measured how often that happens.

Days 5–10The course is already over

After the day-5 injection you are done. In mice, the p16-driven senescence signal had measurably dropped by this stage, and aged kidney tissue showed apoptosis of senescent cells within 3 days of exposure. Continuing to inject past day 5 adds exposure without adding a target.

Weeks 3–4Where the animal results actually showed up

Every functional endpoint in the Baar paper was read at roughly this point, not earlier: running-wheel activity was scored 18 to 21 days after the first dose, and plasma urea, creatinine, fur density and responsiveness at day 30. Re-measure bloods, grip strength, activity or skin here, not on day 7.

Months 3–6The question of a repeat

Nobody has measured how fast senescent cells re-accumulate in a human. Repeat intervals in circulation range from three months to once a year, with nothing behind any of them. The published mouse work never ran back-to-back courses, and the authors argued against sustained FOXO4 inhibition.

Senolytics clear existing senescent cells; they do not stop new ones forming. The rate they re-accumulate tracks glycaemic control, sleep debt, UV exposure, smoking, visceral fat and untreated chronic inflammation.

Feeling Something? Check Here

🟢 Normal: keep going
  • Mild sting, redness or a small lump at the site for a few hours.
  • One to two days of low-grade fatigue or achiness 24–48 h after a dose (self-reported, never measured in a trial).
  • No change in weight, appetite or urine output.
  • Across 30 days of dosing, mice showed no change in body weight, kidney weight, platelet count or any other whole-blood value.
🟡 Talk to a doctor
  • Fatigue or malaise still present past 72 h.
  • Fever above 38 °C.
  • Persistent nausea or vomiting.
  • New easy bruising, nosebleeds or bleeding gums: get a CBC with platelets.
  • Thrombocytopenia is what limits the rival senolytic ABT-263/navitoclax; FOXO4-DRI did not move platelet counts in mice at 30 days, and nobody has checked in a human.
  • Darker urine, or noticeably less of it: get a renal panel.
  • A flare of an existing autoimmune condition.
  • Injection site still red and firm after 48 h.
🔴 Stop and get help now
  • Hives, lip or throat swelling, wheeze or faintness.
  • TAT-fused cationic peptides can provoke mast-cell and complement reactions on any dose in a course, not just the first.
  • Chest pain, palpitations or new breathlessness.
  • Severe abdominal pain.
  • Confusion or fainting.
  • Spreading hot red skin around the injection site with fever (cellulitis).
  • Any bleeding that will not stop.
  • Stop the course, skip the remaining injections, and get emergency care.
Do not use FOXO4-DRI if any of these apply
  • Active cancer, current cancer treatment, or a history of malignancy without oncology sign-off: the peptide works by manipulating p53, and senescence is an anti-tumour brake.
  • Pregnancy, breastfeeding, or actively trying to conceive.
  • Under 18.
  • Li-Fraumeni syndrome or any known p53-pathway disorder.
  • An open wound, recent surgery, or a healing fracture: senescent cells are required for normal wound closure via PDGF-AA, and clearing them measurably delays healing.
  • Active infection or fever.
  • Significant kidney or liver impairment.
  • Chemotherapy or radiotherapy outside oncologist supervision.
  • Known allergy to the peptide, or to bacteriostatic water / benzyl alcohol.

FOXO4-DRI has never been given to a human in a registered trial, so no validated contraindication list exists. The stops above come from the animal work and from how the compound behaves in cells.

FAQ

Has FOXO4-DRI ever been tested in a human?+

No. As of 2026 there is not one completed or registered human trial; a ClinicalTrials.gov search for FOXO4 returns zero interventional studies. Everything on this page traces back to mouse experiments and cell culture. Cleara Biotech, the Dutch spin-out founded on this work, remains preclinical and has publicly shifted its focus toward the FOXO4–p53 interaction generally rather than this specific peptide. Anyone injecting FOXO4-DRI is running a single-person experiment and should frame it that way, both to themselves and to their doctor.

Why only three injections? Shouldn't I run it longer, like other peptides?+

Because it is a senolytic, not a signalling peptide. BPC-157 or ipamorelin nudge a pathway that resets the moment you stop, so daily dosing makes sense for them. FOXO4-DRI deletes cells. Once the accessible senescent population is gone, further injections have no substrate to act on; in the mouse chemotherapy model, adding FOXO4-DRI on top of genetic senescent-cell clearance produced no additional benefit at all. Three doses across five days, then months off, is the entire published design.

Every study used IV or IP. Is subcutaneous injection actually equivalent?+

Unknown, and this is the biggest quiet assumption in every FOXO4-DRI dosing chart, including this one. Baar 2017 dosed intravenously; the Leydig-cell and pulmonary-fibrosis follow-ups dosed intraperitoneally. No published study has given it subcutaneously or measured what fraction reaches circulation that way. FOXO4-DRI is a roughly 5.4 kDa, strongly cationic TAT-fusion peptide, and cationic peptides tend to bind extracellular matrix at the injection site, so subQ delivery could plausibly be substantially lower than IV. Treat subQ unit charts as convention rather than pharmacology.

How does the 5 mg/kg mouse dose translate to a person?+

Applying the standard FDA body-surface-area conversion (divide the mouse dose by 12.3) gives about 0.41 mg/kg, or roughly 28 mg per injection for a 70 kg adult (around 85 mg for a full three-dose course, which is eight or nine 10 mg vials). Real-world protocols run 1 to 3.3 mg per injection, roughly a tenth of that. So the honest position is not that community doses are dangerous overkill but the opposite: nobody has demonstrated that the doses people actually use do anything at all. Cost, not evidence, set the community dose.

How often can a course be repeated?+

There is no evidence-based answer. The published work never ran repeat courses, and human senescent-cell re-accumulation rates have never been measured. Common practice is one to three courses a year with 3 to 6 months between them, but that figure appears only on peptide sites and has no study behind it. The relevant caution from the paper's own discussion is that FOXO4 has a normal role in DNA-damage repair and Foxo4-knockout mice handle acute damage badly, which is why the authors explicitly ruled out permanent FOXO4 inhibition. Erring toward longer gaps is the safer mistake.

How do I reconstitute and store it?+

Add 2 mL of bacteriostatic water slowly down the inside wall of a 10 mg vial (never squirt it onto the powder and never shake it), then swirl gently until clear. That gives 5 mg/mL, so 1 mg is 20 units on a U-100 syringe, 2.5 mg is 50 units and 3.3 mg is 66 units. Keep unopened lyophilised vials in the freezer; once mixed, refrigerate at 2–8 °C and use within about four weeks. Since a full course is only three injections across five days, one mixed vial covers it comfortably and long-term storage of reconstituted peptide never becomes an issue.

Can I stack it with dasatinib + quercetin or fisetin?+

There is no human data on combining senolytics, and one relevant detail sits in Baar's own paper: they tested dasatinib and quercetin against senescent IMR90 fibroblasts, found no selectivity for senescent cells in their hands, and dropped the combination for that reason. Stacking two agents that both push cells toward apoptosis multiplies the unknowns without any evidence of additive benefit. If you are going to run an unvalidated compound, run one at a time so that anything that happens can actually be attributed.

Will I feel anything from a course?+

Most likely not much, and that is the expected outcome rather than a sign of a bad batch. In animals nothing measurable moved until roughly week three: running-wheel activity at day 18 to 21, kidney markers and fur density at day 30. Anything noticed inside 48 hours is more plausibly the mild inflammatory malaise reported anecdotally after doses than a therapeutic effect. If a vendor or protocol promises noticeable results within days, that is a marketing claim with nothing behind it.

Sources

Every dosing claim on this page traces to animal or cell-culture work. There is no human trial to cite, because none exists.

Disclaimer: This content is for informational and research purposes only and is not medical advice. FOXO4-DRI is an investigational compound with no completed or registered human clinical trials; every dose described here is extrapolated from animal research or copied from community practice, not established in people. Always consult a qualified healthcare professional before starting any peptide protocol. PeptideDeck is not responsible for individual use.

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