Meta Information
ID:semax
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-20
Model
agent_curation_2026_05_20_peptides
Interactions
Target id:
/condition/fda-compounding-risk
Target name:
FDA 503A Bulk Drug Substances List
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Semax is listed on the FDA's 503A Bulk Drug Substances List (2023). It has no FDA-approved indication in the United States. Semax has established clinical use in Russia (for stroke and neurological conditions), but this does not confer US regulatory status. Any compounded semax product in the US lacks independent quality verification.
Actionable advice:
Semax is available in Russia as a prescription drug but has no FDA approval in the US. US compounded products are unapproved. If using, source from reputable compounding pharmacies and verify purity.
Validation status:
validated_via_regulatory
Evidence tier:
tier_b
Evidence basis:
regulatory_advisory_verbatim
Evidence anchors:
Exact phrase from label:
Certain Bulk Drug Substances for Use in Compounding That May Present Significant Safety Risks
Label source:
US FDA compounding advisory. Semax was placed in Category 2 (substances that may present significant safety risks) and was among the 12 peptides the FDA removed from Category 2 on 2026-04-15 pending Pharmacy Compounding Advisory Committee review; it remains unapproved with no verified safety profile.
Action type:
informational_none
Target id:
/class/nootropics-cognitive-enhancers
Target name:
Other Nootropic Agents / Neurotrophic Factors
Severity:
moderate
Interaction type:
adverse
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The Semax monograph notes theoretical potentiation of effects when combined with other nootropic agents, neurotrophic factors, or compounds affecting monoaminergic neurotransmission. Semax upregulates BDNF and NGF and modulates dopaminergic/serotonergic systems. Combinations with racetams, peptide nootropics (e.g., noopept), or neurotrophic supplements are unstudied but could produce additive CNS stimulation.
Actionable advice:
If combining Semax with other nootropics or neurotrophic agents, start at lower doses of each and monitor for overstimulation, agitation, or sleep disruption.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Class inference: semax is itself a nootropic; combining it with other cognitive enhancers has not been studied and effects are additive/unknown. Plausible, not demonstrated.
Label source:
Class inference
Action type:
monitor
Target id:
/condition/acute-psychosis
Target name:
Acute Psychosis
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Acute psychosis is listed as a theoretical contraindication for Semax. As a neuropeptide that modulates dopaminergic and serotonergic systems and upregulates BDNF, Semax could theoretically exacerbate psychotic symptoms in acutely psychotic individuals, though clinical evidence for this specific contraindication is limited.
Actionable advice:
Semax should not be used in individuals with acute psychosis. This is a theoretical contraindication based on mechanism.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: semax enhances striatal dopamine release (Eremin 2005), and dopaminergic facilitation can theoretically exacerbate psychosis; caution in active psychotic illness is reasonable but not directly studied.
Label source:
Class inference
Action type:
avoid
Target id:
/condition/elevated-intracranial-pressure
Target name:
Conditions Involving Elevated Intracranial Pressure
Severity:
major
Interaction type:
adverse
Nature:
conditional
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Conditions involving elevated intracranial pressure are listed as theoretical contraindications for Semax. This concern stems from Semax's neuroprotective and neurotrophic stimulating effects, which could theoretically worsen intracranial hypertension, though direct clinical evidence is lacking.
Actionable advice:
Semax should be avoided in conditions associated with elevated intracranial pressure until safety in this context is established.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Safety data for semax in pregnant or breastfeeding women are lacking. Precaution is warranted per the clinical monograph.
Actionable advice:
Semax should not be used during pregnancy or breastfeeding due to absence of safety data.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/class/maois
Target name:
Monoamine Oxidase Inhibitors (MAOIs)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Semax can increase the turnover of monoamine neurotransmitters like dopamine and serotonin; co-administration with MAOIs could theoretically lead to a dangerous hypertensive crisis or serotonin syndrome.
Actionable advice:
Semax should not be used at all when taking any MAOI medication.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: semax raises monoamine (dopamine/serotonin) tone, so co-use with MAOIs could theoretically increase serotonergic/sympathomimetic risk. Theoretical class caution; no semax-specific case data.
Label source:
Class inference
Action type:
avoid
Target id:
/intervention/intranasal-medications
Target name:
Other Intranasal Sprays
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
0.5
Hours after target:
0.5
Description:
Using other nasal sprays (like decongestants or corticosteroids) close to Semax administration can wash away the peptide or interfere with its absorption through the nasal mucosa.
Actionable advice:
Administration of Semax and any other nasal spray should be separated by at least 30 minutes.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Pharmaceutical inference: semax is administered intranasally; other intranasal agents applied to the same mucosa can compete for absorption surface, so spacing is sensible. Practical, not a studied interaction.
Label source:
Class inference
Action type:
separate
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if Semax is excreted in breast milk or what its effects might be on a nursing infant.
Actionable advice:
Semax should not be used while breastfeeding.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
avoid
Target id:
/class/stimulants
Target name:
Stimulant Medications
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Both Semax and stimulant medications (e.g., amphetamines, methylphenidate) increase dopaminergic activity, which can lead to overstimulation, anxiety, restlessness, and increased cardiovascular strain.
Actionable advice:
Co-administration is best avoided, or used with extreme caution under medical supervision.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Our results reveal the positive modulatory effect of Semax on the striatal serotonergic system and the ability of Semax to enhance both the striatal release of dopamine and locomotor behavior elicited by D-amphetamine.
Label source:
PubMed: Eremin KO et al., Neurochem Res (2005) - Semax activates dopaminergic and serotonergic brain systems and potentiates amphetamine (rodent) (PMID 16362768)
Action type:
avoid
Target id:
/class/serotonergic-agents
Target name:
Serotonergic Medications (SSRIs, SNRIs, etc.)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Semax may modulate serotonin systems, and combining it with other serotonergic drugs could theoretically increase the risk of serotonin syndrome, a potentially serious condition.
Actionable advice:
This is best used with caution, and it is a good idea to monitor for symptoms like agitation, confusion, or rapid heart rate.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Our results reveal the positive modulatory effect of Semax on the striatal serotonergic system and the ability of Semax to enhance both the striatal release of dopamine and locomotor behavior elicited by D-amphetamine.
Label source:
PubMed: Eremin KO et al., Neurochem Res (2005) - Semax activates dopaminergic and serotonergic brain systems and potentiates amphetamine (rodent) (PMID 16362768)
Action type:
monitor
Target id:
/class/dopaminergic-agents
Target name:
Dopaminergic Medications (e.g., Levodopa)
Severity:
moderate
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Semax can enhance the effects of dopaminergic agents used for conditions like Parkinson's disease, potentially requiring dose adjustments to avoid side effects.
Actionable advice:
It is important to talk to a physician before combining, as dose adjustments of the dopaminergic agent may be necessary.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Our results reveal the positive modulatory effect of Semax on the striatal serotonergic system and the ability of Semax to enhance both the striatal release of dopamine and locomotor behavior elicited by D-amphetamine.
Label source:
PubMed: Eremin KO et al., Neurochem Res (2005) - Semax activates dopaminergic and serotonergic brain systems and potentiates amphetamine (rodent) (PMID 16362768)
Action type:
adjust_with_prescriber
Target id:
/condition/seizure-disorder
Target name:
Seizure Disorder / Epilepsy
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
While not definitively established, some nootropic agents may lower the seizure threshold, posing a theoretical risk for individuals with a history of seizures.
Actionable advice:
This is best used with extreme caution and only under the guidance of a neurologist.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
informational_none
Target id:
/condition/nasal-congestion
Target name:
Nasal Congestion (e.g., from a cold)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Impaired airflow and inflammation of the nasal mucosa due to a cold, allergies, or sinusitis will significantly reduce the absorption and effectiveness of intranasal Semax.
Actionable advice:
Semax is best used once nasal passages are clear, for optimal effect.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Pharmaceutical inference: intranasal absorption of semax depends on healthy nasal mucosa; congestion/rhinitis can reduce or vary uptake. Practical consideration.
Label source:
Class inference
Action type:
informational_none
Target id:
/dietary/alcohol-acute
Target name:
Alcohol (Acute Consumption)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Alcohol is a neurotoxin and CNS depressant that counteracts the neuroprotective and cognitive-enhancing goals of Semax therapy.
Actionable advice:
Alcohol consumption is best avoided or minimized to maximize the benefits of Semax.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Class inference: combining a neuroactive nootropic peptide with alcohol (a CNS depressant) has unknown, potentially opposing CNS effects. Low-evidence caution.
Label source:
Class inference
Action type:
avoid
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Some ACTH fragments have shown effects on the coagulation system in preliminary research; there is a theoretical risk of altered bleeding time when combined with these medications.
Actionable advice:
This is best used with caution, and it is worth monitoring for any signs of unusual bruising or bleeding.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
coverage with another anticoagulant should be strongly considered.
(2.4, 5.1)
-------------------------------ADVERSE REACTIONS-----------------------------Most common adverse reactions (>1%) are related to bleeding.
Label source:
FDA label: Apixaban [class-derived from: Apixaban]
Action type:
monitor
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
As an ACTH analogue, Semax has a theoretical potential to slightly increase blood pressure, which could minimally counteract the effects of blood pressure-lowering medications.
Actionable advice:
It is a good idea to check blood pressure regularly if combining Semax with antihypertensive drugs.
Validation status:
unvalidatable
Evidence tier:
tier_e
Evidence basis:
unvalidatable
Evidence anchors:
Source url:
Scientific literature support not found
Exact phrase from label:
Label source:
Action type:
monitor
Target id:
/intervention/cerebrolysin
Target name:
Cerebrolysin
Severity:
minor
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
null
Description:
Both Semax and Cerebrolysin are peptide-based nootropics that promote neurotrophic factors like BDNF, potentially leading to additive or synergistic cognitive benefits.
Actionable advice:
May be used together, but start with lower doses of each to assess tolerance.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Class inference: semax and cerebrolysin are both neuroactive/neurotrophic peptides; a combined neuromodulatory effect is plausible but unstudied.
Label source:
Class inference
Action type:
informational_none
Target id:
/intervention/exercise
Target name:
Exercise
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
null
Description:
Semax increases BDNF levels, and exercise is a potent natural stimulus for BDNF production. Using Semax before a workout may enhance focus and the neuroplastic benefits of the exercise.
Actionable advice:
Consider administering Semax 30-60 minutes before exercise for potential synergistic effects.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Class inference: exercise and semax both modulate monoaminergic/BDNF systems; a complementary cognitive/mood effect is plausible but not demonstrated for the combination.
Label source:
Class inference
Action type:
informational_none