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These are illustrative — not a contraindication checklist, because there is no FDA-approved indication: Pregnancy or breastfeeding — no reproductive or developmental toxicology data exists History of or active seizure disorder — melanocortin receptor modulation carries theoretical CNS excitatory potential Active or suspected neuroendocrine malignancy — ACTH-fragment analogs carry theoretical concern in the setting of neuroendocrine pathology Known hypersensitivity to Semax or formulation components Hepatic or renal impairment — pharmacokinetics under compromised organ function are uncharacterized Side effects and safety considerations The human safety data for Semax come almost exclusively from Russian clinical trials, primarily the Gusev group studies including the 2018 Gusev et al

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