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SS-31 (Elamipretide) dosage and protocol
Mitochondrial-targeting peptide that binds to cardiolipin to protect and restore mitochondrial function
- Vial size: 50 mg
- Reconstitution: 3 mL bacteriostatic water
- Concentration: 16.67 mg/mL
- Administration: subcutaneous
Research areas
- Mitochondrial Health
- Cardiovascular Health
- Kidney Protection
- Anti-Aging
Quick start
- Reconstitute: Listed as 1.0 mL bacteriostatic water for 10 mg/mL; note a 50 mg vial in 1.0 mL would give 50 mg/mL, so confirm before dosing
- Typical dose: 5-40 mg once daily for 4-12 weeks
- Easy measuring: At the listed 10 mg/mL, 1 unit (0.01 mL) on a U-100 syringe is 100 mcg; 5 mg is 50 units and 10 mg is a full 100-unit syringe
- Storage: Unreconstituted at -20°C; refrigerate at 2-8°C after mixing
Dosing protocol
| Phase | Dose | Frequency | Volume |
|---|---|---|---|
| Weeks 1–2 | 5 mg (5000 mcg) | Once daily (SC) | 0.30 mL (30 units) |
| Weeks 3–8 | 10 mg (10,000 mcg) | Once daily (SC) | 0.60 mL (60 units) |
How it works
SS-31 (elamipretide) is a small, cell-permeable tetrapeptide (D-Arg-dimethylTyr-Lys-Phe-NH2) that concentrates in the inner mitochondrial membrane. There it binds cardiolipin, a phospholipid that anchors and organises the electron transport chain complexes and maintains cristae structure. By stabilising cardiolipin and limiting its peroxidation, SS-31 is proposed to improve electron flow, reduce leakage of reactive oxygen species, and support ATP production in stressed or aging cells. In rodent and large-animal models, SS-31 improved mitochondrial function and reduced injury in heart failure, ischemia-reperfusion, kidney injury and age-related muscle decline. Effects in aged animals included improved exercise capacity and cardiac diastolic function. Human trials have produced mixed results. Studies in primary mitochondrial myopathy and heart failure did not consistently meet their primary endpoints. In Barth syndrome, a rare genetic cardiolipin disorder, the FDA granted accelerated approval to elamipretide in 2025, based on improvements in muscle strength measures; confirmatory evidence is still being gathered. Benefits in healthy people have not been demonstrated.
Reconstitution steps
- Draw 3.0 mL bacteriostatic water with a sterile syringe
- Inject slowly down the vial wall; avoid foaming
- Gently swirl/roll until dissolved (do not shake)
- Label with reconstitution date and refrigerate at 2–8°C, protected from light; use within 30 days
Storage
Store unreconstituted at -20°C. Refrigerate after mixing
Important notes
- Protects mitochondria by binding to cardiolipin
- Well-tolerated over wide dose range
- Dosage varies based on condition being addressed
- Can cause abdominal pain, dizziness, headache
- Start at lower dosing and increase slowly
- Limited clinical use - consider MOTS-C first
Supplies
- Bacteriostatic water (5mL)
- Insulin syringes (1mL)
- Alcohol swabs