Other

SS-31 (Elamipretide)

Controlled trials

A mitochondria-targeting tetrapeptide that binds cardiolipin on the inner mitochondrial membrane.

SubQAdvancedNot approved anywherelongevityrecovery and sleepmetabolic healthneuroprotection

Also known as Elamipretide · MTP-131 · Bendavia · SS-31

At a glance

Dose summary

Typical dose10 mg

Range5 mg–40 mg

FrequencyDaily

Half-life~2.5 h

ScheduleOnce daily

Cycle length8 weeks

RouteSubQ

Experience levelAdvanced

Evidence gradeControlled trials

ApprovalNot approved anywhere

Where the dose comes fromCommunity practice, not a trial

No regulator and no trial set these numbers. They describe what people actually do, recorded so you can see the range rather than guess at it — which is not the same thing as a recommendation.

Reconstitution

What to draw, at the usual vial

A 50 mg vial reconstituted with 2 mL of bacteriostatic water gives 25.00 mg/mL. A typical 10 mg dose is 0.400 mL — pull the plunger to 40 units on a U-100 syringe.

Concentration25.00 mg/mL

Draw volume0.400 mL

U-100 units40 units

Doses per vial5

Same dose, other vial sizes

Vial	Water	Concentration	Draw	Units	Doses
10 mg	2 mL	5.00 mg/mL	2.000 mL	200 units	1
50 mg	2 mL	25.00 mg/mL	0.400 mL	40 units	5

The highlighted row is the one quoted above: the smallest listed vial that holds at least four typical doses. Change any of it — a different vial, more or less water, a different dose — on the reconstitution calculator, which draws the syringe to true U-100 graduations.

Mechanism & evidence

What it is, and what is known

A mitochondria-targeting tetrapeptide that binds cardiolipin on the inner mitochondrial membrane. Unlike most research peptides it has a real human trial record: Stealth BioTherapeutics has run randomized phase 2 and phase 3 studies in primary mitochondrial myopathy (the MMPOWER program), Barth syndrome, dry age-related macular degeneration and heart failure, most using 40 mg subcutaneously once daily. Results have been mixed — several trials, including MMPOWER-3, missed their primary endpoints — and it is not an approved medicine.

The 40 mg upper bound is the trial dose; community protocols typically run far lower at 5-10 mg daily, which is the typical value shown. Plasma half-life after subcutaneous dosing is short, roughly 2-3 hours.

The caveat

A real trial record — and several of those trials, including MMPOWER-3, missed their primary endpoints. Community protocols run far below the trial dose.

Tolerability

Reported side effects

Injection site reactions — redness, itching and induration are common and are the dominant adverse effect reported in trials
Headache
Nausea
Dizziness

Hard stops

Do not use this if

Pregnancy, possible pregnancy, or breastfeeding
Under 18

These are flags, not a screening. They do not replace a conversation with a clinician who knows your history.

Handling

Storage

Sealed powder, refrigerated24 months

After reconstitution, refrigerated30 days

Keep it cold, keep it dark, and label the vial with the date you mixed it. Discard anything cloudy or past the window above.

Combinations

Commonly stacked with

NAD+Limited human dataOther EpitalonLimited human dataOther

Stacking multiplies the side-effect surface and makes it impossible to tell which compound did what. Add one thing at a time.

Where it shows up

Protocols using this compound

Advanced Mitochondrial (MOTS-c + SS-31)10 mg · once dailyThe two most talked-about mitochondrial peptides run together: MOTS-c, a mitochondrially encoded peptide that activates AMPK, and SS-31 (elamipretide), a tetrapeptide that binds cardiolipin on the inner mitochondrial membrane. Two different points of attack on the same organelle, which is the whole rationale. Graded advanced because both are thin on human data and because nothing you can measure will tell you whether it worked.

References

Sources

Educational information only, not medical advice. Talk to a licensed clinician before starting, changing, or stopping anything.