SS-31 (Elamipretide) Dosage Protocol
SS-31 (elamipretide) is a mitochondrial-targeted tetrapeptide that binds cardiolipin in the inner mitochondrial membrane, stabilizing electron-transport chain function.
⚡ Quickstart Highlights
Dosing & Reconstitution Guide
Route: Subcutaneous | Frequency: Once daily | Half-life: ~2 hours (extended mitochondrial residence)
Standard Approach (1 mL = 50.00 mg/mL)
Reconstituting with 1 mL bacteriostatic water produces a concentration of 50.00 mg/mL. Volume per dose changes with concentration; mg dose itself does not change between vial sizes.
| Phase / Protocol | Dose | U-100 Units | Volume | Doses per vial |
|---|---|---|---|---|
| Weeks 1–2 (titration) | 5 mg | 10 units | 0.10 mL | 10 doses |
| Weeks 3–8 (target) | 10 mg | 20 units | 0.20 mL | 5 doses |
Reconstitution Steps
- Wipe the vial stopper and BAC water vial with alcohol; let dry.
- Draw 1 mL of bacteriostatic water into a sterile syringe.
- Inject slowly down the inside glass wall of the peptide vial. Do not aim at the powder.
- Gently swirl until fully dissolved. Do not shake.
- Label with reconstitution date. Refrigerate at 2–8°C; use within 28 days.
Supplies Needed
Estimates for an 8-week and 12-week cycle at 10 mg per dose, once daily (7 doses/week).
| Item | 8-Week Cycle | 12-Week Cycle |
|---|---|---|
| SS-31 (Elamipretide) () vials | 12 vials | 17 vials |
| Insulin syringes (U-100) | 56 | 84 |
| Bacteriostatic water (10 mL) | 2 × 10 mL | 2 × 10 mL |
| Alcohol swabs | 1 × 100-pack | 2 × 100-pack |
Protocol Overview
SS-31 (elamipretide) protocols are typically continuous daily dosing for 12–24 weeks given the gradual nature of mitochondrial-function effects. Phase 2/3 trials in mitochondrial myopathy ran 24 weeks.
Dosing Protocol
Daily titration (subcutaneous):
- Weeks 1–2 (titration): 5 mg/day.
- Weeks 3–8 (target): 10 mg/day. Aligned with trial doses used in cardiac and ophthalmic studies.
Cycle structure: 12–24 weeks continuous. Effects accumulate gradually; expect 8–12 weeks before subjective changes.
Storage Instructions
| State | Temperature | Duration |
|---|---|---|
| Lyophilized | −20°C (−4°F) | Up to 24 months, dry & dark |
| Reconstituted | 2–8°C (35–46°F) | Up to 28 days, protect from light |
Important Notes
How This Works
SS-31 is a synthetic tetrapeptide (D-Arg-2',6'-dimethylTyr-Lys-Phe-NH2) of the Szeto-Schiller class. Its alternating cationic-aromatic structure concentrates it in the inner mitochondrial membrane (1000–5000× more than cytoplasm). It binds cardiolipin — the unique phospholipid that organizes the electron-transport chain — preserving cristae structure and ATP synthesis under oxidative stress.
Potential Benefits & Side Effects
Potential Benefits
- Selective mitochondrial targeting via cardiolipin binding.
- Stabilization of electron-transport chain efficiency.
- Preservation of ATP synthesis under oxidative stress.
- Studied in mitochondrial myopathy.
- Cardioprotective effects in ischemia-reperfusion.
Side Effect Profile
- Generally well-tolerated.
- Injection-site reactions most common.
- Mild transient nausea or fatigue.
Lifestyle Factors
- Pair with aerobic exercise to amplify mitochondrial biogenesis.
- Adequate sleep supports mitochondrial recovery.
- CoQ10, alpha-lipoic acid sufficiency complement effects.
Injection Technique
- Subcutaneous, abdomen/thigh/upper arm. Rotate sites.
- 90° angle with short insulin needle.