SS-31 (Elamipretide) is a synthetic mitochondria-targeted tetrapeptide that stabilizes cardiolipin in the inner mitochondrial membrane, restoring electron transport chain efficiency and ATP production. It's one of the few mitochondrial peptides with human clinical trial data.
SS-31 is not FDA-approved. Everything below reflects published clinical trial and community protocols. This is not medical advice.
Quick Reference: Standard Protocol
| Parameter |
Detail |
| Vial |
10 mg |
| BAC Water |
2 mL |
| Concentration |
5 mg/mL |
| Dose |
500 mcg (10 units on insulin syringe) |
| Route |
Subcutaneous |
| Timing |
AM |
| Frequency |
5 days on, 2 days off |
| Cycle |
8 weeks on, 8 weeks off |
| Storage |
Refrigerate, use within 28 days |
For the full SS-31 profile and vendor pricing, see our SS-31 peptide page.
Cycling Details
500 mcg daily for 5 consecutive days, then 2 days off. Continue this pattern for 8 weeks, then 8 weeks off before repeating.
SS-31's rapid mitochondrial uptake (>1,000-fold concentration within minutes) means no loading phase is necessary. The 5on/2off pattern within the 8-week cycle prevents potential desensitization, and the 8-week off period allows assessment of sustained effects.
Morning injection is most common — may support daytime energy levels. Some users dose 30-60 minutes pre-workout.
Routes of Administration
Subcutaneous injection is the standard community route. Inject into abdomen, thigh, or anywhere with SC fat. Volume is 0.1 mL with insulin syringe (29-31 gauge).
Intravenous is used only in clinical trials — provides rapid peak plasma levels but shorter tissue exposure than SC. Not practical for self-administration.
Reconstitution Quick Reference
| Vial Size |
BAC Water |
Concentration |
500 mcg Dose |
| 10 mg |
2 mL |
5 mg/mL |
10 units |
Math: 10 mg / 2 mL = 5 mg/mL = 5,000 mcg/mL. For 500 mcg: 500 / 5,000 = 0.1 mL = 10 units.
Swirl gently — do not shake. Refrigerate at 2-8 C, use within 28 days. For step-by-step instructions, see the full SS-31 Reconstitution Guide.
Where These Numbers Come From
Community doses are dramatically different from clinical trial doses — for good reason.
TAZPOWER Trial (Barth Syndrome): 40 mg SC daily for 12 weeks in patients with genetic cardiolipin deficiency causing heart failure (Thompson et al., 2021).
PROGRESS-HF Trial: 4 mg SC daily for 4 weeks in heart failure patients with reduced ejection fraction.
Phase I Safety: IV doses up to 250 mcg/kg (~17.5 mg for a 70 kg adult) showed no dose-limiting toxicity (Szeto, 2014).
Why community doses are much lower: Clinical trials targeted severe genetic/cardiac conditions requiring aggressive intervention. Community protocols use 500 mcg for general longevity/mitochondrial support. SS-31 binds cardiolipin with high affinity — there's a finite amount to stabilize. Lower daily dose with cycling provides sustained benefits with wide safety margin.
Preclinical speed: SS-31 improves mitochondrial ADP sensitivity within 1 hour in aged human muscle (Siegel et al., 2023) — one of the fastest-acting peptides documented.
Stacking Protocols
| Stack |
Purpose |
Protocol |
| SS-31 + MOTS-c |
Dual mitochondrial — structure + signaling |
SS-31 500 mcg + MOTS-c 1 mg, both 5on/2off |
| SS-31 + NAD+ |
Mitochondrial optimization + fuel |
SS-31 500 mcg 5on/2off + NAD+ 100 mg 2-3x/week |
| SS-31 + Epitalon |
Mitochondria + telomere maintenance |
Two key aging pathways covered |
SS-31 stabilizes mitochondrial structure; MOTS-c activates metabolic signaling. Different mechanisms, complementary effects. For the full comparison, see our SS-31 vs MOTS-c.
Side Effects & Safety
- Excellent safety profile — 40 mg daily was well-tolerated for 12+ weeks in TAZPOWER
- No dose-limiting toxicity up to 0.25 mg/kg IV in Phase I
- Occasional mild injection site irritation at community doses
- Rare initial energy fluctuations — first few days only
- No significant adverse events in any clinical trial
- Generally very well-tolerated at 500 mcg daily
Frequently Asked Questions
What is the standard SS-31 dose?
500 mcg subcutaneously daily, 5 days on / 2 days off, 8 weeks on / 8 weeks off. Draw 10 units from a 10 mg vial reconstituted with 2 mL BAC water.
Clinical trials used 4-40 mg daily for severe conditions (Barth syndrome, heart failure). Community protocols use 500 mcg for general mitochondrial support — different applications.
How do I reconstitute SS-31?
Add 2 mL BAC water to a 10 mg vial for 5 mg/mL. 500 mcg = 10 units. Refrigerate, use within 28 days.
Can SS-31 be taken orally?
No. SS-31 is a tetrapeptide destroyed by digestive enzymes. Subcutaneous injection only.
How fast does SS-31 work?
Preclinically, mitochondrial function improves within 1 hour. Run 8-week cycles to assess sustained effects.
What's the difference between SS-31 and MOTS-c?
SS-31 binds cardiolipin directly (structural). MOTS-c activates AMPK (signaling). Both cycle 8wk on/off with 5on/2off. Different mechanisms, often stacked together.
References
| Citation |
Topic |
PMID |
| Zhao et al., J Biol Chem (2004) |
SS-31 discovery, mitochondrial targeting |
15178689 |
| Birk et al., J Am Soc Nephrol (2013) |
Cardiolipin binding mechanism |
23813215 |
| Szeto, Br J Pharmacol (2014) |
Comprehensive SS-31 review, Phase I data |
24117165 |
| Siegel et al., Aging Cell (2013) |
Rapid mitochondrial improvement in aged mice |
23692570 |
| Siegel et al., GeroScience (2023) |
ADP sensitivity in aging human muscle |
37462785 |
| Thompson et al., Genet Med (2021) |
TAZPOWER trial (Barth syndrome) |
33077895 |
| Campbell et al., Free Radic Biol Med (2019) |
Age-related redox stress reversal |
30597195 |
For educational and research purposes only. This is not medical advice. SS-31 is not FDA-approved for any indication.