Peptide Profile
SS-31 (Elamipretide)
A revolutionary mitochondria-targeting peptide that works like a direct energy boost for your cells—binding to cardiolipin in your mitochondria to supercharge ATP production, reduce oxidative stress, and protect your cellular powerhouses from age-related decline.
Dose Range
5-40mg
Frequency
Once daily
Route
Subcutaneous injection
Cycle Length
4-6 weeks
Onset
Moderate (1-2 weeks)
Evidence
Moderate
Compound Profile
Scientific & Efficacy Data
C32H49N9O5
Molecular Formula
639.8 g/mol
Molecular Weight
Developed By · 2004
Dr. Hazel Szeto and Dr. Peter Schiller
Weill Cornell Medical College / University of Montreal
Primary Benefits
Directly targets and stabilizes cardiolipin in the inner mitochondrial membrane—the only peptide with this validated mechanism of action
Enhances ATP production by optimizing electron transport chain efficiency and reducing energy-wasting reactive oxygen species
Reduces oxidative stress at its source—inside the mitochondria where most ROS are produced—rather than just scavenging after the fact
Amino Acid Sequence
D-Arg-dimethylTyr-Lys-Phe-NH2Dosing
How much
do I take?
Starting Dose
5-10 mg
Begin with the lower dose to assess your tolerance. SS-31 is rapidly absorbed subcutaneously, typically reaching peak levels within 30-60 minutes. This conservative approach lets you gauge how your body responds before increasing.
Standard Dose
20-40 mg
The 40 mg daily dose has been used in multiple clinical trials and represents the most studied protocol. This is the dosage that showed effects in heart failure and mitochondrial disease studies. Subcutaneous injection is the standard route.
Advanced Dose
40 mg
Extended protocols for those with established tolerance under medical supervision. Some clinical trials have used 40 mg daily for 24+ weeks in specific patient populations. Do not exceed 40 mg daily—higher doses haven't shown additional benefits.
Timing
Best time to take
Morning injection is often preferred since SS-31 supports cellular energy production—aligning with your active hours makes sense. However, timing is flexible based on your schedule.
With food?
SS-31 can be taken regardless of food timing. The peptide is absorbed efficiently whether you've eaten or not, so fit it into whatever routine works best for you.
If stacking
If combining with other peptides, inject at different sites. SS-31 pairs well with NAD+ precursors like NMN for comprehensive mitochondrial support. Space different peptide injections at least 30 minutes apart.
Adjusting Your Dose
Increase if
- +You've completed 2+ weeks at starting dose with no issues
- +You're following a research protocol calling for standard doses
- +Your healthcare provider recommends advancement based on your goals
Decrease if
- -You experience persistent injection site reactions beyond 48 hours
- -Headaches or nausea don't improve after the first week
- -Any unexpected or uncomfortable side effects arise
- -You have any kidney function concerns
Signs of right dose
- ✓Improved energy levels, especially sustained throughout the day
- ✓Better exercise tolerance or recovery
- ✓No significant injection site issues
- ✓General sense of vitality maintained or enhanced
Dosing Calculator
Calculate Your Exact Dose
Amount to Draw
10
units
Suitability
Is this
right for me?
Best For
Mitochondrial Health Enthusiasts
If you're focused on optimizing cellular energy at the most fundamental level, SS-31 targets the actual machinery inside your mitochondria. It binds to cardiolipin—the special fat molecule that holds your electron transport chain together—keeping your cellular powerhouses running smoothly.
Aging Adults Concerned About Cellular Decline
Mitochondrial dysfunction is now recognized as a hallmark of aging. Your cells' energy factories get less efficient over time, producing more harmful byproducts. SS-31 helps protect and restore mitochondrial function, addressing one of the root causes of age-related decline.
Heart Health Supporters
Your heart is one of the most energy-demanding organs, packed with mitochondria. Clinical trials have studied SS-31 in heart failure patients because cardiac cells are especially vulnerable to mitochondrial dysfunction. Supporting heart mitochondria supports overall cardiovascular function.
Those Recovering from Oxidative Stress
Whether from intense exercise, illness, or environmental factors, oxidative stress damages your mitochondria from the inside out. SS-31 works as an antioxidant exactly where reactive oxygen species are produced—right at the inner mitochondrial membrane—neutralizing them before they cause harm.
Consider Alternatives If
Who Should Avoid
Do not use if
- ×You are pregnant or might become pregnant—effects on fetal development are unknown
- ×You are breastfeeding—the peptide could potentially pass into breast milk
- ×You have severe kidney disease—SS-31 is excreted by the kidneys and may accumulate
- ×You've had allergic reactions to elamipretide or similar peptides
- ×You're under 18 years old—pediatric safety not established
- ×You have known sensitivity to any component of the formulation
Use with caution if
- !You have moderate kidney impairment—may need dose adjustment
- !You're taking other medications that stress the kidneys
- !You have a history of severe allergic reactions to any peptide
- !You're on blood thinners—may increase bruising at injection sites
- !You have uncontrolled diabetes—monitor blood sugar during use
- !You're taking other experimental compounds—interactions unknown
Administration
How do I
use it?
Reconstitution
What you need
- •Bacteriostatic water (BAC water) for multi-use reconstitution
- •Insulin syringes (29-31 gauge) for accurate dosing
- •Alcohol swabs for cleaning vial tops and injection sites
- •Your SS-31 lyophilized powder vial
Injection
Route
Subcutaneous injection (just under the skin)—the standard method used in clinical trials with approximately 92% bioavailability
Best sites
- •Abdominal area (about 2 inches away from the belly button)
- •Front or outer thigh (middle section)
- •Back of the upper arm
Technique
- 1.Wash your hands thoroughly with soap and water
- 2.Clean the injection site with an alcohol swab and let it air dry completely
- 3.Pinch about an inch of skin to create a fold of fatty tissue
- 4.Insert the needle at a 45-90 degree angle (45 if lean, 90 if you have more subcutaneous tissue)
- 5.Inject the solution slowly and steadily
- 6.Wait 5-10 seconds before withdrawing the needle
- 7.Apply light pressure with a clean swab if needed—do not rub
Storage
Signs of degradation
Sample Daily Schedule
Safety
Is it
safe?
Safety Profile
SS-31 (elamipretide) has demonstrated a favorable safety profile across multiple clinical trials, including studies lasting up to 24 weeks. The most common adverse events are mild injection site reactions. In September 2025, elamipretide received FDA approval for Barth syndrome, validating its safety in that population. Most side effects are mild to moderate and typically resolve with continued use or dose adjustment.
Safety data comes from Phase 1-3 clinical trials in various populations including heart failure patients, those with primary mitochondrial myopathies, and Barth syndrome patients. While generally well-tolerated, long-term safety beyond 6 months requires more data in healthy populations. Always work with a healthcare provider when using this compound.
Common Side Effects
Experienced by some users
Injection site reactions
Redness, swelling, itching, or mild pain at the injection site is the most frequently reported side effect in clinical trials. This is your skin's normal reaction to the injection process.
Management: Rotate injection sites between abdomen, thigh, and arm. A cool compress can help reduce discomfort. Reactions typically fade within 24-48 hours.
Headache
Some users experience mild to moderate headaches, particularly during the first week of use. This may be related to changes in cellular energy metabolism.
Management: Stay well-hydrated and consider over-the-counter pain relief if needed. Headaches usually resolve as your body adjusts within the first 1-2 weeks.
Fatigue
Paradoxically, some people feel tired initially even though SS-31 supports energy production. Your body may be recalibrating its energy systems.
Management: Rest as needed and ensure adequate sleep. This typically improves after the first week as mitochondrial function optimizes.
Nausea
Mild stomach upset or nausea can occur, particularly when starting treatment or at higher doses.
Management: Taking your injection with a small meal may help. If persistent, consider temporarily reducing your dose.
Less Common
- •Dizziness
- •Flushing
These typically resolve with continued use or dose adjustment.
Stop and Seek Help If
- ×Any signs of allergic reaction—stop immediately and seek medical attention
- ×Injection site reactions that spread, worsen, or show signs of infection
- ×Persistent nausea, headaches, or dizziness that don't improve after 2 weeks
- ×Development of kidney-related symptoms (significant changes in urination, swelling)
- ×Any side effect that feels serious or significantly impacts your quality of life
- ×Your healthcare provider advises discontinuation
SS-31 (elamipretide) is FDA-approved only for Barth syndrome. For other uses, it remains a research compound. Never start, stop, or adjust your protocol without guidance from a qualified healthcare provider. This information is for educational purposes only and is not medical advice.
Interactions
With other peptides
- ✓Potentially synergistic pairing—Epithalon targets telomeres while SS-31 targets mitochondria, addressing two major aging mechanisms simultaneously.
- ✓Can be combined for comprehensive cellular protection and healing support. Inject at different sites.
- ✓Both target mitochondrial function through different mechanisms. May have additive effects but combined use hasn't been extensively studied.
- ✓Safe combination for multi-pathway anti-aging approach. Different mechanisms of action without known interactions.
With medications
- !Nephrotoxic drugs (aminoglycosides, NSAIDs) - SS-31 is excreted by the kidneys. Combining with kidney-stressing medications may increase risk of renal issues. Consult your doctor.
- ✓Diabetes medications (metformin, insulin) - Both may affect mitochondrial function or glucose metabolism. Monitor blood sugar more closely during SS-31 use.
- ✓Blood thinners (warfarin, aspirin) - May increase bruising at injection sites. Not dangerous but worth monitoring. Inform your healthcare provider.
- ✓Heart failure medications - SS-31 has been studied in heart failure patients alongside standard medications. Generally compatible but always inform your cardiologist.
With supplements
- ✓CoQ10 (Ubiquinol) - Excellent synergy—both support mitochondrial electron transport chain function through complementary mechanisms.
- ✓NAD+ precursors (NMN, NR) - Potentially beneficial combination for comprehensive mitochondrial support. NMN supports NAD+ levels while SS-31 protects mitochondrial structure.
- ✓PQQ - May work synergistically to support mitochondrial biogenesis and function. Both target different aspects of mitochondrial health.
- ✓Alpha-lipoic acid - Both have antioxidant properties. Safe combination that may provide enhanced mitochondrial protection.
- ✓High-dose iron supplements - Iron can catalyze oxidative reactions in mitochondria. Avoid taking high-dose iron supplements simultaneously—space them out.
Effectiveness
Does it
work?
Evidence Level
Moderate human trials
What to Expect
Days 1-7
What you might notice
- •Injection site reactions are most common during this period
- •Possible mild headache or fatigue as your body adjusts
- •Some people notice subtle energy changes
- •Most users don't feel dramatic differences yet
What's normal
- •Mild injection site redness that fades within 24-48 hours
- •Feeling slightly tired or having mild headaches initially
- •No immediate dramatic changes—SS-31 works at the cellular level
What's next
- →Continue your daily protocol consistently
- →Track any effects or side effects in a simple log
- →Initial side effects typically improve after day 5-7
Weeks 2-4
What you might notice
- •Side effects usually diminish significantly
- •May start noticing improved energy levels
- •Some report better exercise tolerance
- •Sleep quality may improve
What's normal
- •Fewer injection site reactions as you rotate sites
- •Gradual sense of improved vitality
- •Feeling adjusted to the daily routine
What's next
- →Maintain consistent daily dosing
- →Consider if dose adjustment is appropriate
- →Continue tracking your response
Weeks 4-8+
What you might notice
- •Sustained improvements in energy and vitality
- •Better recovery from physical exertion
- •Overall sense of cellular health optimization
- •Effects stabilize at their optimal level
What's normal
- •Consistent well-being without significant side effects
- •Maintained energy levels throughout the day
- •Feeling the compound has reached its steady-state effect
What's next
- →Discuss with your healthcare provider about continuing or cycling
- →Some protocols suggest cycling off periodically
- →Evaluate your goals and whether to continue
Signs It's Working
Energy and Vitality
- ✓Improved sustained energy throughout the day
- ✓Less afternoon energy crashes
- ✓Better stamina during physical activities
- ✓Feeling more mentally alert
- ✓Waking up feeling refreshed
Physical Performance
- ✓Improved exercise tolerance
- ✓Faster recovery after workouts
- ✓Better endurance during cardio activities
- ✓Reduced muscle fatigue during exertion
General Well-Being
- ✓Overall sense of vitality and wellness
- ✓Improved stress resilience
- ✓Better sleep quality
- ✓Feeling more robust and healthy
Not Seeing Results?
Common reasons
- •Expecting immediate dramatic results—SS-31 works at the cellular level and effects are often subtle and gradual
- •Inconsistent dosing—daily consistency is important for achieving steady-state levels
- •Poor quality peptide from unreliable source—always verify purity with third-party certificates of analysis
- •Improper storage that degraded the peptide—verify your solution is clear before each use
- •Underlying health issues affecting mitochondrial response—some conditions may require higher doses or longer treatment
- •Not supporting overall mitochondrial health—diet, sleep, and lifestyle factors significantly impact results
Key Research
"Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential"
Tung C, Varzideh F, Farroni E, 2025
Finding: This comprehensive review confirmed SS-31's unique ability to selectively bind cardiolipin in mitochondria, stabilizing cristae structure, reducing oxidative stress, and enhancing ATP production. Clinical trials like PROGRESS-HF, TAZPOWER, and MMPOWER-3 demonstrate significant therapeutic potential across multiple conditions involving mitochondrial dysfunction.
View Study"Mitochondrial protein interaction landscape of SS-31"
Chavez JD, Tang X, Campbell MD, 2020
Finding: Using advanced chemical cross-linking and mass spectrometry, researchers mapped exactly which proteins SS-31 interacts with inside mitochondria. All the interacting proteins are known cardiolipin binders involved in either ATP production or metabolic processes—confirming SS-31's highly targeted mechanism of action.
View Study"Structure-activity relationships of mitochondria-targeted tetrapeptide pharmacological compounds"
Mitchell W, Tamucci JD, Ng EL, 2022
Finding: This study analyzed how SS-31's specific amino acid sequence affects its activity. The research showed SS-31 modulates membrane electrostatics and can permeate cells to target mitochondria. All tested peptide variants were pharmacologically active in restoring mitochondrial membrane potential and promoting cell survival under stress.
View Study"SS-31: A promising therapeutic agent against bleomycin-induced pulmonary fibrosis in Mice"
Gu Q, Wang Y, Zhang H, 2025
Finding: At 5 mg/kg daily, SS-31 significantly reduced lung fibrosis in mice by protecting mitochondrial structure and function. The peptide reduced oxidative stress markers, inflammatory factors (TNF-alpha, IL-1beta, IL-6), and improved overall lung tissue health—demonstrating its potential beyond cardiac applications.
View Study"Mitochondrial Cardiolipin-Targeted Tetrapeptide, SS-31, Exerts Neuroprotective Effects Within In Vitro and In Vivo Models of Spinal Cord Injury"
Ravenscraft B, Lee DH, Dai H, 2025
Finding: SS-31 protected neurons from mitochondrial dysfunction and cell death in both laboratory and animal models of spinal cord injury. The peptide reduced cardiolipin loss, prevented neurite degeneration, and improved behavioral recovery—highlighting its neuroprotective potential.
View StudyFrequently Asked Questions