SS-31 (Elamipretide)

Mitochondrial-Targeted Peptide | Cardiolipin Protector

Half-life: ~2 hours
6 studies
2025 latest
4 recent
Well Studied
Dose 5-10mg general support, 10-40mg clinical/performance protocols
Frequency Once daily (morning or pre-workout for athletic use)
Cycle 4-12 weeks for therapeutic protocols
Storage Reconstituted: 2-8°C in amber/dark vials, use within 30 days. Light sensitive

Community Research

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SS-31 (Elamipretide) is an aromatic-cationic tetrapeptide that selectively binds to cardiolipin in the inner mitochondrial membrane, preventing lipid peroxidation and optimizing electron transport chain function for enhanced cellular energy production.

Mechanism of Action

Selectively binds to cardiolipin in inner mitochondrial membrane, preventing lipid peroxidation and optimizing electron transport chain function. This improves ATP production and reduces oxidative damage at the mitochondrial level.

01 Directly protects mitochondria
02 Improves cellular energy production (ATP)
03 Reduces oxidative damage
04 Enhances exercise capacity
05 Excellent safety profile in clinical trials
06 Cardioprotective effects

Molecular Data

Type
Aromatic-cationic tetrapeptide
Peak 0.0 mcg
Trough 0.0 mcg
SS Peak 0.0 mcg
SS Trough 0.0 mcg

Research Indications

Mitochondrial
Enhanced ATP Production most effective

Optimizes electron transport chain function for improved cellular energy.

Oxidative Stress Reduction most effective

Prevents cardiolipin peroxidation and reduces mitochondrial oxidative damage.

Mitochondrial Disease Support effective

Significant improvements in 6-minute walk test and fatigue scores in PMM patients.

Cardiovascular
Cardiac Protection effective

Reduces cardiac injury markers and improves mitochondrial function in surgical patients.

Heart Failure Support effective

Reduces ischemia-reperfusion injury and supports cardiac function.

Exercise Tolerance effective

Enhanced exercise capacity and reduced fatigue.

Anti-Aging
Age-Related Muscle Function moderate

Reversed age-related decline in muscle function in animal studies.

Cognitive Protection moderate

Neuroprotective effects demonstrated in Alzheimer's models.

Cellular Rejuvenation moderate

Supports overall cellular health through mitochondrial optimization.

Dosing Protocols

Subcutaneous or intravenous injection. SS-31 dissolves readily and should be protected from light due to photosensitivity.

GoalDoseFrequencyRoute
General mitochondrial support5-10mgOnce dailySubQ
Athletic performance10-20mgOnce daily pre-workoutSubQ
Clinical protocols40mgOnce dailySubQ or IV
Acute cardioprotection0.25mg/kg/hrContinuous infusionIV

Reconstitution Instructions

Materials Needed:
  • SS-31 peptide vial
  • Bacteriostatic water or saline
  • Insulin syringes (for SubQ)
  • Alcohol prep pads
  • Sterile filter (optional for IV)
  • Amber vials (light protection)
  1. 1 Clean vial with alcohol pad
  2. 2 Add 1-2mL bacteriostatic water per 10mg peptide
  3. 3 Gently swirl to dissolve (dissolves readily)
  4. 4 Verify clear, colorless solution
  5. 5 Optional: sterile filtration for IV use
  6. 6 Label with concentration and date
  7. 7 Store immediately at 2-8°C
  8. 8 Protect from light - use amber vials if available

Interactions

++
NAD+
Both support mitochondrial function through different mechanisms.
synergistic
++
MOTS-c
Both are mitochondrial peptides with complementary mechanisms.
synergistic
++
Humanin
May work together to protect cellular function.
synergistic
+
GHK-Cu
Different mechanisms; no conflicts.
compatible
+
BPC-157
BPC-157 focuses on tissue repair while SS-31 targets cellular energetics.
compatible
+
Thymosin Beta-4
Both cardioprotective via different pathways.
compatible

What to Expect

Day 1-3
Subtle energy improvements, reduced fatigue
Week 1-2
Better exercise endurance, faster recovery
Week 2-4
Improved stamina, clearer thinking, better sleep
Week 4-8
Significant exercise capacity improvements
Week 8-12
Sustained energy, potential biomarker changes

Side Effects & Safety

Common Side Effects

  • Excellent safety profile in clinical trials
  • No significant side effects reported at therapeutic doses
  • Mild injection site reactions possible
  • Safe for long-term use based on current data

Stop Signs - Discontinue if:

  • Severe injection site reactions
  • Allergic reaction signs (rash, breathing difficulty)
  • Unusual fatigue or weakness (paradoxical reaction)
  • Cardiovascular symptoms
  • Severe headaches or vision changes

Contraindications

  • Known hypersensitivity to peptides
  • Pregnancy or breastfeeding (limited data)

Quality Checklist

Good Signs

  • Pharmaceutical grade (>98% purity required for clinical applications)
  • Clear, colorless solution after reconstitution
  • Certificate of Analysis available
  • Proper cold chain maintenance

Warning Signs

  • Light sensitive - protect from exposure using amber vials
  • Solution pH should be 6.5-7.5 (physiological range)

Bad Signs

  • Yellow or brown discoloration indicates degradation
  • Cloudy solution or visible particles
  • Improper storage conditions

References

  • Randomized Dose-Escalation Trial of Elamipretide in Adults with Primary Mitochondrial Myopathy (MMPOWER)
    Karaa, A., et al.
    Neurology (2018)

    Phase I/II trial in 36 patients showed dose-dependent improvement in 6-minute walk test (64.5m vs 20.4m placebo at highest dose) after 5 days of treatment with excellent safety profile.

  • Novel Mitochondria-Targeting Peptide in Heart Failure Treatment (EMBRACE)
    Daubert, M.A., et al.
    Circulation: Heart Failure (2017)

    IV infusion in heart failure patients showed significant decrease in left ventricular end-diastolic volume (-18 mL, P=0.009) and end-systolic volume (-14 mL, P=0.005) at the highest dose.

  • Improving Mitochondrial Function with SS-31 Reverses Age-Related Redox Stress and Improves Exercise Tolerance in Aged Mice
    Siegel, M.P., et al.
    Free Radical Biology and Medicine (2019)

    8 weeks of SS-31 (3 mg/kg/day) in aged mice reversed age-related decline in mitochondrial ATP production, restored redox homeostasis, and significantly increased treadmill endurance.

  • TAZPOWER: Phase 2/3 Randomized Clinical Trial of Elamipretide in Barth Syndrome
    Thompson, W.R., et al.
    Genetics in Medicine (2021)

    40mg daily in Barth syndrome patients. Primary endpoints not met at 12 weeks, but open-label extension showed cumulative 96.1m improvement in 6MWT at 168 weeks (P=0.003) with sustained fatigue improvements.

  • Efficacy and Safety of Elamipretide in Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial
    Karaa, A., et al.
    JAMA Neurology (2023)

    Phase 3 trial (218 patients) did not meet primary 6MWT endpoint overall, but post-hoc analysis showed improvement in patients with nuclear DNA variants. Well-tolerated with mild-to-moderate adverse events.

  • Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential
    Machiraju, P., et al.
    International Journal of Molecular Sciences (2025)

    Comprehensive review covering PROGRESS-HF, TAZPOWER, MMPOWER-3, and ReCLAIM trials. Highlights elamipretide's unique cardiolipin-binding mechanism and broad therapeutic potential across mitochondrial diseases.

Disclaimer

This information is for educational and research purposes only. Consult a healthcare professional before use.