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SS-31 (Elamipretide)

Phase 2/3 Clinical Trials
peptideSubcutaneous injection

A peptide engineered to go straight to your cells' power plants (mitochondria). It repairs the inner walls of your mitochondria, boosting energy production (ATP) by 20-40% and reducing harmful free radicals by 30-50%. Tested in over 500 patients in advanced clinical trials. Think of it as the foundation peptide -- by giving your cells more energy, it makes every other peptide work better too.

What to Expect

1

Week 1–2

Subtle increase in cellular energy. Improved exercise tolerance if mitochondrial dysfunction is present. Effects are at the cellular level initially.

2

Week 3–6

Noticeable improvement in stamina and energy. Reduced muscle fatigue. Better recovery from physical exertion. Improved mitochondrial biomarkers on labs.

3

Week 8+

Significant mitochondrial optimization. Improved cardiac function in those with dysfunction. Enhanced overall energy metabolism. Potential reversal of age-related mitochondrial decline.

Common Side Effects

Injection site reactionsHeadacheMild GI discomfort
Tolerance: None — addresses structural mitochondrial decline
Cycling: Daily dosing for 8-12 weeks, 4-8 weeks off. Still in clinical trials — follow study protocols.

Scientific Overview

SS-31 (Elamipretide, D-Arg-Dmt-Lys-Phe-NH2) is a mitochondria-targeted tetrapeptide that concentrates >1000-fold in mitochondrial inner membranes by binding to cardiolipin, a phospholipid unique to mitochondria. This interaction stabilizes cristae structure, optimizes electron transport chain efficiency, and reduces electron leak/ROS production. Phase 2/3 trials (500+ patients) in Barth syndrome and primary mitochondrial myopathy demonstrated safety at 4–40mg daily dosing for up to 28 weeks. SS-31 addresses the fundamental age-related decline in mitochondrial function.

Dosing

4-5 mg subq, 3 times a week on an empty stomach. Clinical trials showed it was safe at 4-40 mg daily for 28 weeks. Most people notice energy improvements within 3-7 days.

Practical Guide

Reconstitution

Mix vial per pharmacy instructions. Typically 5-40mg doses subcutaneously.

Storage

Refrigerate after reconstitution. Use within 14 days. Protect from light.

Injection Sites

Lower abdomenOuter thigh

Subcutaneous injection with insulin syringe. Daily dosing during treatment cycles.

Timing

Morning dosing preferred — aligns with mitochondrial activity peaks. Consistent daily timing.

Food

No known food interactions.

Benefit Profile

Longevity
9/10
🧠 Brain & Cognition
7/10
💪 Muscle Growth
5/10
🧊 Inflammation
4/10
🔥 Fat Loss
3/10
🩹 Injury Healing
3/10

Medical Considerations

Medical oversight strongly recommendedNot safe during pregnancy

Contraindications

  • Pregnancy/nursing
  • Known hypersensitivity to peptide components

Drug Interactions

Other mitochondrial-targeted compounds (CoQ10, MitoQ — theoretical additive effects)Statins (both affect mitochondrial function)

Recommended Monitoring

  • Renal function (cleared renally)
  • Cardiac monitoring if heart failure present

This information is for educational purposes only. Always consult a qualified healthcare provider before starting any peptide protocol.

Pricing

VendorVariantPrice
Limitless Biotech10mg$82.99
Code: PSTACK10Buy
Skye Peptides10mg$79.99BEST
Peptide Sciences
Announced voluntary shutdown
10mg$95.00

Published Research

20 studies indexed(2020–2026)7 clinical trials13 reviews

Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER.

Thompson WR, Manuel R, et al.·Genet Med·2024
Clinical Trial

Genotype-specific effects of elamipretide in patients with primary mitochondrial myopathy: a post hoc analysis of the MMPOWER-3 trial.

Karaa A, Bertini E, et al.·Orphanet J Rare Dis·2024
Clinical Trial

Elamipretide Topical Ophthalmic Solution for the Treatment of Subjects with Leber Hereditary Optic Neuropathy: A Randomized Trial.

Karanjia R, Sadun AA·Ophthalmology·2024
Clinical Trial

Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial.

Karaa A, Bertini E, et al.·Neurology·2023
Clinical Trial

Identifying responders to elamipretide in Barth syndrome: Hierarchical clustering for time series data.

Van den Eynde J, Chinni B, et al.·Orphanet J Rare Dis·2023
Clinical Trial

Natural history comparison study to assess the efficacy of elamipretide in patients with Barth syndrome.

Hornby B, Thompson WR, et al.·Orphanet J Rare Dis·2022
Clinical Trial

A randomized crossover trial of elamipretide in adults with primary mitochondrial myopathy.

Karaa A, Haas R, et al.·J Cachexia Sarcopenia Muscle·2020
Clinical Trial

Elamipretide: First Approval.

Shirley M·Drugs·2026
Review

Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential.

Tung C, Varzideh F, et al.·Int J Mol Sci·2025
Review

Contemporary insights into elamipretide's mitochondrial mechanism of action and therapeutic effects.

Sabbah HN, Alder NN, et al.·Biomed Pharmacother·2025
Review
Showing 10 of 20 studies. Search PubMed for the complete list.