SS-31 (Elamipretide)
Mitochondrial-Targeted Peptide | Cardiolipin Protector
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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.
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.
Molecular Data
Research Indications
Optimizes electron transport chain function for improved cellular energy.
Prevents cardiolipin peroxidation and reduces mitochondrial oxidative damage.
Significant improvements in 6-minute walk test and fatigue scores in PMM patients.
Reduces cardiac injury markers and improves mitochondrial function in surgical patients.
Reduces ischemia-reperfusion injury and supports cardiac function.
Enhanced exercise capacity and reduced fatigue.
Reversed age-related decline in muscle function in animal studies.
Neuroprotective effects demonstrated in Alzheimer's models.
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.
| Goal | Dose | Frequency | Route |
|---|---|---|---|
| General mitochondrial support | 5-10mg | Once daily | SubQ |
| Athletic performance | 10-20mg | Once daily pre-workout | SubQ |
| Clinical protocols | 40mg | Once daily | SubQ or IV |
| Acute cardioprotection | 0.25mg/kg/hr | Continuous infusion | IV |
Reconstitution Instructions
- 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 Clean vial with alcohol pad
- 2 Add 1-2mL bacteriostatic water per 10mg peptide
- 3 Gently swirl to dissolve (dissolves readily)
- 4 Verify clear, colorless solution
- 5 Optional: sterile filtration for IV use
- 6 Label with concentration and date
- 7 Store immediately at 2-8°C
- 8 Protect from light - use amber vials if available
Interactions
What to Expect
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
Frequently Asked Questions
Is SS-31 light sensitive and does it really need amber vials?
Yes, SS-31 is photosensitive and requires light protection. Store reconstituted solutions in amber vials or dark containers at 2-8°C. The peptide's aromatic-cationic structure is vulnerable to photodegradation, which can compromise its mitochondrial-binding effectiveness.
How quickly does SS-31 improve exercise tolerance?
Initial improvements in energy and fatigue appear within 1-3 days, with better exercise endurance noticed by week 1-2. Peak exercise capacity improvements typically develop over 4-8 weeks as mitochondrial ATP production optimizes.
Can SS-31 be used with NAD+ boosters and will they interact?
Yes, SS-31 and NAD+ are synergistic because both target mitochondrial function through complementary mechanisms - SS-31 directly protects cardiolipin while NAD+ supports electron transport chain enzymes. Combining them may enhance energy production more than either alone.
What's the difference between clinical-grade SS-31 (40mg daily) and athletic performance doses?
Athletic protocols use 10-20mg daily, while clinical trials for mitochondrial disease used 40mg daily. The higher clinical dose targets more significant mitochondrial dysfunction; athletic users typically achieve performance benefits at lower doses with less potential for excessive metabolic stimulation.
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 MiceSiegel, 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 SyndromeThompson, 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 TrialKaraa, 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 PotentialMachiraju, 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.
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Disclaimer
This information is for educational and research purposes only. Consult a healthcare professional before use.