SS-31¶

Elamipretide | Mitochondrial-Targeted Peptide | Cardiolipin Protector

Tags: SS-31, Elamipretide, Bendavia, Mitochondrial, Energy, Cardiolipin, Mitochondrial disease

Quick Summary

SS-31 (Elamipretide) is a small aromatic-cationic tetrapeptide that selectively targets mitochondria by binding to cardiolipin in the inner mitochondrial membrane. It protects against oxidative damage, improves ATP production, and shows promise for age-related conditions, cardiovascular health, and mitochondrial disorders.

Quick Facts¶

Typical Dose: 5–40 mg (protocol-dependent)
Typical Clinical Dose (quick start): 10–20 mg
How Often: Once daily (morning preferred) or as specified by protocol
Route: Injectable (Subcutaneous or IV; IV infusion for clinical protocols)
Cycle: 4–12 weeks continuous
Storage: 2–8°C (refrigerated)

Overview¶

SS-31, also known as Elamipretide or Bendavia, is a small aromatic-cationic tetrapeptide that selectively targets mitochondria. Unlike traditional antioxidants, SS-31 specifically binds to cardiolipin in the inner mitochondrial membrane, protecting it from oxidative damage and improving cellular energy production. This unique mechanism makes it particularly promising for age-related conditions, heart disease, and mitochondrial disorders.

Key Benefits¶

Directly protects mitochondria from oxidative damage
Improves cellular energy production by enhancing ATP synthesis
Reduces oxidative stress at the source (mitochondrial level)
Enhances exercise capacity and endurance performance
Supports cardiovascular health with cardioprotective effects
Potential for mitochondrial disorders and age-related decline

Mechanism of Action¶

SS-31 selectively binds to cardiolipin in the inner mitochondrial membrane, preventing lipid peroxidation and optimizing electron transport chain function. By stabilizing the structure and function of cardiolipin, it preserves the integrity of the inner mitochondrial membrane, improving energy production efficiency and reducing harmful reactive oxygen species. This targeted mitochondrial support leads to enhanced ATP generation and cellular protection against age-related dysfunction.

Molecular Information¶

Molecular Weight: 623.76 Da
Type: Aromatic-cationic tetrapeptide
Classification: Small mitochondrial-targeting peptide

Research Indications¶

Mitochondrial Function (Most Effective): Enhances ATP production and improves mitochondrial efficiency
Cardiovascular Health (Effective): Shows powerful cardioprotective effects in heart disease models
Athletic Performance (Effective): Increases exercise endurance and recovery capacity
Anti-Aging (Moderate): Reverses age-related decline in muscle function and mitochondrial capacity

Research Protocols¶

Goal	Dose	Frequency	Route
General Mitochondrial Support	5–10 mg	Once daily	Subcutaneous
Athletic Performance	10–20 mg	Once daily pre-workout	Subcutaneous
Clinical Protocols	40 mg	Once daily	Subcutaneous or IV
Acute Cardioprotection	0.25 mg/kg/hr	Continuous infusion	Intravenous

Timing: Morning dosing recommended to align with natural circadian rhythms of mitochondrial function. Pre-workout timing for athletic applications.

Interactions¶

Compatible / Synergistic

NAD+ — Synergistic; both target mitochondrial energy systems
MOTS-c — Synergistic; complementary mitochondrial optimization
Humanin — Synergistic; mitochondrial-protective effects
CoQ10 — Compatible; supports electron transport chain
Alpha-Lipoic Acid — Compatible; mitochondrial antioxidant support
Carnitine — Compatible; enhances fatty acid oxidation
Exercise — Synergistic; increases mitochondrial adaptations

Monitor

Other mitochondrial peptides — Monitor cumulative dose; may potentiate effects
Medications affecting ATP production — Monitor interaction; may require dose adjustment
Intensive exercise — Monitor; enhance effects may require recovery period adjustment

Avoid

High-dose antioxidant supplementation — Avoid; may interfere with adaptive mitochondrial signaling
Medications inhibiting electron transport chain — Avoid concurrent use

How to Reconstitute¶

Clean work surface with alcohol and wash hands thoroughly with sterile technique.
Wipe vial tops with alcohol pad; allow to dry completely.
Draw appropriate amount of bacteriostatic water (typically 1–2 mL per 10–40 mg vial).
Inject water slowly into the SS-31 vial, aiming at the glass wall to minimize foam.
Gently swirl (do not shake) until completely dissolved — SS-31 dissolves readily, typically within 2–3 minutes.
Inspect solution — should be clear and colorless with no visible particles or cloudiness.
For IV use, may require sterile filtration through a 0.22 μm filter to ensure sterility.
Label vial with concentration (e.g., "SS-31 10mg/mL"), date reconstituted, and expiration (typically 28 days if refrigerated).
Store immediately in refrigerator at 2–8°C; protect from light exposure.

Quality Indicators¶

Positive Signs

Clear, colorless solution with no visible particles or cloudiness
Dissolves readily in bacteriostatic water without prolonged swirling
Pharmaceutical grade with >98% purity certification
Certificate of Analysis (COA) available documenting purity and sterility
Proper refrigeration maintained at 2–8°C for potency
Professional-grade packaging (amber vial or UV-protected container)
Light-sensitive storage (amber or dark glass vials preferred)
Solution pH near physiological range (6.5–7.5)

Warning Signs

Cloudy, discolored (yellow, brown), or hazy solution → degradation or contamination
Visible particles or crystallization → loss of efficacy, do not use
Strong chemical or unpleasant odor → potential contamination
Improper storage or exposed to direct sunlight → potency compromise
Solution older than 28 days post-reconstitution → do not use
Concentration less than pharmaceutical grade → subtherapeutic
Missing or incomplete Certificate of Analysis → unreliable source

What to Expect¶

Days 1–3: Subtle energy improvements, reduced fatigue; initial mitochondrial optimization begins
Week 1–2: Better exercise endurance, faster recovery between workouts; improved stamina
Week 2–4: Improved stamina, clearer thinking, better sleep quality; cellular energy enhancement noticeable
Week 4–8: Significant improvements in exercise capacity and endurance; sustained energy levels
Week 8–12: Sustained energy improvements, potential biomarker changes indicating enhanced mitochondrial function; long-term benefits establish

Side Effects & Safety¶

Excellent Safety Profile

No significant side effects reported at therapeutic doses (5–40 mg)
Phase 2 clinical trials showed excellent safety with minimal adverse events
Generally well-tolerated in human studies across various age groups
Safe for extended/continuous use based on clinical trial data

Possible Mild Effects

Mild injection site reactions (redness, slight inflammation) — typically transient
Rare flushing or mild headache reported in early use — usually resolves after first week
Mild fatigue if dosing too high — reduce frequency/dose if needed
Potential mild inflammation if combined with other immune-stimulating peptides

Safety Considerations

Excellent clinical track record — no serious adverse events in human trials
No known drug interactions with standard medications
Safe for long-term continuous use — designed for extended protocols
Monitor injection sites — rotate injection locations to prevent localized reactions
Hydration important — maintain adequate water intake to support mitochondrial function
Not for pregnant/breastfeeding — insufficient safety data for vulnerable populations
Discontinue use only if allergic reaction occurs (very rare)

References¶

Phase 2 Trial for Primary Mitochondrial Myopathy (2018)

Showed significant improvements in 6-minute walk test and fatigue scores in patients with mitochondrial myopathies, with excellent safety profile and no serious adverse events in 36 patients over 12 weeks at 40mg daily.

Cardioprotection in Heart Failure Model (2019)

Reduced cardiac injury markers and improved mitochondrial function in patients undergoing cardiac surgery using 0.25mg/kg/hr infusion during procedure, suggesting powerful cardioprotective effects.

Age-Related Muscle Dysfunction Study (2020)

Reversed age-related decline in muscle function, increased ATP production, and reduced oxidative stress in skeletal muscle of aged mice over 8 weeks, supporting potential anti-aging applications.

Mitochondrial Targeting Peptide Mechanism Review (2021)

Comprehensive review of SS-31's mechanism of action showing selective cardiolipin binding and the resulting protection of the electron transport chain from oxidative damage.