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SS-31 (Elamipretide) Dosage Guide: Protocols, Timing & How Much to Take (2026)

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Dosage Protocols

No FDA-approved dosing guidelines exist for SS-31 outside of clinical trial protocols. The following dosing information is derived from published clinical research and community reports:

Clinical Trial Dosing:

  • EMBRACE-STEMI trial: Intravenous infusion of 0.05 mg/kg/hour over 1 hour
  • PROGRESS-HF trial: Single 4-hour intravenous infusion at 0.005, 0.05, or 0.25 mg/kg/hour
  • Primary mitochondrial myopathy trials (MMPOWER-3): 40 mg/day subcutaneously for up to 24 weeks
  • TAZPOWER trial (Barth syndrome): 40 mg/day subcutaneously for 28 weeks

Community and Research Chemical Use:

  • Conservative starting dose: 5 mg subcutaneously once daily
  • Moderate dose: 10–20 mg subcutaneously once daily
  • Higher dose: 20–40 mg subcutaneously once daily (matching clinical trial dosing for mitochondrial myopathy)

These doses reflect clinical trial protocols for specific conditions (primary mitochondrial myopathy, Barth syndrome). No published data exists for subcutaneous self-administration in healthy individuals. Note: the Phase 3 MMPOWER-3 trial did not meet its primary endpoints for the general PMM population.

Cycling Guidelines:

  • Clinical trials used continuous dosing for up to 36 weeks without apparent tolerance
  • Community protocols sometimes implement 8 weeks on, 4 weeks off
  • Cycling scientific necessity is unestablished; continuous use mirrors clinical trial practice
  • Morning administration may align better with circadian rhythms governing mitochondrial activity

Frequently Asked Questions

Cycling necessity is not scientifically established. Clinical trials used continuous dosing for up to 36 weeks without apparent tolerance development. Some users implement 8-weeks-on, 4-weeks-off protocols precautionally, but this practice is not supported by clinical evidence.

This content is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making any health-related decisions.

References

  1. Szeto HH. First-in-class cardiolipin-protective compound as a therapeutic agent to restore mitochondrial bioenergetics. Br J Pharmacol. 2014;171(8):2029-2050.
  2. Birk AV, et al. The mitochondrial-targeted compound SS-31 re-energizes ischemic mitochondria by interacting with cardiolipin. J Am Soc Nephrol. 2013;24(8):1250-1261.
  3. Daubert MA, et al. Novel Mitochondria-Targeting Peptide in Heart Failure Treatment: A Randomized, Placebo-Controlled Trial of Elamipretide. Circ Heart Fail. 2017;10(12):e004230.
  4. Butler J, et al. Effects of Elamipretide on Left Ventricular Function in Patients With Heart Failure With Reduced Ejection Fraction: The PROGRESS-HF Phase 2 Trial. J Card Fail. 2020;26(5):429-437.
  5. Thompson R, et al. Current and future treatment approaches for Barth syndrome. J Inherit Metab Dis. 2022;45(1):17-28.
  6. Karaa A, et al. Randomized dose-escalation trial of elamipretide in adults with primary mitochondrial myopathy. Neurology. 2018;90(14):e1212-e1221.
  7. Stealth BioTherapeutics. Elamipretide Development Program.
  8. Sabbah HN, et al. Chronic Therapy With Elamipretide (MTP-131), a Novel Mitochondria-Targeting Peptide, Improves Left Ventricular and Mitochondrial Function in Dogs With Advanced Heart Failure. Circ Heart Fail. 2016;9(2):e002206.
  9. Gibson CM, et al. EMBRACE STEMI study: a Phase 2a trial to evaluate the safety, tolerability, and efficacy of intravenous MTP-131 on reperfusion injury in patients undergoing primary percutaneous coronary intervention. Eur Heart J. 2016;37(16):1296-1303.
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