SS-31 (Elamipretide) protocol

Standard (longevity range)

Weeks 1–2

12.5u

2.5 mg · Daily AM

Tolerance ramp. Start low; assess GI and injection-site response.

Weeks 3–12

25u

5 mg · Daily AM

Standard longevity-community working dose; some protocols run up to 10 mg/day. FDA Forzinity is 40 mg/day SC for Barth syndrome only, the disease-modifying dose, not a longevity target.

Off

4–8 weeks

Consolidation. Sequences naturally into a MOTS-c cycle.

Phase	How often	Dose	Units	Notes
Weeks 1–2	Daily AM	2.5 mg	12.5u	Tolerance ramp. Start low; assess GI and injection-site response.
Weeks 3–12	Daily AM	5 mg	25u	Standard longevity-community working dose; some protocols run up to 10 mg/day. FDA Forzinity is 40 mg/day SC for Barth syndrome only, the disease-modifying dose, not a longevity target.
Off	4–8 weeks	–	–	Consolidation. Sequences naturally into a MOTS-c cycle.

Cycle & timing

Cycle: 8–12 wks on / 4 wks off (longevity range); Forzinity is daily-continuous for Barth.

Timing: Daily AM or anytime, consistency more important than timing.

Where: SubQ abdomen or outer thigh.

What to expect

Energy and exercise-capacity improvement at 4–8 weeks. Injection-site redness expected. First step of the mitochondrial longevity sequence: SS-31 → MOTS-c.

How much to buy

For 12-wk @ 5 mg × 7/wk:

77

× 5mg vials

39

× 10mg vials

8

× 50mg vials

Men & women

Unisex mitochondrial peptide, same protocol for men and women, no cycle effect. FDA-approved (Forzinity) use is disease-specific; avoid in pregnancy.

Dilution calculator

Set to the guide's typical mix for SS-31 (Elamipretide). Change anything to see where to draw.

Vial size

BAC water added

Dose you want

Draw to

25u

Volume

0.25 mL

Strength

20 mg/mL

Doses per vial

2

Assumes a U-100 insulin syringe (100 units = 1 mL). Double-check against the compound's page before you draw.

Recommended mixes

Vial	Water	Strength
5 mg	0.25 mL	20 mg/mL
10 mg	0.50 mL	20 mg/mL
50 mg	2.5 mL	20 mg/mL

5 mg: 1 unit = 0.20 mg

Storage

PowderFreeze-dried: -4°F.
MixedReconstituted: 36–46°F, use within 4 weeks.

Don't use if: Pregnancy · Lactation · Active mitochondrial disease without specialist supervision

Stop if you notice

Persistent injection-site reactions
Headache not resolving

Side effects

Injection-site redness/swelling (most common). Headache, fatigue. Generally mild.

Labs

Fasting glucose (Week 0/4/8); CMP/BMP renal (baseline + mid-cycle, renally cleared). Out of range? Rising glucose/HbA1c = blood sugar creeping toward diabetes (recheck, tighten diet); a falling eGFR = kidney strain, usually dehydration (hydrate, hold the dose).

What these labs mean →

Warnings

FDA-approved (Forzinity) for Barth syndrome only; longevity use is off-label. Cardiolipin binding saturates at ~1 mg/kg.

Patient education

Aseptic technique; single-use sterile needle each injection; never share vials/needles. Sharps in an FDA-cleared container. Maintain cold chain; mark first-puncture date; inspect every vial before use. Rotate injection sites.

These apply on top of the universal safety rules.

Pairs well with

MOTS-c

mitochondrial stack, usually run as supportive precedent

MOTS-c

NAD+

mitochondrial energy

NAD+

Humanin

MDP pairing

Humanin

Avoid with

Active mitochondrial disease without specialist supervision

FDA approved only for Barth syndrome under monitoring

Can SS-31 (Elamipretide) + MOTS-c share a syringe?

Can share a syringe. Both are water-based. Combine them if you dose on the same schedule and site.

What it does

FDA accelerated approval as FORZINITY® for Barth syndrome (Sep 19, 2025), the first FDA-approved mitochondria-targeted drug (commercially available Dec 2025).

Mitochondria-targeted tetrapeptide, FDA accelerated approval as FORZINITY® for Barth syndrome (Sep 19, 2025), the first FDA-approved mitochondria-targeted drug (commercially available Dec 2025). Concentrates in the inner mitochondrial membrane via cardiolipin binding.

Other indications

Other indications (dry AMD / geographic atrophy, primary mitochondrial myopathy) remain trial-stage; not approved.

References

medsbase researchdosing peptidedosages DailyMed

From the guide, page 91.