Primus Anabolics

SS-31

Improves mitochondrial function, reduces oxidative stress and increases ATP production by binding to cardiolipin

SS-31
07 Apr 2026

Quickstart – key points

SS-31 (elamipretide) is a mitochondria-targeted tetrapeptide that selectively binds to cardiolipin in the inner mitochondrial membrane, stabilizing the electron transport chain complexes and reducing the production of reactive oxygen species, while simultaneously improving ATP synthesis.

This peptide has shown protective effects in preclinical models of heart failure, neurodegenerative diseases, and age-related muscle atrophy, and received accelerated FDA approval in 2025 as the first treatment for Barth syndrome.

This educational protocol presents a daily subcutaneous administration approach using 50 mg vials with a practical reconstitution to facilitate measurement with an insulin syringe.

  • Reconstitution: Add 3.0 mL of bacteriostatic water → approximate concentration of 16.67 mg/mL.
  • Typical daily range: 5–10 mg once daily (gradual titration); advanced protocols can reach 15–20 mg/day under supervision.
  • Easy measurement: At 16.67 mg/mL, 1 unit = 0.01 mL ≈ 167 mcg on a U-100 syringe.
  • Storage: Lyophilized: freeze at −20 °C; after reconstitution, refrigerate at 2–8 °C; use within 4 weeks.

Dosage and Reconstitution Guide

Educational guide for reconstitution and daily dosing.

Standard / gradual approach (3.0 mL = ~16.67 mg/mL)

  • Weeks 1–2: 5 mg (5000 mcg) → 30 units (0.30 mL)
  • Weeks 3–8: 10 mg (10,000 mcg) → 60 units (0.60 mL)

Frequency: one daily subcutaneous injection at the same time. This concentration allows keeping doses within manageable volumes for greater precision.

Reconstitution Steps

  1. Draw 3.0 mL of bacteriostatic water with a sterile syringe
  2. Inject slowly down the side of the vial; avoid shaking hard
  3. Mix gently until completely dissolved
  4. Label with the date and refrigerate between 2–8 °C, protected from light
  5. Use within a maximum of 4 weeks

Advanced / Aggressive approach (3.0 mL = ~16.67 mg/mL)

  • Weeks 1–2: 5 mg → 30 units (0.30 mL)
  • Weeks 3–4: 10 mg → 60 units (0.60 mL)
  • Weeks 5–8: 15 mg → 90 units (0.90 mL)
  • Optional weeks 9–12: 20 mg → divide into 2 injections of 60 units

Note: Advanced doses (15–20 mg/day) are based on clinical trials in severe conditions and should only be performed under medical supervision. 20 mg doses require dividing the injection. Use beyond 12 weeks requires careful monitoring.

Important: this guide is only educational and is not medical advice.

Required Supplies

  • Peptide vials (SS-31, 50 mg each):
    • 8 weeks ≈ 10 vials
    • 12 weeks (10 mg/day) ≈ 16 vials
    • 12 weeks (up to 15 mg/day) ≈ 21 vials
  • Bacteriostatic water (30 mL):
    • 8 weeks: 30 mL → 1 bottle
    • 12 weeks: 48 mL → 2 bottles
    • 12 weeks advanced: 63 mL → 3 bottles

Protocol Summary

  • Objective: improve mitochondrial function, increase ATP production, and reduce oxidative stress.
  • Duration: 8–12 weeks.
  • Dose: 5–10 mg daily (up to 15–20 mg in advanced protocols).
  • Reconstitution: 3 mL per 50 mg vial.
  • Storage: frozen if lyophilized; refrigerated after reconstitution; use within 4 weeks.

Dosing Protocol

  • Start: 5 mg daily for 2 weeks
  • Standard Goal: 10 mg daily
  • Advanced Goal: 15–20 mg daily (only with supervision)
  • Frequency: 1 time per day
  • Duration: 8–12 weeks
  • Schedule: constant, rotating zones

Storage

  • Reconstituted: 2–8 °C, use within 4 weeks
  • Let reach room temperature before opening

Important Notes

  • Use a new syringe for each injection
  • Rotate injection sites
  • Inject slowly
  • Mild reactions at the injection point are common
  • Record dose and effects
  • Divide high doses into several injections

How it works

SS-31 is a cell-permeable peptide that acts directly on mitochondria. It binds to cardiolipin, a key lipid for the structure and functioning of the electron transport chain. This improves energy efficiency, reduces oxidative stress, and increases ATP production in tissues with high energy demand.

In preclinical studies it has shown protection against multiple diseases related to mitochondrial dysfunction. In human clinical trials it has shown good tolerance, although efficacy results have been mixed, except in Barth syndrome, where it did show clear improvements.

Potential Benefits and Side Effects

  • Benefits:

    • Improves mitochondrial function
    • Increases cellular energy production
    • Reduces oxidative stress
    • Improves muscle function in certain conditions

  • Side Effects:

    • Injection site reactions (very common)
    • Redness, itching or mild discomfort
    • Generally disappear within a few hours

No severe toxicities have been observed in studies, but long-term data are limited.

Lifestyle Factors

  • Diet rich in micronutrients (B vitamins, CoQ10, magnesium)
  • Strength training and cardio
  • Sleep 7–9 hours
  • Stress management
  • Avoid substances that damage mitochondria (excessive alcohol, toxins)

Injection Technique

  • Clean vial and skin with alcohol
  • Use new syringe
  • Pinch the skin
  • Insert the needle at 45–90°
  • Inject slowly
  • Wait a few seconds before withdrawing
  • Rotate sites (abdomen, thighs, arms, buttocks)
  • Do not reuse needles and dispose of correctly