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Elamipretide

Mitochondrial Support

Elamipretide is a mitochondria-targeted tetrapeptide developed to support mitochondrial health and energy production. It binds cardiolipin in the inner mitochondrial membrane, preserving mitochondrial structure and reducing oxidative stress. Elamipretide has shown benefit in patients with primary mitochondrial myopathies, cardiovascular disease, and other conditions associated with impaired energy metabolism. It is commonly used in protocols that involve SS-31 or serve as follow-up to NAD+ and MOTS-c-based mitochondrial repair stacks.

Reconstitute
2 mL BAC + 2mg vial
10 mcg/unit
Daily Range
20–40 mg Subcutaneous (SQ)
Once daily
Standard Dose
40 mg
Cycle
4–8 weeks
then reassess
Mitochondrial DysfunctionPeptideMitochondrial Medicine

Dosing & Reconstitution Guide

IV dosing is critical for safety. Do not exceed 140mg daily in clinical studies. Monitor for infusion reactions and report any adverse events immediately.

Standard / Gradual Approach

2mg Vialstandard
PhaseDoseVolume
Week 170mg7000 units
Week 2100mg10000 units
Week 3140mg14000 units
Week 4140mg14000 units

Protocol Summary

Subcutaneous (SQ): Once daily · Dose range 20–40 mg with gradual titration
Cycle Length: 4–8 weeks typical; reassess before extending

Frequency & Cycling

SubQ Injection

Administered daily for 4–6 weeks depending on use case. May be extended up to 12 weeks in chronic mitochondrial dysfunction protocols. Used with or after NAD+ and SS-31 in mitochondrial support stacks. Cycle breaks of 4 weeks are commonly used.

🧪 Quick Start

Vial Size
2 mg
BAC Water
2 mL
Concentration
1000 mcg/unit

Potential Benefits & Use Cases

Elamipretide is an investigational drug in most jurisdictions. Use only under clinical supervision or approved research protocols.
Supports mitochondrial function by reducing oxidative stress and enhancing ATP production
May improve cellular energy production, muscle endurance, and organ function
Studied for neurodegenerative diseases, cardiovascular health, and age-related mitochondrial decline
Clinical data Strong preclinical Limited data

Mechanism of Action

→Selectively targets mitochondria, stabilizing cardiolipin to enhance electron transport chain efficiency
→Reduces reactive oxygen species (ROS), decreasing oxidative damage and cellular apoptosis
→Improves ATP production, supporting muscle function, cognition, and organ health

Stacking Synergies

+
SS-31
Complementary effects in mitochondrial support and neuroprotection

Lifestyle & Optimization

diet

Consume antioxidant-rich foods (berries, leafy greens, nuts). Minimize oxidative stress through lifestyle choices.

sleep

Ensure 7–9 hours of sleep nightly.

timing

Consistent daily dosing.

exercise

Maintain moderate exercise routine to support mitochondrial function.

Peptide Research & Preclinical Studies

Evidence-Based Research Findings

Study TitleType
Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical TrialReference
October 10, 2024 Cardiovascular and Renal Drugs Advisory Committee (CRDAC) MeetingReference

Side Effects & Safety

Common Side Effects

• Mild nausea
• Transient fatigue
• Localized injection discomfort

Contraindications & Warnings

• Not recommended for individuals with uncontrolled metabolic disorders without supervision
• Long-term safety studies are still ongoing; periodic monitoring is advised

Long-Term Safety Data

• Limited human trials available, but early results suggest a favorable safety profile

🧮 Dose Calculator

Concentration
10.0
mcg/unit
Draw Volume
50
units (0.500 mL)
For a 500 mcg dose, draw 50 units on a U-100 insulin syringe
🧬

Bioavailability & Absorption

SubQ Injection
Rapid absorption after subcutaneous administration.
Oral Administration
Not available due to poor oral bioavailability.
Intranasal
Not specified
Half-Life
4-6 hours
Degradation
Predominantly metabolized by renal pathways.
Tissue Specificity
Targets mitochondrial tissues, especially muscle and heart.
⚗️

Peptide Details

Molecular Weight
751
Formula
C41H72N14O8S2
Sequence
D-Arg-Dmt-Lys-Phe-NH2
⚖️

Legal Status & Regulatory

RegionStatus
EUNot Approved
FDANot Approved
CanadaNot Approved
AustraliaNot Approved

Storage Instructions

Lyophilized (Powder)
Store at 2-8°C if provided as lyophilized powder. If supplied as solution, maintain at 2-8°C and protect from light. Do not freeze. Solution is typically stable for 30 days post-opening when refrigerated.
Reconstituted (Mixed)
Refrigerate at 2–8°C after reconstitution. Use within 28 days.