SS-31 Dosage Chart: Studied Doses, Frequency

Key takeaways

The only labeled SS-31 dose is Forzinity (elamipretide) 40 mg injected under the skin once daily, for patients with Barth syndrome who weigh at least 30 kg; adults with severe kidney impairment who are not on dialysis take 20 mg.
The same 40 mg daily dose was used for 24 to 48 weeks in the mitochondrial myopathy and macular degeneration trials and for 4 weeks in heart failure; none of those trials met its primary endpoint.
Intravenous trials used weight-based infusions (0.05 mg/kg per hour for an hour after a heart attack; up to 0.25 mg/kg per hour for two hours in myopathy and in healthy older adults), and an eye trial used 1% drops twice a day.
Seller charts of 1 to 20 mg a day in 4- to 12-week cycles match no study. There is no studied dose for aging, energy or performance in healthy people.
Forzinity comes ready to use at 80 mg/mL. We give no reconstitution example for research vials, which are unapproved drugs of unverified content.

The direct answer: the studied SS-31 dose is 40 mg of elamipretide injected under the skin once a day. That is the FDA label dose for Barth syndrome in patients weighing at least 30 kg, and the dose used in every published long-term trial; intravenous and eye-drop doses appear only in early studies. No dose has been studied for aging or wellness, and the 1 to 20 mg cycles on seller charts come from no trial. Our SS-31 (elamipretide) profile covers the mechanism, the evidence and the legal status, and our MOTS-c dosage chart does the same job for the other mitochondrial peptide sold alongside it.

The studied doses

Study	Dose, route and frequency	Population and duration	What happened
Forzinity label (Barth syndrome)	40 mg subcutaneously once daily; 20 mg daily in adults with eGFR under 30 mL/min not on dialysis	Patients weighing at least 30 kg; the pivotal data are 12 males aged 12 to 35, with 8 treated through 168 weeks	12-week controlled crossover negative on both primary endpoints; knee-extensor strength rose a median 34 to 68 newtons in the open-label extension; accelerated approval (Forzinity label)
MMPOWER	0.01, 0.1 or 0.25 mg/kg per hour intravenously for 2 hours, daily for 5 days	36 adults with primary mitochondrial myopathy	Top dose: 64.5 versus 20.4 meters more on a 6-minute walk (P = 0.053) (Karaa 2018)
MMPOWER-3	40 mg subcutaneously once daily, 24 weeks	218 adults with primary mitochondrial myopathy	No difference in walking (-3.2 meters, P = 0.69) or fatigue (Karaa 2023)
EMBRACE STEMI	0.05 mg/kg per hour intravenously for 1 hour, once, at angioplasty	Adults with a first anterior heart attack	Infarct size not reduced; no imaging or clinical benefit (Gibson 2016)
PROGRESS-HF	4 mg or 40 mg subcutaneously once daily, 28 days	71 adults with heart failure and ejection fraction of 40% or less	No change in heart volumes or ejection fraction (Butler 2020)
ReCLAIM-2	40 mg subcutaneously once daily, 48 weeks	176 adults aged 55 or older with geographic atrophy	Both primary endpoints missed; slower photoreceptor-layer loss as a secondary finding (Ehlers 2025)
LHON eye-drop trial	1% eye drops, one drop twice daily, 52 weeks, then open label	12 adults with Leber hereditary optic neuropathy	Visual acuity no better than in vehicle-treated eyes; well tolerated (Karanjia 2024)
Healthy older adults	0.25 mg/kg per hour intravenously for 2 hours, once	39 adults aged 60 to 85 with poorly functioning muscle mitochondria	Maximal ATP production in a hand muscle up 27% versus 12% on placebo right after; no difference by day 7; no effect on fatigue (Roshanravan 2021)

Two things stand out. Published long-term studies converged on one dose, 40 mg once a day, and the drug's short life in the body fits a daily schedule: blood levels peak 30 to 60 minutes after an injection, and the dose is recovered in the urine within about 48 hours (Forzinity label). And outside Barth syndrome, no dose, route or schedule met a primary endpoint. A chart can tell you what was given; it cannot tell you that it worked.

What the label says, exactly

For Barth syndrome, the label dose is fixed, not calculated per kilogram. Weight decides only eligibility: patients must weigh at least 30 kg, and safety and effectiveness below that are not established. The other instructions (Forzinity label):

Frequency: once daily, at the same time each day. A missed dose is skipped, never doubled.
Kidneys: no change for mild or moderate impairment; 20 mg once daily for adults with eGFR under 30 mL/min who are not on dialysis, because exposure rises by 125% at that level. There is not enough information to dose patients on dialysis or children with kidney impairment.
Route and sites: subcutaneous only, into the abdomen at least 2 inches from the navel or the outer thigh, rotating sites daily. It is not approved for intravenous use, nor for newborns because of its benzyl alcohol preservative.
Product: a ready-to-use solution of 80 mg/mL in vials of 280 mg in 3.5 mL. A 40 mg dose is 0.5 mL. An opened vial is discarded after 8 days, which by our arithmetic covers 7 daily doses.
Side effects that come with the dose: injection-site reactions in every patient on drug in the controlled trial (redness 100% versus 25% on placebo), hypersensitivity reactions including serious ones, and a temporary rise in eosinophils.

Why a rare-disease label dose is not a wellness protocol

It is tempting to treat 40 mg a day as the "real" dose and anything else as a guess. The first half is right; the conclusion people draw from it is not.

The dose was chosen for a sick population. The patients in the Barth trial had a genetic defect in cardiolipin itself, the molecule elamipretide binds. The adults in the myopathy trial had genetic mitochondrial disease, and those in the eye trial had advanced macular degeneration. A healthy 45-year-old has none of that, and no trial has asked whether 40 mg a day, or any dose, does anything in someone whose mitochondria are working.

The dose did not work in most of the populations that took it. In 218 adults with mitochondrial myopathy, 176 with macular degeneration and 71 with heart failure, 40 mg a day did not beat placebo on the primary endpoint (Karaa 2023) (Ehlers 2025) (Butler 2020). Even in Barth syndrome, the controlled phase was negative; the strength gains that earned approval came from an uncontrolled extension, and a confirmatory trial is now required.

The one healthy-aging study is not a dosing study. It gave one infusion and measured within hours. The rise in muscle energy capacity had no measurable effect on fatigue and was not different from placebo a week later (Roshanravan 2021). It tells you the drug reaches muscle; it does not tell you what a daily injection would do over months.

The charts sellers circulate

What the charts say	Where the number comes from	Status
1 to 5 mg once daily, often starting at 1 mg	No study	Never tested
5 to 10 mg once daily, sometimes 'in the morning'	No study; described as a 'research community range'	Never tested
10 to 20 mg daily 'for performance', sometimes before workouts	No study	Never tested
0.5 to 1 mg three to five times a week	No study	Never tested
Cycles of 4 to 8 or 8 to 12 weeks, or 4 weeks on and 2 weeks off	No study; every trial dosed continuously	Never tested
10 mg and 50 mg powder vials mixed with 1 to 5 mL of bacteriostatic water	Dosing-site arithmetic for vendor vial sizes	Content and sterility unverified

These are claims from dosing sites circulating in October 2026, not doses. Some of the same pages quote the trials as well, and not always correctly: one lists EMBRACE STEMI as 0.25 mg/kg, when the infusion was 0.05 mg/kg per hour for one hour (Gibson 2016). The common thread is that the chart doses are fractions of the trial dose with no rationale for the fraction. The only subcutaneous dose below 40 mg tested in an efficacy trial, 4 mg a day in heart failure, did nothing (Butler 2020).

Reconstitution: why there is no example here

The approved product needs none: Forzinity is a solution, and 40 mg is 0.5 mL. The product that does need mixing is the freeze-dried research vial, and we do not give a worked example for it. Its content has not been verified by anyone, so a calculation would assign a precise volume to an unknown amount of an unknown substance. And FDA treats exactly this kind of help as evidence that a research product is a drug for people: its August 24, 2026 warning letters to five peptide vendors, which covered SS-31, cited dosing guidance, reconstitution calculators and bundled bacteriostatic water, as recorded in our legal tracker. The reconstitution calculator is built for medications a pharmacy has dispensed with a labeled concentration; the peptide dosage chart lists the compounds that have one.

Bottom line

The SS-31 dosage chart that holds up has one subcutaneous dose in it, 40 mg once a day, and one approved use, Barth syndrome in patients of at least 30 kg, with 20 mg for severe kidney impairment. Around it sit intravenous infusions and eye drops from early trials, nearly all of which missed their goals. The 1 to 20 mg cycles on seller charts are not a cautious version of that dose; they are a different, untested regimen of an unverified product. If you have Barth syndrome, the dose is the one on the label and your specialist manages it. If you do not, there is no studied dose to follow.

Frequently asked questions

+What is the SS-31 dose per day?

The only labeled dose is 40 mg of elamipretide injected under the skin once a day, for patients with Barth syndrome who weigh at least 30 kg, reduced to 20 mg a day in adults with severe kidney impairment who are not on dialysis. The heart failure, mitochondrial myopathy and macular degeneration trials used the same 40 mg daily dose. There is no studied daily dose for healthy people.

+What is the SS-31 dosage protocol for anti-aging?

There is none. No trial has given SS-31 to healthy people for aging, energy or performance over weeks or months. The only study in healthy older adults gave a single two-hour intravenous infusion and measured muscle energy production the same day. Protocols online, such as 5 to 10 mg a day in four- to eight-week cycles, were written by sellers and community sites.

+How much SS-31 was used in clinical trials?

Subcutaneous trials used 40 mg once daily, for 4 weeks in heart failure, 24 weeks in mitochondrial myopathy and 48 weeks in macular degeneration; one heart failure arm used 4 mg. Intravenous trials used weight-based infusions: 0.05 mg/kg per hour for one hour after a heart attack, and 0.01 to 0.25 mg/kg per hour for two hours in myopathy and in older adults. An eye-drop trial used a 1% solution twice a day.

+Is SS-31 dosed by weight?

The approved product is not. Forzinity is a fixed 40 mg dose for anyone with Barth syndrome weighing at least 30 kg; weight decides only who can take it, and safety and effectiveness below 30 kg are not established. Weight-based doses, in milligrams per kilogram per hour, belong to the intravenous infusions used in the early heart and myopathy trials.

+How long do you take SS-31?

In Barth syndrome, the label gives a once-daily dose with no fixed stopping point; the longest data cover 8 patients treated for 168 weeks, 3 of them for 192. Trials elsewhere ran from a single infusion to 48 weeks. The four-weeks-on, two-weeks-off and eight-to-twelve-week cycles on seller charts were not tested in any study.

+Does SS-31 need to be reconstituted?

The approved product does not: Forzinity is a ready-to-use solution of 80 mg/mL, so a 40 mg dose is 0.5 mL drawn from the vial, and an opened vial is discarded after 8 days. The freeze-dried 'SS-31' powders sold online for research need mixing, but their content is unverified and they are unapproved drugs, so we do not give a reconstitution example for them.

+What happens if you miss a dose of SS-31?

For Forzinity, the label says to skip the missed dose and take the next one at the usual time, without doubling up. Doses should be given at the same time each day.

SS-31 Dosage Chart: Studied Doses, Frequency

The studied doses

What the label says, exactly

Why a rare-disease label dose is not a wellness protocol

The charts sellers circulate

Reconstitution: why there is no example here

Bottom line

Frequently asked questions

Sources

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