SS-31 dosage calculator
Enter a vial and a dose and this returns the concentration, the volume and the syringe units. Underneath it, the same arithmetic worked out in advance for common vials, and the doses published studies of SS-31 actually used, every one quoted and cited. It converts numbers. It does not suggest what to take.
Work out concentration and what to draw
Two divisions, both shown. Concentration = mass in the vial ÷ diluent volume. Volume to draw = mass you want ÷ that concentration. Syringe units are that volume × the units per millilitre on your syringe's own scale.
Worked example: 5 mg in 2 mL is 2,500 mcg/mL, so 250 mcg is 0.1 mL, which is 10 units on a U-100 syringe and 4 units on a U-40. The scale is printed on the barrel; reading a U-40 syringe as if it were U-100 is a two-and-a-half-fold error.
SS-31 reconstitution chart
Units on a standard U-100 insulin syringe, where 100 units is 1 mL. The rows are the absolute doses quoted in studies of SS-31, from 40 mg to 40 mg, so this chart is specific to this compound rather than a generic ladder. More diluent means more units for the same dose, which is easier to measure accurately and empties the vial no faster.
| Dose | 1 mL diluent (2,000 mcg/mL) | 2 mL diluent (1,000 mcg/mL) | 3 mL diluent (667 mcg/mL) |
|---|---|---|---|
| 40 mg | 2,000 >1 mL | 4,000 >1 mL | 6,000 >1 mL |
| Dose | 1 mL diluent (5,000 mcg/mL) | 2 mL diluent (2,500 mcg/mL) | 3 mL diluent (1,667 mcg/mL) |
|---|---|---|---|
| 40 mg | 800 >1 mL | 1,600 >1 mL | 2,400 >1 mL |
| Dose | 1 mL diluent (10,000 mcg/mL) | 2 mL diluent (5,000 mcg/mL) | 3 mL diluent (3,333 mcg/mL) |
|---|---|---|---|
| 40 mg | 400 >1 mL | 800 >1 mL | 1,200 >1 mL |
Read a figure off this chart only if it matches the vial in front of you. A vial labelled a different strength, or reconstituted with a different volume, gives a different number for the same dose, and that is the single most common way these calculations go wrong.
Doses in published studies of SS-31
Each row is quoted from a paper in this compound's source ledger and carries the kind of evidence it came from. 6 of 6 come from human studies; the rest are animal or laboratory work.
| Evidence | Dose as the paper states it | Source |
|---|---|---|
| Human clinical trial | Randomized controlled trial, humans, 2024: doses stated in the abstract: 40 mg. Patients entering the OLE continued elamipretide 40 mg subcutaneous daily. | pmid-38602181 |
| Human clinical trial | Randomized controlled trial, humans, n=218, 2023: doses stated in the abstract: 40 mg/d. After screening, eligible participants were randomized 1:1 to receive either 24 weeks of elamipretide at a dose of 40 mg/d or placebo subcutaneously. | pmid-37268435 |
| Human clinical trial | Phase 3 clinical trial, humans, n=8, 2022: doses stated in the abstract: 40 mg daily. A phase 3, observational, retrospective, and non-interventional study was designed to establish a natural history control (NHC) cohort of patients with Barth syndrome (BTHS) to provide further analysis of the efficacy of elamipretide observed in an… | pmid-36056411 |
| Human clinical trial | Randomized controlled trial, humans, n=12, 2021: doses stated in the abstract: 40 mg per day. In part 1, 12 subjects were randomized to 40 mg per day of elamipretide or placebo for 12 weeks, followed by a 4-week washout and then 12 weeks on the opposite arm. | pmid-33077895 |
| Human clinical trial | Randomized controlled trial, humans, n=30, 2020: doses stated in the abstract: 40 mg/day. Participants were randomly assigned (1:1) to 40 mg/day SC elamipretide for 4 weeks followed by placebo SC for 4 weeks, separated by a 4-week washout period, or the opposite sequence. | pmid-32096613 |
| Observational, human | Case report, humans, 2025: doses stated in the abstract: 0.25 mg/kg; 0.5 mg/kg. On day of life (DOL) 34, therapy with daily IV elamipretide (0.25 mg/kg increased to 0.5 mg/kg on DOL39) began, followed by standard-of-care oral heart failure medications. | pmid-39917770 |
Weight-normalised doses, and why they are not on the chart
Some studies state a dose per kilogram. Those figures are deliberately absent from the chart above, because multiplying one by a body weight produces a number that looks like a dose and is not one. Interspecies scaling is not arithmetic: a rat milligram-per-kilogram figure does not become a human dose by multiplication.
- Case report, humans, 2025: weight-normalized doses as published: 0.25 mg/kg; 0.5 mg/kg. On day of life (DOL) 34, therapy with daily IV elamipretide (0.25 mg/kg increased to 0.5 mg/kg on DOL39) began, followed by standard-of-care oral heart failure medications. pmid-39917770
Escalation schedules used in studies
Where a trial raised the dose over time rather than starting at the target, this is what it did. The starting dose is often the part that decides tolerability, which is why it is reported here and not only the dose the trial finished on.
- Randomized controlled trial, humans, n=36, 2018: Participants were randomized to intravenous elamipretide (0.01, 0.1, and 0.25 mg/kg/h or placebo for 2 hours in a dose-escalating sequence). pmid-29500292
How long studies ran, and how far a vial goes
A vial lasts for a number of draws, not a number of weeks: divide the mass in the vial by the mass per draw and round down, which the vial planner does. How long that represents depends on frequency. For context, these are the durations studies of SS-31 actually ran for.
- Randomized controlled trial, humans, 2024: durations stated: 28 week; 168 week. TAZPOWER was a 28-week randomized, double-blind, and placebo-controlled trial followed by a 168-week OLE. pmid-38602181
- Randomized controlled trial, humans, n=12, 2024: durations stated: 52 week; 52 weeks. This phase II, prospective, randomized, vehicle-controlled, single-center clinical trial involved administration of elamipretide 1% topical ophthalmic solution to patients with LHON over a 52-week double-masked treatment period, followed by an… pmid-37923251
- Randomized controlled trial, humans, n=218, 2023: durations stated: 24 weeks. After screening, eligible participants were randomized 1:1 to receive either 24 weeks of elamipretide at a dose of 40 mg/d or placebo subcutaneously. pmid-37268435
- Clinical trial, humans, 2023: durations stated: 12 years. In clinical trials, elamipretide produced clinical and functional improvements in adults and adolescents with mitochondrial disorders, such as primary mitochondrial myopathy and Barth syndrome; however, experience in younger patients is limited and to our knowledge, these are the… pmid-36636586
- Randomized controlled trial, humans, n=12, 2021: durations stated: 12 weeks; 4 week. In part 1, 12 subjects were randomized to 40 mg per day of elamipretide or placebo for 12 weeks, followed by a 4-week washout and then 12 weeks on the opposite arm. pmid-33077895
Storage and stability, as published
Reconstitution starts a clock. These are the storage and stability conditions stated in papers in this ledger. They describe what the study did, which is not the same as a shelf life for a vial in your fridge.
- Clinical trial, humans, 2023: Elamipretide targets the inner mitochondrial membrane where it binds to cardiolipin, resulting in improved membrane stability, cellular respiration, and ATP production. pmid-36636586
- Case report, humans, 2025: Elamipretide, an investigational drug that binds to cardiolipin on the inner mitochondrial membrane, leads to improved membrane stability, enhanced adenosine triphosphate production, and reduced reactive oxygen species. pmid-39917770
- Animal study, mice, 2026: Mechanistically, single-cell transcriptome analysis reveals that SS-31 increased the maternal mRNA degradation, and the levels of genes associated with mitochondrial function and mitophagy in aged oocytes, such as Pink1, Rps27a, Tomm7 and Map1lc3b. pmid-41612464
- Animal study, mice, 2026: These results support a mechanism in which elamipretide stabilizes between FAO enzymes and ETC complexes, thereby improving mitochondrial function independently of changes in cardiolipin levels. pmid-41500837
- Animal study, rats, 2025: To investigate the role of endothelial glycocalyx (eGC) degradation in mediating the progression from systemic inflammation to neuroinflammation and cognitive impairment in aged rats, and to explore the protective effects of the mitochondrial-targeted peptide SS-31. pmid-41247543
- In vitro study, 2020: We found that SS-31 binding does not destabilize lamellar bilayers even at the highest binding concentrations; however, it did cause saturable alterations in lipid packing. pmid-32273339
How SS-31 was given
The route changes what a dose means. The same number given intravenously and subcutaneously is not the same exposure.
- Randomized controlled trial, humans, n=12, 2025: administration by subcutaneous route reported. The BTHS-SA was administered in TAZPOWER, a phase 2, randomized, double-blind, placebo-controlled crossover study to evaluate daily subcutaneous injections of elamipretide in subjects with genetically confirmed BTHS. pmid-40281531
- Randomized controlled trial, humans, 2024: administration by subcutaneous route reported. Patients entering the OLE continued elamipretide 40 mg subcutaneous daily. pmid-38602181
- Randomized controlled trial, humans, n=12, 2024: administration by topical route reported. This study aimed to assess the safety, tolerability, and potential efficacy of topical elamipretide in patients affected with Leber hereditary optic neuropathy (LHON). pmid-37923251
- Randomized controlled trial, humans, n=218, 2023: administration by subcutaneous route reported. After screening, eligible participants were randomized 1:1 to receive either 24 weeks of elamipretide at a dose of 40 mg/d or placebo subcutaneously. pmid-37268435
- Randomized controlled trial, humans, n=30, 2020: administration by subcutaneous route reported. This study aims to evaluate the effect of subcutaneous (SC) elamipretide dosing on exercise performance using the 6 min walk test (6MWT), patient-reported outcomes measuring fatigue, functional assessments, and safety to guide the development… pmid-32096613
- Randomized controlled trial, humans, n=36, 2018: administration by intravenous route reported. Participants were randomized to intravenous elamipretide (0.01, 0.1, and 0.25 mg/kg/h or placebo for 2 hours in a dose-escalating sequence). pmid-29500292
Questions people ask
- How many units is 40 mg of SS-31?
- It depends entirely on how the vial was reconstituted. In a 5 mg vial with 2 mL of diluent it is 1,600 units on a U-100 syringe; with 1 mL it is 800. The chart above gives the rest.
- Does adding more diluent waste the peptide?
- No. The mass in the vial does not change. More diluent spreads the same mass through more liquid, so each dose is a larger, easier-to-measure volume and the vial yields exactly as many doses as before.
- Why does this page not recommend a dose?
- Because a dose is a clinical decision rather than a division. It depends on why someone is taking something, what else they take and how their kidneys and liver are working, none of which is knowable from a number typed into a box.
- Where do the doses in the table come from?
- Each is quoted from a specific paper indexed in Europe PMC, linked in the source column, and labelled with the kind of study it came from. The full evidence is on the SS-31 record.
What this calculator will not do
It will not take a body weight and return a milligram figure, and it will not tell you how often to draw. The table above is the published record, not a menu. A dose that appeared in a trial appeared under supervision, with monitoring, in people selected for that trial.
Other calculators
- Generic reconstitution calculatorThe same arithmetic, without a compound attached
- Unit convertermg, mcg, ng and syringe units
- Vial plannerDraws per vial and how long it lasts
- All compound calculatorsEvery compound with published dose figures