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How to Inject SS-31: Sites, Syringes and Steps

Where to inject SS-31, which syringe to use, how to read units and the hygiene steps that prevent infection.

Medical review pendingMitochondria-targeting peptideUpdated
This is a general guide to subcutaneous injection, not a substitute for being shown by a nurse, pharmacist or doctor. If you were prescribed a SS-31 pen, follow the pen's own instructions instead.

Injection sites

Most peptides are injected under the skin (subcutaneously), into the fatty layer rather than the muscle.

  • Belly: at least 2 inches (5 cm) away from the navel.
  • Front and outer thighs.
  • Back of the upper arms, if someone else can reach it.
  • Rotate sites each time and avoid skin that is bruised, scarred or irritated.

Syringe and needle

U-100 insulin syringes are marked in units: 100 units equal 1 mL, so 10 units is 0.1 mL. They come in 0.3, 0.5 and 1 mL sizes; a smaller syringe has finer marks and is easier to read for small doses. Needle length and gauge used for SS-31 in studies: not reported in study abstracts (PubMed search, 11 Oct 2026).

How to read an insulin syringe

Step by step

  1. 1Wash your handsUse soap and water, and work on a clean surface.
  2. 2Check the vialLabel, lot and date present; solution clear with no particles. Mixing a powder vial first? Use sterile bacteriostatic water.
  3. 3Clean the vial top and the siteWipe both with an alcohol swab and let them dry.
  4. 4Draw the dosePull the plunger to the units mark for your dose, then tap out air bubbles and re-check the mark.
  5. 5InjectPinch a fold of skin, insert the needle at 45 to 90 degrees, push the plunger slowly and wait a few seconds before withdrawing.
  6. 6Dispose safelyPut the used syringe straight into a sharps container. Never reuse or share needles.
How to reconstitute a peptide vial

What the approved elamipretide label says

The label directs subcutaneous injection into the abdomen at least 2 inches from the navel or the outer thigh, with the site rotated daily.[10]

It tells users not to inject where the skin is tender, bruised, red or hard, and to avoid scars and stretch marks.[10]

Each vial is for one patient only, nothing else is to be mixed in the same syringe, and opened vials are discarded after 8 days.[10]

Adult patients or caregivers may administer it after proper training, according to the label.[10]

The label states the product is not approved for intravenous use.[10]

How trials gave it

The long-term Barth syndrome extension had patients continue elamipretide 40 mg by subcutaneous injection once daily.[11]

The macular degeneration phase 2 trial gave daily subcutaneous 40 mg for 48 weeks, then a 4-week follow-up.[12]

The ReCLAIM high-risk drusen phase 1 trial reported subcutaneous administration as highly feasible.[13]

In dogs with heart failure, subcutaneous elamipretide at 0.5 mg/kg was used. This is animal data.[14]

Common questions

Where do you inject SS-31?

Under-the-skin (subcutaneous) injections are usually given in the belly, at least 2 inches from the navel, the front of the thighs or the back of the upper arms. Rotate sites each time.

What syringe is used for SS-31?

Vials are usually drawn with a U-100 insulin syringe, where 100 units equal 1 mL. Common sizes hold 0.3, 0.5 or 1 mL. Match the syringe to the dose so the mark is easy to read.

How often is SS-31 injected?

The interval comes from the study or prescription, not from this guide. See the dosage page for what studies used.

More on SS-31

DosageDoses used in published studies, with the source for each.CalculatorVial, water and dose to syringe units.Side effectsWhat labels and studies report, and what is unknown.ResultsStudy outcomes and when they were measured.BenefitsClaimed benefits next to what published studies measured.How it worksTarget, mechanism and how long it acts, from the label or studies.

Sources

  1. 1Metric (SI) Prefixes (NIST Reference on Constants, Units, and Uncertainty)National Institute of Standards and Technology (NIST) · 2025physics.nist.govAccessed 2 Oct 2026
  2. 2BASAGLAR (insulin glargine) injection, prescribing information (DailyMed)U.S. Food and Drug Administration / DailyMed (Eli Lilly and Company label) · 2026dailymed.nlm.nih.govAccessed 2 Oct 2026
  3. 3PubMed search: (elamipretide[tiab] OR Bendavia[tiab] OR "MTP-131"[tiab] OR Forzinity[tiab] OR (("SS-31"[tiab] OR SS31[tiab]) AND (peptide*[tiab] OR mitochondri*[tiab] OR cardiolipin[tiab] OR Szeto[tiab]))) (526 results)PubMed · 2026pubmed.ncbi.nlm.nih.govAccessed 2 Oct 2026
  4. 4PubMed search: (elamipretide[tiab] OR Bendavia[tiab] OR "MTP-131"[tiab] OR Forzinity[tiab] OR (("SS-31"[tiab] OR SS31[tiab]) AND (peptide*[tiab] OR mitochondri*[tiab] OR cardiolipin[tiab] OR Szeto[tiab]))) AND (randomized[tiab] OR trial[tiab] OR patients[tiab]) (133 results)PubMed · 2026pubmed.ncbi.nlm.nih.govAccessed 2 Oct 2026
  5. 5PubMed search: (elamipretide[tiab] OR Bendavia[tiab] OR "MTP-131"[tiab] OR Forzinity[tiab] OR (("SS-31"[tiab] OR SS31[tiab]) AND (peptide*[tiab] OR mitochondri*[tiab] OR cardiolipin[tiab] OR Szeto[tiab]))) AND (half-life[tiab] OR pharmacokinetic*[tiab]) (11 results)PubMed · 2026pubmed.ncbi.nlm.nih.govAccessed 2 Oct 2026
  6. 6PubMed search: elamipretide[tiab] AND (TAZPOWER[tiab] OR "Barth syndrome"[tiab]) AND (randomized[tiab] OR crossover[tiab]) (6 results)PubMed · 2026pubmed.ncbi.nlm.nih.govAccessed 2 Oct 2026
  7. 7PubMed search: elamipretide[tiab] AND (macular[tiab] OR "geographic atrophy"[tiab]) (9 results)PubMed · 2026pubmed.ncbi.nlm.nih.govAccessed 2 Oct 2026
  8. 8PubMed search: elamipretide[tiab] AND (fibromyalgia[tiab] OR fatigue[tiab] OR "chronic pain"[tiab]) (19 results)PubMed · 2026pubmed.ncbi.nlm.nih.govAccessed 2 Oct 2026
  9. 9PubMed search: (elamipretide[tiab] OR Bendavia[tiab] OR "MTP-131"[tiab] OR Forzinity[tiab] OR (("SS-31"[tiab] OR SS31[tiab]) AND (peptide*[tiab] OR mitochondri*[tiab] OR cardiolipin[tiab] OR Szeto[tiab]))) AND (adverse[tiab] OR "side effect*"[tiab] OR safety[tiab] OR tolerab*[tiab] OR toxicity[tiab] OR "case report"[pt]) (77 results)PubMed · 2026pubmed.ncbi.nlm.nih.govAccessed 11 Oct 2026
  10. 10FORZINITY prescribing information (FDA label)FDA label, DailyMed · current labeldailymed.nlm.nih.govAccessed 2 Oct 2026
  11. 11Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER.Genetics in medicine : official journal of the American College of Medical Genetics · 2024PMID 38602181Accessed 2 Oct 2026
  12. 12ReCLAIM-2: A Randomized Phase II Clinical Trial Evaluating Elamipretide in Age-related Macular Degeneration, Geographic Atrophy Growth, Visual Function, and Ellipsoid Zone Preservation.Ophthalmology science · 2025PMID 39605874Accessed 2 Oct 2026
  13. 13Phase 1 Clinical Trial of Elamipretide in Intermediate Age-Related Macular Degeneration and High-Risk Drusen: ReCLAIM High-Risk Drusen Study.Ophthalmology science · 2022PMID 36246187Accessed 11 Oct 2026
  14. 14Effects of elamipretide on skeletal muscle in dogs with experimentally induced heart failure.ESC heart failure · 2019PMID 30688415Accessed 2 Oct 2026

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