Side-by-side comparison of mechanisms, dosing, interactions, and stacking potential.
| Cerebrolysin | SS-31 (Elamipretide) | |
|---|---|---|
| Category | Peptides | Peptides |
| Standard Dose | Research indicates 10-30 mL daily via intravenous infusion for neurological indications. 5-10 mL for cognitive optimization. | Research indicates 0.05-0.25 mg/kg daily via subcutaneous injection. Clinical trials used 4-40 mg/day IV or SC. |
| Timing | Morning administration preferred for cognitive effects. IV infusion over 15-20 minutes. | Morning dosing preferred. No food timing restrictions. |
| Cycle Duration | 10-20 day intensive cycles repeated every 3-6 months. Some protocols use ongoing 3x weekly maintenance. | Clinical trials ranged from single dose to 48 weeks. Optimal cycle length not established. |
| Evidence Level | moderate_human | Emerging (Phase 2/3 trials) |
Cerebrolysin is a porcine brain-derived peptide preparation containing a standardized mixture of low-molecular-weight neuropeptides (<10 kDa) and free amino acids obtained through enzymatic proteolysis. It exerts multimodal neurotrophic effects by simultaneously upregulating VEGF, BDNF, IGF-1, and NGF while downregulating TNF-alpha. Cerebrolysin increases furin protease concentration, which promotes pro-NGF to mature NGF conversion. It activates TrkB receptor signaling (BDNF/TrkB/CREB pathway), inhibits neuronal apoptosis, reduces microglial activation, and promotes neurogenesis.
Research indicates 10-30 mL daily via intravenous infusion for neurological indications. 5-10 mL for cognitive optimization.
Morning administration preferred for cognitive effects. IV infusion over 15-20 minutes.
10-20 day intensive cycles repeated every 3-6 months. Some protocols use ongoing 3x weekly maintenance.
SS-31 (D-Arg-Dmt-Lys-Phe-NH2, also known as elamipretide/Bendavia) is a cell-permeable tetrapeptide that localizes to the inner mitochondrial membrane and binds cardiolipin via electrostatic interactions. This stabilizes cardiolipin against oxidative damage, preserving cristae integrity, reducing ROS production, and maintaining mitochondrial ATP production. SS-31 interacts with proteins in two functional groups: oxidative phosphorylation complexes and 2-oxoglutarate metabolic enzymes — all known cardiolipin binders. It restores mitochondrial function without acting as a direct antioxidant.
Research indicates 0.05-0.25 mg/kg daily via subcutaneous injection. Clinical trials used 4-40 mg/day IV or SC.
Morning dosing preferred. No food timing restrictions.
Clinical trials ranged from single dose to 48 weeks. Optimal cycle length not established.
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