Side-by-side comparison of mechanisms, dosing, interactions, and stacking potential.
| SS-31 (Elamipretide) | Tesamorelin | |
|---|---|---|
| Category | Peptides | Peptides |
| Standard Dose | Research indicates 0.05-0.25 mg/kg daily via subcutaneous injection. Clinical trials used 4-40 mg/day IV or SC. | Research indicates 2 mg administered once daily via subcutaneous injection (FDA-approved dose for HIV lipodystrophy). |
| Timing | Morning dosing preferred. No food timing restrictions. | Morning administration on empty stomach. Consistent daily timing recommended. |
| Cycle Duration | Clinical trials ranged from single dose to 48 weeks. Optimal cycle length not established. | 26+ weeks in clinical trials. Long-term use is common; effects are not sustained after discontinuation. |
| Evidence Level | Emerging (Phase 2/3 trials) | Strong (FDA-approved indication), Moderate (longevity) |
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.
Tesamorelin is an FDA-approved synthetic 44-amino acid GHRH analog with a trans-3-hexenoic acid modification at the N-terminal tyrosine that confers resistance to DPP-IV degradation. It binds GHRH receptors on anterior pituitary somatotrophs, stimulating endogenous GH production and secretion while maintaining pulsatile release patterns. Tesamorelin selectively reduces visceral adipose tissue (15-20% reduction in trials) while preserving subcutaneous fat, and markedly increases plasma GH and IGF-1 levels with once-daily dosing.
Research indicates 2 mg administered once daily via subcutaneous injection (FDA-approved dose for HIV lipodystrophy).
Morning administration on empty stomach. Consistent daily timing recommended.
26+ weeks in clinical trials. Long-term use is common; effects are not sustained after discontinuation.
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