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Lean Stack (SS-31/MOTs-C/Tesamorelin)

Three distinct pathways: Tesamorelin is a GHRH analog that drives growth hormone release, MOTs-C is a mitochondrial-derived peptide studied for metabolic signaling and AMPK activation, and SS-31 (elamipretide) binds cardiolipin in the inner mitochondrial membrane.

Dr. Jonathan Snipes, MDMedically reviewed by Dr. Jonathan Snipes, MD. Last reviewed September 23, 2026.
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Lean Stack (SS-31/MOTs-C/Tesamorelin) injectable vial compounded by a licensed U.S. 503A compounding pharmacy for Rx Peps Direct

Verify us before you order

  • Your prescriber

    Kim Callender, NP, FNP-BC

    Lead prescriber. Medical director: Jonathan Snipes, MD.

    Look them up on the federal NPI Registry: Callender, Snipes

  • Lean Stack (SS-31/MOTs-C/Tesamorelin) lab report

    Passed sterility and endotoxin

    Tested by Eagle Analytical, lot lg342010884, report dated Oct 5, 2026.

    Open the report (PDF), all 2 reports

  • Patient reviews

    On Trustpilot

    See our reviews on Trustpilot.

Three PathwaysVisceral Fat FocusMitochondrial SupportSingle Vial

What It Is

The current Lean Stack formula, compounded by a licensed U.S. 503A compounding pharmacy. It replaced the original four-peptide formula in September 2026: AOD-9604 and ipamorelin came out and SS-31 went in, so each of the three peptides covers a different pathway instead of overlapping.

How It Works

One injection covers three areas. Tesamorelin acts on the growth hormone pathway and has established activity on visceral fat. MOTs-C is studied for its role in cellular metabolism and energy use. SS-31 is studied for mitochondrial membrane stability, cellular energy production, and oxidative stress.

Who It's For

Patients working on body composition who want growth hormone, metabolic, and mitochondrial support in a single daily injection, including patients who were on the original Lean Stack.

Who Should Avoid It

Combined contraindications of all three components. Not for active cancer, pituitary tumors, or pregnancy. Report new swelling, joint pain, or hand numbness to your clinician.

Ready to add Lean Stack (SS-31/MOTs-C/Tesamorelin)?

A licensed provider reviews every order.

Protocol & Pricing

Pharmacy Price

$125

5mL vial of 3 peptides

You pay pharmacy price. No markup.

Starting Dose

20 units (0.4mg SS-31 + 0.4mg MOTs-C + 0.4mg Tesa)

Form

Injectable vial, 5mL

Your pharmacy label will read

SS-31 ELAMIPRETIDE / MOTs-C / TESAMORELIN

2MG/ 2MG/ 2MG/ML (5 ML)

The label shows strength per mL, not the total in the vial.

What that means

Each ingredient, in the order the label lists them
IngredientLabel showsIn the vialPer 20 units
SS-312mg/mL10mg0.4mg
MOTs-C2mg/mL10mg0.4mg
Tesamorelin2mg/mL10mg0.4mg

Listed in the same order as your label. Multiply each per-mL strength by the 5mL vial to get the amount in the vial. About 25 injections per vial.

Dosing Protocol

20 units subcutaneous injection daily for 5 days, 2 days off. 20 units = 0.2mL delivering SS-31 0.4mg + MOTs-C 0.4mg + Tesamorelin 0.4mg per injection.

Beyond Use Date

90 Days from compounding (USP <797>)

A licensed U.S. 503A compounding pharmacy assigns this date and prints it on your vial label. Always follow the label.

Ready to add Lean Stack (SS-31/MOTs-C/Tesamorelin)?

A licensed provider reviews every order.

Stacking Guide

Stacks Well With

BPC-1575-Amino-1MQ

Do Not Combine With

Elamipretide (SS-31)MOTS-CMOTS-C High-DoseTesamorelin High-DoseTesamorelin/Ipamorelin

Ready to add Lean Stack (SS-31/MOTs-C/Tesamorelin)?

A licensed provider reviews every order.

Related Peptides

BPC-157

A 15-amino acid peptide prescribed as an injection under the skin. Studied for tissue repair, mostly in animals.

$80 · 3mg/mL, 5mL vial (15mg total)

5-Amino-1MQ

An NNMT inhibitor that activates cellular energy pathways to boost metabolism.

$80 · 5mg/mL, 5mL vial (25mg total)

Independently tested

Lean Stack (SS-31/MOTs-C/Tesamorelin) certificate of analysis

All 2 Lean Stack (SS-31/MOTs-C/Tesamorelin) samples tested for sterility and endotoxin passed both. Latest sample received by the lab Sep 25, 2026.

Every Lean Stack (SS-31/MOTs-C/Tesamorelin) batch dispensed by a licensed U.S. 503A compounding pharmacy is independently tested by Eagle Analytical Services (FDA-registered, A2LA ISO 17025 accredited). Sterility testing checks that nothing grows in the sample; the USP <85> endotoxin test checks for bacterial toxins that can cause fever. Below is the lab's own report for each of the 2 most recent lots.

Lot lg342010884, received Sep 25, 2026

Sterility
PassCelsis Sterility Test. Started Sep 25, 2026, completed Oct 5, 2026. Method suitability ETX-260824-0801
Bacterial endotoxin
PassUSP <85>. Measured <2 EU/mL, limit 700 EU/mL. Started Sep 28, 2026, completed Sep 28, 2026
Sample, as printed
ELAMIPRETIDE/ MOTs-C/ TESAMORELIN 2 MG/ 2 MG/ 2 MG/ML (5 ML) Injection
Lot #
lg342010884
Storage
Refrigerated
Received by lab
Sep 25, 2026
Laboratory
Eagle Analytical Services Inc., Houston, TX
Submission #
ETX-260925-0322
Signed
Alison Eng, Quality Control Manager
Scan of Eagle Analytical report ETX-260925-0322 for lot lg342010884. Opens the original PDF.
Eagle Analytical report ETX-260925-0322. Open the original PDF (opens in a new tab)

Eagle Analytical Services is an independent FDA-registered laboratory, A2LA accredited to ISO 17025, based in Houston, Texas. They have no commercial relationship with Rx Peps Direct. Rx Peps Direct prescribes; the pharmacy compounds and dispenses; Eagle tests every batch. Three separate companies. Results apply only to the tested sample as received. Browse our full quality program on the quality page.

Ready to add Lean Stack (SS-31/MOTs-C/Tesamorelin)?

A licensed provider reviews every order.

How to get Lean Stack (SS-31/MOTs-C/Tesamorelin) prescribed online

Lean Stack (SS-31/MOTs-C/Tesamorelin) is available by prescription after an online medical review and dispensed for human use by a licensed 503A pharmacy. That is what separates it from research-use-only vials sold without a prescription. There is no membership, just a medical review fee per order, and automatic refills are optional.

  1. 1

    Complete a $39 medical review. Answer a short intake about your health history and your goals for Lean Stack (SS-31/MOTs-C/Tesamorelin). The $39 fee is the only charge Rx Peps Direct collects, paid once, not a recurring subscription.

  2. 2

    A licensed provider reviews it. A US-licensed clinician reviews your intake and, if Lean Stack (SS-31/MOTs-C/Tesamorelin) is appropriate for you, writes a patient-specific prescription. The starting dose is typically 20 units (0.4mg SS-31 + 0.4mg MOTs-C + 0.4mg Tesa).

  3. 3

    The pharmacy compounds and ships it. A licensed 503A compounding pharmacy in Texas compounds Lean Stack (SS-31/MOTs-C/Tesamorelin) and ships it pre-reconstituted by FedEx overnight in a reusable cooled case. Your fill is a 5mL injectable vial holding SS-31 2mg/mL (10mg total), MOTs-C 2mg/mL (10mg total), Tesamorelin 2mg/mL (10mg total), and you pay the pharmacy $125 per vial at wholesale, with no clinic markup, plus a $15 flat FedEx overnight shipping fee charged by the pharmacy.

Rx Peps Direct prescribes Lean Stack (SS-31/MOTs-C/Tesamorelin) in the 28 states plus Washington, DC where its medical team is licensed. Start your $39 medical review or browse all peptides for weight loss. Comparing services first? See how Rx Peps Direct stacks up against seven other providers in our best telehealth for compounded peptides comparison.

Ready to add Lean Stack (SS-31/MOTs-C/Tesamorelin)?

A licensed provider reviews every order.

Common questions about Lean Stack (SS-31/MOTs-C/Tesamorelin)

What is in the Lean Stack?
Three peptides in one 5 mL vial, each at 2 mg/mL: SS-31 (elamipretide), MOTS-C, and tesamorelin, for 10 mg of each and 30 mg total. A licensed U.S. 503A compounding pharmacy compounds it and charges $125 per vial at wholesale. Rx Peps Direct charges a separate $39 medical review.
What happened to the AOD-9604 version of the Lean Stack?
The pharmacy discontinued the original four-peptide Lean Stack (AOD-9604, MOTS-C, tesamorelin and ipamorelin) in September 2026 and replaced it with the current formula, which drops AOD-9604 and ipamorelin and adds SS-31. An open order for the old formula cannot be converted; the new vial needs a new prescription. AOD-9604 is still available on its own as a sublingual troche, and tesamorelin with ipamorelin is available as its own vial.
Can you take tesamorelin and MOTS-C together?
Yes. The Lean Stack puts tesamorelin and MOTS-C, plus SS-31, in the same vial so they are taken as one injection. Do not add standalone tesamorelin, MOTS-C, or SS-31 on top of it, because the vial already contains them. Rx Peps Direct's ordering system blocks those duplicate combinations, and your provider reviews every order.
What is the Lean Stack dosage?
The pharmacy's direction is 20 units (0.2 mL) injected subcutaneously once daily for 5 days, then 2 days off. Each 20-unit dose delivers 0.4 mg each of SS-31, MOTS-C, and tesamorelin. A 5 mL vial holds 25 doses, which lasts about five weeks on that schedule. Your provider confirms the protocol at review.

Ready to add Lean Stack (SS-31/MOTs-C/Tesamorelin)?

A licensed provider reviews every order.