MOTS-c Dosage Chart: Units, Timing, Cycle, Vial Math

The MOTS-c Dosage Chart

A dosage chart normally condenses what trials found. For MOTS-c there is nothing to condense: no completed human trial of the peptide exists at any dose. The rows below are labeled by what stands behind them, and the labels matter more than the numbers.

The PeRx dose is a small fraction of the convention figures, 2 mg a week against 5 to 15, and neither side is in error: the convention was never derived from anything, and the PeRx row was written to fit a 2 mg/mL vial in one syringe draw. The only row with a trial in it is empty. The molecule itself is covered in the MOTS-c guide Read nextMOTS-c Dosage Chart: Units, Protocols & EffectsMOTS-c is the 16-amino-acid mitochondrial peptide your body releases during exercise. This guide leads with what most readers came for: a real dosage chart with per-injection amounts, insulin syringe unit conversions, weekly totals, and cycle lengths. Then it covers the AMPK mechanism, the metformin comparison, the 2015 USC discovery story, and an honest read of the evidence.Read article ; this page stays on the numbers.

Units on an Insulin Syringe at 2 mg/mL

Doses are written in milligrams and drawn in units. A U-100 insulin syringe holds 100 units per milliliter, so units measure liquid, not peptide, and the concentration on the vial is the bridge. The conversion is one line: units equals milligrams divided by the concentration in mg/mL, times 100. At 2 mg/mL every milligram is 50 units, every 10 units is 0.2 mg, and the prescribed 0.4 mg is 20 units.

One syringe tops out at 2 mg at this strength, so the 5 mg per injection in the convention rows would be 250 units, two and a half syringes, and a 10 mg vial would be gone in two doses.

The catalog-wide reference is the peptide dosage chart Read nextPeptide Dosage Chart: Doses for Every PeRx PeptideEvery peptide PeRx prescribes, in one dosing reference: route, typical dose, and frequency, with a link to the detailed chart for each. Plus the syringe math that turns milligrams into units, and the reason charts from different pharmacies never quite agree.Read article ; how to inject peptides Read nextHow to Inject Peptides: Subcutaneous GuideA clear, practical walkthrough of subcutaneous peptide injections, from supply setup to sharps disposal. Written for patients new to self-injection with ready-to-use PeRx vials.Read article covers the mechanics.

Where the Numbers Come From

MOTS-c was described in 2015 by Changhan Lee, Pinchas Cohen and colleagues: a 16-amino-acid peptide encoded inside the mitochondrial 12S ribosomal RNA gene. In their mice, MOTS-c injected into the abdominal cavity at 0.5 or 5 mg per kilogram per day activated AMPK in muscle and prevented the insulin resistance and weight gain a high-fat diet otherwise produced. In 2021 the same group reported that mice dosed the same way at 5 or 15 mg per kilogram per day ran longer on a treadmill, old mice included.

Lee C, Zeng J, Drew BG, et al. "The mitochondrial-derived peptide MOTS-c promotes metabolic homeostasis and reduces obesity and insulin resistance." Cell Metabolism. 2015;21(3):443-454. View study

Reynolds JC, Lai RW, Woodhead JST, et al. "MOTS-c is an exercise-induced mitochondrial-encoded regulator of age-dependent physical decline and muscle homeostasis." Nature Communications. 2021;12(1):470. View study

A per-kilogram dose injected into a mouse’s abdomen cannot be turned into a subcutaneous human dose: the species and route differ, and nobody has measured how much injected MOTS-c reaches a person’s bloodstream or how long it stays. The 2021 paper did include ten young men, but it measured their own MOTS-c, which rose in muscle and blood after one workout and was back to baseline four hours later: a finding about exercise, not injections. The only pharmacokinetic-related human data is a test-tube study showing MOTS-c breaks down quickly in human blood.

Knoop A, Thomas A, Thevis M. "Development of a mass spectrometry based detection method for the mitochondrion-derived peptide MOTS-c in plasma samples for doping control purposes." Rapid Communications in Mass Spectrometry. 2019;33(4):371-380. View study

The most thorough public review of that gap is the FDA staff briefing document for the July 2026 Pharmacy Compounding Advisory Committee meeting, dated May 11, 2026. Reviewers found no clinical studies of MOTS-c in humans, no pharmacokinetic study in animals or people, and no dose-response assessment even in rodents; the nomination cited twelve references, none clinical. A 2023 review put it from the other side: no method of using MOTS-c in the clinic has been developed.

U.S. Food and Drug Administration. "FDA Briefing Document for MOTS-c-Related Bulk Drug Substances (MOTS-c (free base) and MOTS-c acetate)." Pharmacy Compounding Advisory Committee Meeting, July 23-24, 2026. Evaluation dated May 11, 2026. View study

Zheng Y, Wei Z, Wang T. "MOTS-c: A promising mitochondrial-derived peptide for therapeutic exploitation." Frontiers in Endocrinology. 2023;14:1120533. View study

The analog that was dosed, and the trial that will dose MOTS-c

The one molecule in this family with a completed human trial is CB4211, an engineered analog from CohBar. It is not MOTS-c; it was designed to differ. Its Phase 1a/1b study began in mid-2018 and was suspended that November because, in the company’s words, mild injection-site reactions had been "unexpectedly persistent": painless bumps where some of the dose appeared to linger. Dosing resumed, and in August 2021 CohBar reported that the four-week Phase 1b stage in twenty adults met its safety endpoint with no serious adverse events. No later-phase trial was ever registered, and the company’s 2022 annual report said no suitable formulation had been found. Its dose says nothing about MOTS-c and is left off the chart on purpose.

CohBar, Inc. "CohBar Provides Update on CB4211 Clinical Trial: CB4211 Phase 1 Clinical Trial Temporarily Suspended to Address Injection Site Reactions." Press release filed as Exhibit 99.1 to Form 8-K, U.S. Securities and Exchange Commission, November 5, 2018. View study

CohBar, Inc. "CohBar Announces Positive Topline Results from the Phase 1a/1b Study of CB4211." Press release filed as Exhibit 99.2 to Form 8-K, U.S. Securities and Exchange Commission, August 10, 2021. View study

ClinicalTrials.gov. "A Phase 1a/1b Study of CB4211 in Healthy Non-obese Subjects and Subjects With Nonalcoholic Fatty Liver Disease." NCT03998514. Sponsor: CohBar, Inc. Phase 1; completed April 2021. View study

MOTS-c itself is now being tested. A Phase 2a study, NCT07505745, began recruiting on February 2, 2026: randomized, double-blind and placebo-controlled, about 120 adults aged 18 to 65 with prediabetes and a body mass index of 27 to 40, and a fixed subcutaneous dose once daily for 12 weeks against placebo. The primary measures are insulin sensitivity at 12 weeks and adverse events through week 16. The registration does not state the milligram dose, and primary completion is estimated for February 2027.

ClinicalTrials.gov. "MOTS-c for Improving Insulin Sensitivity in Adults With Prediabetes and Overweight/Obesity." NCT07505745. Sponsor: Hudson Biotech. Phase 2a, randomized, double-blind, placebo-controlled; study start February 2, 2026; recruiting as of October 2026. View study

So where did 5 to 15 mg a week come from, and where did 0.4 mg a day? Both from practice. The range that spread across clinics and forums grew by repetition, with no derivation behind it. The PeRx figure has a shorter history: the prescribing physician fixed a 20-unit draw for the pharmacy’s 2 mg/mL fill, a dose that fits one syringe and one vial cleanly. It is a prescription, with a screening record and a label behind it, not a finding.

U.S. Food and Drug Administration. "July 23-24, 2026: Meeting of the Pharmacy Compounding Advisory Committee." Meeting page with briefing documents, questions to the committee, agenda and presentations. View study

When to Inject: Morning, Fasted, Before Training

The prescription says each morning, on an empty stomach, with nothing to eat for at least 30 minutes afterward, and the reasoning is mechanistic. MOTS-c acts through AMPK, the energy sensor that shifts a cell from storing fuel to burning it, the same switch exercise and nutrient restriction flip. In cell experiments MOTS-c moves into the nucleus under glucose restriction, and the body makes more of it during a workout. A fasted or pre-training injection stacks the peptide on the state it is meant to reinforce.

Hardie DG, Ross FA, Hawley SA. "AMPK: a nutrient and energy sensor that maintains energy homeostasis." Nature Reviews Molecular Cell Biology. 2012;13(4):251-262. View study

Kim KH, Son JM, Benayoun BA, Lee C. "The Mitochondrial-Encoded Peptide MOTS-c Translocates to the Nucleus to Regulate Nuclear Gene Expression in Response to Metabolic Stress." Cell Metabolism. 2018;28(3):516-524. View study

That is a rationale built from mechanism. No human study has compared a fasted injection with a fed one, or morning with evening, so the fasting window is a sensible default, not a measured requirement. On training days, inject before the session; on other days, before breakfast. Water is fine, and the injection does not break a fast, as do peptides break a fast Read nextDo Peptides Break a Fast? A Clinic AnswerInjected peptides carry almost no calories, so in the caloric sense they generally do not break a fast. The nuance most people miss is insulin and mTOR signaling, which matters more for some peptides than others. Here is how a clinic thinks about it, peptide by peptide.Read article explains.

Morning rather than night has a practical reason: insomnia is one of the two reactions the prescription names, so a morning dose keeps any alerting effect away from bedtime. Site choice and rotation are in where to inject MOTS-c Read nextWhere to Inject MOTS-c: Sites, Rotation, TimingMOTS-c is a subcutaneous injection. The four standard sites work, but rotation, timing relative to exercise, and a few small technique details meaningfully change comfort and consistency. Here is the practical guide patients ask for after their first vial arrives.Read article ; which peptides care about the clock is in best time of day to take peptides Read nextBest Time of Day to Take PeptidesTiming is not the same for every peptide. Growth hormone secretagogues line up with your sleep, cognitive peptides fit the morning, and a few are taken on demand. Here is a practical, category-by-category guide to when each one is usually taken, and why your provider prescribes it that way.Read article .

The 8-On, 4-Off Cycle

The prescription runs for 8 weeks, then stops for 4 before it can be restarted. No human study has tested whether MOTS-c should be cycled or for how long, so the structure is a precaution: months of continuous AMPK stimulation with this peptide have never been studied in people, and a scheduled stop limits that unknown to eight weeks at a time. The break is also when to read whatever you tracked; MOTS-c before and after Read nextMOTS-c Before and After: What Changes, and WhenEvery MOTS-c before-and-after page online agrees on a tidy schedule: energy in week one, visceral fat by week six, a new body by week twelve. No study of injected MOTS-c in people has ever reported a result, so that schedule was written by nobody. This guide separates what patients typically report from what has actually been measured, week by week, and shows you how to run a before-and-after on yourself that would survive a skeptic.Read article lays that out week by week.

Other sources describe 8 to 12 week cycles with a washout, or continuous use; neither has evidence over the other. On a PeRx prescription the label governs, and which peptide classes need breaks at all is in the peptide cycling guide Read nextPeptide Cycling Chart: When to Pause Each ClassPeptide therapy is rarely meant to run forever. Some peptides need scheduled breaks to keep working. Others can be used continuously. The right cycle depends on the peptide class, your goals, and what is happening at the receptor level. Here is the practical guide to cycling, peptide by peptide.Read article .

What a Vial Covers: 25 Doses, Five Weeks, Two Vials per Cycle

A 5 mL vial at 2 mg/mL holds 10 mg, which at 0.2 mL per dose is 25 doses: five weeks on a Monday to Friday schedule. An 8-week cycle needs 40 doses, so the first vial runs out midway through week six and the second finishes the cycle with 10 doses, two weeks’ worth, still in it. The catalog lists MOTS-c as a one-month supply; one vial is not one cycle.

What becomes of those 10 doses depends on the beyond-use date on the label, since the 4-week break comes first. Keep every vial refrigerated at 36 to 46 degrees Fahrenheit, upright, out of light and never frozen; how to store peptides Read nextHow to Store Peptides: Fridge, Travel & Shelf LifeStoring peptides is simpler than most of the internet makes it sound, especially with PeRx. Because every vial ships fully reconstituted and ready to use, there is nothing to mix and no powder to manage. Keep it cold, keep it dark, do not freeze it. Here is the complete answer, product by product.Read article covers travel and the rest.

If You Feel Palpitations or Cannot Sleep: The Halving Rule

The prescription carries one adjustment. If you experience heart palpitations or insomnia, reduce the dose by half at your next injection: 10 units instead of 20, which is 0.1 mL and 0.2 mg, on the same schedule. Stay there. The label does not provide for stepping back up on your own, and a reaction that made you halve the dose is something the care team should hear about. No trial explains why those two; they are simply the complaints most often reported.

That is all the dose can do about side effects. Everything else, from what has been measured in people to the blood-sugar interaction, is in MOTS-c side effects Read nextMOTS-c Side Effects: What Is Known and What Is NotEvery MOTS-c side-effect list online shares one problem: no study of injected MOTS-c in people has ever reported results, so none of those lists has a number behind it. This page sorts the evidence into what was measured in humans (almost nothing, mostly on an analog), what FDA reviewers flagged in 2026, and what users report, with straight answers on blood sugar, cancer, and the heart.Read article , the page to read before the first injection.

What Changes the Dose, and What Does Not

Very little, which is the point of a fixed prescription. Body weight does not change it: the mouse studies dosed per kilogram, but into mice, with no pharmacokinetics to scale from, so the 20 units is the same for every adult who passes screening. The goal does not change it either, whatever numbers websites assign to metabolism, body composition or energy. Searches for a MOTS-c dosage for weight loss deserve a direct answer: there is not one. No dose has been tested against weight in a human trial, and PeRx does not prescribe MOTS-c for weight loss; what the evidence does support is graded in MOTS-c benefits Read nextMOTS-c Benefits: What the Evidence SupportsAlmost every benefit attributed to MOTS-c traces back to a mouse, a cell culture, or a blood test measuring the peptide your own mitochondria already make. This page grades each claim by what was measured, what it was measured in, and whether anyone has given injected MOTS-c to a person and looked.Read article . There is no loading phase and no titration upward.

Other medications change the screening conversation rather than the dose. Anything that lowers blood sugar, including metformin, insulin and sulfonylureas, belongs on your intake form, because the combination has never been tested; MOTS-c vs metformin Read nextMOTS-c vs. Metformin: Peptide or the Pill?Both MOTS-c and metformin flip the same cellular switch: AMPK, the master sensor that turns on during exercise and fasting. That shared mechanism is why they keep getting compared in longevity circles. But one is a decades-old, oral, FDA-approved diabetes drug used off-label, and the other is a mitochondrial peptide given as a subcutaneous injection. This guide breaks down how each works, where the human evidence actually stands, and why the honest answer is not either-or.Read article walks through the overlap. The same holds for a GLP-1: if you take semaglutide or tirzepatide, whether an FDA-approved brand or a compounded version prepared against your own prescription, the MOTS-c dose is unchanged and the two stay separate prescriptions. MOTS-c and semaglutide Read nextMOTS-c and Semaglutide: Can You Combine Them?Ask this question online and you get two kinds of answers. Retail sites say yes and quote fat-loss percentages that do not exist anywhere in the literature. Cautious sites say nothing has been studied and stop there. Both halves are doing part of the job. This page does the whole thing: what is actually known, including the analog trial almost nobody mentions, and how a prescribing clinic thinks about the combination in practice.Read article covers that pairing; MOTS-c vs NAD+ Read nextMOTS-c vs. NAD+: The Mitochondrial Energy DuoMOTS-c is a signal your mitochondria release during exercise. NAD+ is the coenzyme those mitochondria burn to make energy and run repair. People treat them as rivals because both live in the "cellular energy" conversation, but they sit at different points in the same system. This guide breaks down how each one works, which to consider first, and why the honest framing is complementary rather than either-or.Read article covers the other common comparison.

What a Month of MOTS-c Costs

PeRx MOTS-c Explore PeRxMOTS-cThe Mitochondrial PeptideView peptide is $229 per 5 mL vial. At 20 units per dose that is 25 doses, so a dose costs about $9.16 and a five-day week about $46. An 8-week cycle is two vials, $458 before any discount. The price includes the provider review, 503A compounding, refrigerated shipping and the syringes and swabs in the box; nothing is charged until a licensed provider approves the prescription.

MOTS-c

PeRx MOTS-c is prescribed by a licensed provider after screening, compounded by a US-based 503A pharmacy at a fixed 2 mg/mL, and tested for potency and sterility. It ships fully reconstituted and ready to use, so the 20-unit draw on the label is the only number you need.

Twenty-five doses per vial, each weekday morning. $229 per vial.

A labeled 2 mg/mL. No mixing step and no strength to work out.

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If You Miss a MOTS-c Dose

If you remember the same morning before eating, take the dose then. If you remember after food, take it at the next fasted window that day or let the day go and resume the next weekday morning; one missed weekday out of forty changes nothing worth correcting. Never inject twice to catch up. Weekends are not missed doses; Monday is a normal dose, not a make-up.

If several days slip, restart at the usual 20 units, not a larger one. If you stopped because something felt wrong, do not quietly restart; the care team needs to hear about that reaction first. If the problem is forgetting, fix the anchor, not the dose: tie the injection to something you already do every weekday morning.

Common Questions