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Established research on intranasal peptide delivery exists for oxytocin, insulin, and several neuropeptides
Rosen ED, Spiegelman BM
PMID 33617860 Elamipretide (SS-31): +3 charge, mitochondrial cardiolipin accumulation, and injection-site-reaction profile (review)
Safety is also dose- and condition-specific: in the LOVIT sepsis trial published in the New England Journal of Medicine (2022), high-dose IV vitamin C was linked to worse outcomes than placebo, which underscores that more is not always better
The 2025 Increlex label requires meal/snack pairing and dose titration starting from a low dose specifically because hypoglycemia is so consistent
