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Home/Compounds/SS-31
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SS-31

Also known as: Elamipretide · Bendavia · MTP-131

Mitochondria-targeted peptide in clinical trials for heart failure and mitochondrial diseases.

B
Grade B
Human observational studies
Human studies26
PubMed citations29
Typical dose4 mg – 40 mg
Routesubcutaneous, intravenous
Regulatory (US)Rx required
Last verified2 days ago
TL;DR · 30-second summary
  • Improves mitochondrial function
  • Reduces oxidative stress at source
  • Fast Track designation for Barth syndrome
  • Phase 3 heart failure trials ongoing

Mechanism of action

Cell-permeable peptide that concentrates in mitochondrial inner membrane, binding cardiolipin. Optimizes electron transport, reduces ROS, and improves ATP synthesis.

Evidence summary

26
Human studies
29
PubMed citations
1
Clinical trials
B
Evidence grade

Phase 2/3 trials for heart failure and Barth syndrome. FDA Fast Track designation for multiple indications. Mixed results in heart failure trials.

Dosing protocols

Educational information only. Consult a licensed provider before using any peptide.
Dose range
4 mg – 40 mg

Clinical trials used 4-40mg IV or subcutaneous. Dosing for general use not established.

Administration routes
subcutaneousintravenous

Side effects & safety

Reported side effects
Injection site reactionsHeadacheFatigue
Contraindications
  • Not established - investigational

Interactions

No documented drug interactions on file.

Regulatory status

United States
Not FDA approved

Investigational - FDA Fast Track and Orphan Drug designations

Compounding
Not permitted

Not available via 503A/503B compounding pharmacies.

Regulatory data last verified 4/17/2026

Citations

PMID 40478241Wang C, Xu X et al. · Polyphosphate- and Antioxidant Peptide-Based Coacervate Delivers miRNA.ACS applied materials & interfaces (2025)HumanPMID 40816230Jacob N, Schecter D et al. · Elamipretide in the Management of Barth Syndrome: Current Evidence and a Case Report.Molecular genetics and metabolism (2025)HumanPMID 40294492Sabbah HN, Alder NN et al. · Contemporary insights into elamipretide's mitochondrial mechanism of action and therapeutic effects.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie (2025)HumanPMID 39940712Tung C, Varzideh F et al. · Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential.International journal of molecular sciences (2025)HumanPMID 40319468Rowe LW, Akotoye C et al. · Beyond the injection: delivery systems reshaping retinal disease management.Expert opinion on pharmacotherapy (2025)HumanPMID 40497970Pavlović N, Križanac M et al. · Mitochondrial Dysfunction: The Silent Catalyst of Kidney Disease Progression.Cells (2025)HumanPMID 38602181Thompson WR, Manuel R et al. · Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER.Genetics in medicine : official journal of the American College of Medical Genetics (2024)HumanPMID 38725011Xia Y, Zhang Y et al. · Comprehensive dry eye therapy: overcoming ocular surface barrier and combating inflammation, oxidation, and mitochondrial damage.Journal of nanobiotechnology (2024)HumanPMID 35111001Nhu NT, Xiao SY et al. · Neuroprotective Effects of a Small Mitochondrially-Targeted Tetrapeptide Elamipretide in Neurodegeneration.Frontiers in integrative neuroscience (2024)PMID 38569981Chaurembo AI, Xing N et al. · Mitofilin in cardiovascular diseases: Insights into the pathogenesis and potential pharmacological interventions.Pharmacological research (2024)HumanPMID 38521160Liu X, Wang FY et al. · Mitochondria-targeting peptide SS-31 attenuates ferroptosis via inhibition of the p38 MAPK signaling pathway in the hippocampus of epileptic rats.Brain research (2024)PMID 38200543Hao Y, Fan Y et al. · ALCAT1-mediated abnormal cardiolipin remodelling promotes mitochondrial injury in podocytes in diabetic kidney disease.Cell communication and signaling : CCS (2024)HumanPMID 39605874Ehlers JP, Hu A et al. · ReCLAIM-2: A Randomized Phase II Clinical Trial Evaluating Elamipretide in Age-related Macular Degeneration, Geographic Atrophy Growth, Visual Function, and Ellipsoid Zone Preservation.Ophthalmology science (2024)HumanPMID 39574155Karaa A, Bertini E et al. · Genotype-specific effects of elamipretide in patients with primary mitochondrial myopathy: a post hoc analysis of the MMPOWER-3 trial.Orphanet journal of rare diseases (2024)HumanPMID 39056750Gandhi S, Sweeney HL et al. · Cardiomyopathy in Duchenne Muscular Dystrophy and the Potential for Mitochondrial Therapeutics to Improve Treatment Response.Cells (2024)HumanPMID 36250163Nickel K, Zhu L et al. · Long-term treatment with Elamipretide enhances healthy aging phenotypes in mice.Aging pathobiology and therapeutics (2024)HumanPMID 37081763Jiang W, He F et al. · Elamipretide reduces pyroptosis and improves functional recovery after spinal cord injury.CNS neuroscience & therapeutics (2023)HumanPMID 36840897Campbell MD, Samuelson AT et al. · Intermittent treatment with elamipretide preserves exercise tolerance in aged female mice.GeroScience (2023)HumanPMID 37268435Karaa A, Bertini E et al. · Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial.Neurology (2023)HumanPMID 37325898Sabbah HN, Taylor C et al. · Temporal evolution of the heart failure phenotype in Barth syndrome and treatment with elamipretide.Future cardiology (2023)Human

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