SS-31
Also known as: Elamipretide, Bendavia
Mitochondrial-Targeted Peptide | Cardiolipin Protector
Overview
SS-31 (Elamipretide) is an aromatic-cationic tetrapeptide that selectively binds to cardiolipin in the inner mitochondrial membrane, preventing lipid peroxidation and optimizing electron transport chain function for enhanced cellular energy production.
Key benefits
- Directly protects mitochondria
- Improves cellular energy production (ATP)
- Reduces oxidative damage
- Enhances exercise capacity
- Excellent safety profile in clinical trials
- Cardioprotective effects
Mechanism of action
Selectively binds to cardiolipin in inner mitochondrial membrane, preventing lipid peroxidation and optimizing electron transport chain function. This improves ATP production and reduces oxidative damage at the mitochondrial level.
Molecular data
- Type
- Aromatic-cationic tetrapeptide
- Half-life
- ~2 hours
Indications
What the research community uses this compound for, with self-reported effectiveness.
Mitochondrial
Enhanced ATP Production
Most effectiveOptimizes electron transport chain function for improved cellular energy.
Oxidative Stress Reduction
Most effectivePrevents cardiolipin peroxidation and reduces mitochondrial oxidative damage.
Mitochondrial Disease Support
EffectiveSignificant improvements in 6-minute walk test and fatigue scores in PMM patients.
Cardiovascular
Cardiac Protection
EffectiveReduces cardiac injury markers and improves mitochondrial function in surgical patients.
Heart Failure Support
EffectiveReduces ischemia-reperfusion injury and supports cardiac function.
Exercise Tolerance
EffectiveEnhanced exercise capacity and reduced fatigue.
Anti-Aging
Age-Related Muscle Function
ModerateReversed age-related decline in muscle function in animal studies.
Cognitive Protection
ModerateNeuroprotective effects demonstrated in Alzheimer's models.
Cellular Rejuvenation
ModerateSupports overall cellular health through mitochondrial optimization.
Dosing protocols
Common protocols by delivery method. Adjust the curve below to model accumulation in your own cycle.
Injectable
Subcutaneous or intravenous injection. SS-31 dissolves readily and should be protected from light due to photosensitivity.
| Protocol | Dose | Frequency | Route / duration |
|---|---|---|---|
| General mitochondrial support | 5-10mg | Once daily | SubQ |
| Athletic performance | 10-20mg | Once daily pre-workout | SubQ |
| Clinical protocols | 40mg | Once daily | SubQ or IV |
| Acute cardioprotection | 0.25mg/kg/hr | Continuous infusion | IV |
Preparation
You will need
- SS-31 peptide vial
- Bacteriostatic water or saline
- Insulin syringes (for SubQ)
- Alcohol prep pads
- Sterile filter (optional for IV)
- Amber vials (light protection)
Steps
- Clean vial with alcohol pad
- Add 1-2mL bacteriostatic water per 10mg peptide
- Gently swirl to dissolve (dissolves readily)
- Verify clear, colorless solution
- Optional: sterile filtration for IV use
- Label with concentration and date
- Store immediately at 2-8°C
- Protect from light - use amber vials if available
Work out the water volume and syringe units in the reconstitution calculator →
Topical
Topical cream/gel formulation available with limited research data. Used primarily for anti-aging skin applications.
| Protocol | Dose | Frequency | Route / duration |
|---|---|---|---|
| Skin anti-aging | 0.5-1% cream/gel | Twice daily | Face, neck, hands |
Interactions
Pairwise interactions with other compounds you might be cycling — the same data behind the cycle builder's safety check.
NAD+
SynergisticBoth support mitochondrial function through different mechanisms.
MOTS-c
SynergisticBoth are mitochondrial peptides with complementary mechanisms.
Humanin
SynergisticMay work together to protect cellular function.
GHK-Cu
CompatibleDifferent mechanisms; no conflicts.
BPC-157
CompatibleBPC-157 focuses on tissue repair while SS-31 targets cellular energetics.
Thymosin Beta-4
CompatibleBoth cardioprotective via different pathways.
Timeline
Typical week-by-week effects reported in clinical and observational data.
- Day 1-3
Subtle energy improvements, reduced fatigue
- Week 1-2
Better exercise endurance, faster recovery
- Week 2-4
Improved stamina, clearer thinking, better sleep
- Week 4-8
Significant exercise capacity improvements
- Week 8-12
Sustained energy, potential biomarker changes
Safety
Reported adverse effects, contraindications, and what to monitor on cycle.
Common side effects
- Excellent safety profile in clinical trials
- No significant side effects reported at therapeutic doses
- Mild injection site reactions possible
- Safe for long-term use based on current data
Stop signs — stop and seek advice
- Severe injection site reactions
- Allergic reaction signs (rash, breathing difficulty)
- Unusual fatigue or weakness (paradoxical reaction)
- Cardiovascular symptoms
- Severe headaches or vision changes
Contraindications
- Known hypersensitivity to peptides
- Pregnancy or breastfeeding (limited data)
Monitoring
- Injection site reactions
- Energy levels and fatigue
- Exercise tolerance
- No known drug interactions
Quality checks
What a legitimate product looks like, what should give pause, and what should make you stop.
Good signs
- Pharmaceutical grade (>98% purity required for clinical applications)
- Clear, colorless solution after reconstitution
- Certificate of Analysis available
- Proper cold chain maintenance
Warning signs
- Light sensitive - protect from exposure using amber vials
- Solution pH should be 6.5-7.5 (physiological range)
Stop signs — don't use
- Yellow or brown discoloration indicates degradation
- Cloudy solution or visible particles
- Improper storage conditions
Recent research
Newer papers and trial readouts on file for this compound, with source and date.
September 2025 · FDA / Drugs
FDA Accelerated Approval for Barth Syndrome
Elamipretide (Forzinity) received FDA accelerated approval as the first cardiolipin-directed mitochondrial therapeutic for Barth syndrome in patients weighing ≥30 kg.
April 2024 · Genetics in Medicine
Long-Term TAZPOWER Extension Results (168 Weeks)
168-week open-label extension data showed sustained improvements in 6MWT (96.1m cumulative, P=0.003), fatigue scores, and 3D left ventricular volumes in Barth syndrome patients.
November 2024 · Ophthalmology Science
ReCLAIM-2 Phase II Trial in Age-Related Macular Degeneration
Phase II trial evaluated elamipretide for geographic atrophy growth, visual function, and ellipsoid zone preservation in AMD patients.
March 2025 · GeroScience
Elamipretide Improves Cardiac and Skeletal Muscle Function During Aging
Demonstrated that elamipretide improves cardiac and skeletal muscle function during aging without detectable changes in tissue epigenetic or transcriptomic age.
References
Primary literature and clinical-trial data informing this entry.
Randomized Dose-Escalation Trial of Elamipretide in Adults with Primary Mitochondrial Myopathy (MMPOWER)
Karaa, A., et al. · Neurology · 2018
Phase I/II trial in 36 patients showed dose-dependent improvement in 6-minute walk test (64.5m vs 20.4m placebo at highest dose) after 5 days of treatment with excellent safety profile.
Novel Mitochondria-Targeting Peptide in Heart Failure Treatment (EMBRACE)
Daubert, M.A., et al. · Circulation: Heart Failure · 2017
IV infusion in heart failure patients showed significant decrease in left ventricular end-diastolic volume (-18 mL, P=0.009) and end-systolic volume (-14 mL, P=0.005) at the highest dose.
Improving Mitochondrial Function with SS-31 Reverses Age-Related Redox Stress and Improves Exercise Tolerance in Aged Mice
Siegel, M.P., et al. · Free Radical Biology and Medicine · 2019
8 weeks of SS-31 (3 mg/kg/day) in aged mice reversed age-related decline in mitochondrial ATP production, restored redox homeostasis, and significantly increased treadmill endurance.
TAZPOWER: Phase 2/3 Randomized Clinical Trial of Elamipretide in Barth Syndrome
Thompson, W.R., et al. · Genetics in Medicine · 2021
40mg daily in Barth syndrome patients. Primary endpoints not met at 12 weeks, but open-label extension showed cumulative 96.1m improvement in 6MWT at 168 weeks (P=0.003) with sustained fatigue improvements.
Efficacy and Safety of Elamipretide in Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial
Karaa, A., et al. · JAMA Neurology · 2023
Phase 3 trial (218 patients) did not meet primary 6MWT endpoint overall, but post-hoc analysis showed improvement in patients with nuclear DNA variants. Well-tolerated with mild-to-moderate adverse events.
Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential
Machiraju, P., et al. · International Journal of Molecular Sciences · 2025
Comprehensive review covering PROGRESS-HF, TAZPOWER, MMPOWER-3, and ReCLAIM trials. Highlights elamipretide's unique cardiolipin-binding mechanism and broad therapeutic potential across mitochondrial diseases.
Last updated . How this page was sourced is described in the methodology.