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The Peptide Effect
phase 3Mitochondrial Health & Longevity

SS-31

Also known as: Elamipretide, Bendavia, MTP-131, SBT-20

SS-31 (Elamipretide) is an aromatic-cationic tetrapeptide that selectively targets and concentrates in the mitochondrial inner membrane. It is the most clinically advanced mitochondria-targeted peptide, currently in Phase 3 trials for Barth syndrome, heart failure, and renal disease. By binding cardiolipin and stabilizing cristae structure, SS-31 restores mitochondrial electron transport chain efficiency and reduces reactive oxygen species production at the source.

Key Facts

Mechanism
SS-31 (D-Arg-Dmt-Lys-Phe-NH2) is an aromatic-cationic tetrapeptide with an alternating aromatic-cationic motif that allows it to freely penetrate cell membranes and concentrate 5,000-fold in the mitochondrial inner membrane. It selectively binds cardiolipin, a phospholipid unique to the inner mitochondrial membrane that is essential for cristae formation and electron transport chain supercomplex assembly. By stabilizing cardiolipin interactions with cytochrome c, SS-31 optimizes electron transport, increases ATP production, and reduces electron leak that generates damaging reactive oxygen species. Unlike conventional antioxidants, SS-31 addresses oxidative stress at its source rather than scavenging free radicals after they are produced.
Research Status
phase 3
Half-Life
~4 hours
Molecular Formula
C₃₂H₄₉N₅O₅
Primary Use
Mitochondrial Health & Longevity
Table of Contents

Benefits

  • Restores mitochondrial function by stabilizing cardiolipin and cristae structurestrong
  • Reduces mitochondrial reactive oxygen species (ROS) at the source of productionmoderate
  • Cardioprotective — improves cardiac function in heart failure models and clinical trialsmoderate
  • Renoprotective — reduces kidney damage in ischemia-reperfusion injurymoderate
  • Improves exercise capacity in patients with heart failure (Phase 2 data)moderate
  • Barth syndrome treatment — improves cardiac and skeletal muscle function (Phase 3)moderate
  • May reverse age-related mitochondrial dysfunction and improve healthspanpreliminary

Dosage Protocols

RouteDosage RangeFrequencyNotes
Subcutaneous injection40 mgOnce dailyPrimary clinical trial dose for Barth syndrome (TAZPOWER study)
Intravenous infusion0.05 mg/kg/hContinuous infusion for 4 hoursUsed in acute settings such as cardiac ischemia-reperfusion studies
Subcutaneous injection (research)4–40 mgOnce dailyDose-finding range explored across multiple Phase 2 trials

Medical disclaimer

Dosage information is provided for educational reference only. Always follow your prescriber's instructions and consult a qualified healthcare provider before starting any peptide protocol.

Side Effects

  • Injection site reactions (pain, redness, induration)common
  • Headachecommon
  • Nausearare
  • Dizziness or lightheadednessrare
  • Potential renal effects at high doses (monitored in clinical trials)serious

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Comparisons

Frequently Asked Questions

How does SS-31 target mitochondria specifically?
SS-31 has an alternating aromatic-cationic motif (D-Arg-Dmt-Lys-Phe) that gives it cell-penetrating properties while also creating an affinity for cardiolipin, a negatively charged phospholipid found exclusively in the inner mitochondrial membrane. The mitochondrial membrane potential (-180mV) drives the positively charged peptide into mitochondria, where it concentrates approximately 5,000-fold relative to the cytoplasm. This selective accumulation means SS-31 reaches therapeutic concentrations at the exact site where oxidative damage originates.
What is the status of SS-31/Elamipretide in clinical trials?
Elamipretide (the pharmaceutical name for SS-31) has been evaluated in multiple clinical trials. The most advanced is the TAZPOWER trial for Barth syndrome, a rare genetic mitochondrial disease. Phase 2 trials have been completed for heart failure (EMBRACE trial), primary mitochondrial myopathy, and age-related macular degeneration (ReCLAIM studies). The compound received FDA Fast Track designation for Barth syndrome. While some trials showed promising biomarker improvements, the FDA has requested additional data before approval.
Can SS-31 prevent aging?
SS-31 addresses a core mechanism of aging — mitochondrial dysfunction and oxidative damage. In aged animal models, it has reversed age-related declines in mitochondrial function, improved cardiac performance, enhanced exercise capacity, and restored kidney function. However, it would be an overstatement to call it an aging preventive. It may help maintain mitochondrial health and slow one aspect of biological aging, but aging is a multifactorial process that cannot be addressed by a single intervention.
How is SS-31 different from conventional antioxidants like vitamin C?
Conventional antioxidants like vitamins C and E work by scavenging free radicals after they are produced, which is inefficient and requires high concentrations. SS-31 works upstream — it prevents excessive free radical production by stabilizing the electron transport chain where ROS originate. This "source reduction" approach is fundamentally more effective than trying to mop up oxidative damage after it occurs. Additionally, SS-31 concentrates specifically in mitochondria rather than distributing throughout the body.
Is SS-31 available for personal use?
Elamipretide is not currently approved by the FDA and is only available through clinical trials or as a research chemical from peptide suppliers. It is under development by Stealth BioTherapeutics (now Larimar Therapeutics after acquisition). Anyone considering SS-31 should be aware that quality control from research chemical suppliers is variable, and the compound has not yet received regulatory approval for any indication.

References

  1. 1
    Optimized mitochondrial targeting of proteins encoded by modified mRNAs rescues cells harboring mutations in mtATP6(2006)PubMed ↗
  2. 2
    Elamipretide (SS-31) for the treatment of Barth syndrome: results from the TAZPOWER trial(2019)PubMed ↗
  3. 3
    Mitochondria-targeted peptide SS-31 prevents mitochondrial dysfunction and reduces kidney injury in ischemia-reperfusion(2017)PubMed ↗
  4. 4
    A mitochondria-targeted peptide reverses age-related cardiac dysfunction(2014)PubMed ↗

Last updated: 2026-02-14