Skip to content
PeptideGeek

Cell energy

SS-31 (Elamipretide), explained simply

A mitochondria-targeting peptide, FDA-approved in 2025 as Forzinity for the rare disease Barth syndrome — though larger trials in other muscle and eye conditions fell short.

Well studied in peopleInjection under the skin (like insulin shots)20 cited sourcesResearch compound — not FDA approved

Start here

What is SS-31 (Elamipretide)?

SS-31, also called elamipretide, is a small peptide that travels into mitochondria, the structures that make your cells' energy, and binds cardiolipin, the fat molecule that keeps them working properly 115. The FDA approved it in September 2025 as FORZINITY to improve muscle strength in Barth syndrome, a rare genetic disease 89; every other use remains investigational. Phase 3 trials in primary mitochondrial myopathy (muscle disease caused by faulty mitochondria) and in dry age-related macular degeneration missed their primary endpoints 1314. It is given as an injection under the skin.

How it works in your body

Think of your cells like tiny cities, and mitochondria (the power plants inside your cells) are the power plants that keep everything running. Inside each power plant is a special membrane with folds called cristae—this is where your cells actually make energy (ATP). A fatty molecule called cardiolipin holds this whole structure together like molecular glue. As we age or face stress, cardiolipin gets damaged and the power plant structure falls apart, making less energy and more pollution (oxidative stress (cell damage from unstable oxygen molecules)) 13. SS-31 is like a repair crew that goes directly to the cardiolipin and stabilizes it 1. When the structure stays intact, your power plants work better—more energy, less cellular pollution, healthier cells 1.

The deeper mechanism, for the curious

Elamipretide (SS-31) is a lab-made tetrapeptide (a chain of four amino acids: D-Arg-dimethylTyr-Lys-Phe-NH2) that can enter cells and home in on mitochondria, the energy factories of the cell 13. Its amino acids alternate between positively charged types (Arg, Lys) and ring-shaped types (dimethylTyr, Phe). This lets it get into cells quickly, even without help from the electrical charge across the mitochondrial membrane, and collect several thousand-fold in the inner mitochondrial membrane (IMM, the inner wall of the mitochondrion) 315. SS-31 sticks to cardiolipin (CL), a fat molecule found only in the IMM that makes up approximately 20% of its fat content 116. CL is essential for: (1) arranging the respiratory chain supercomplexes (clusters of the protein machines that make energy), (2) keeping the folded structure of the cristae (the inner folds), and (3) the proper working of cytochrome c oxidase and other parts of the electron transport chain (the assembly line that makes energy) 2. By steadying CL and changing the electrical charge at the membrane surface, SS-31 makes the handoff of electrons work better, raises ATP (cell fuel) production, and cuts down on electron leaks that create reactive oxygen species (ROS, harmful molecules that damage cells) 13. SS-31 also stops CL from being damaged by oxygen (peroxidation) and from moving to the outer membrane. If those things happened, they would trigger the release of cytochrome c and apoptosis (programmed cell death) 5. Cross-linking mass spectrometry (a method that finds which proteins sit next to each other) found SS-31 partners including ATP synthase, complex III, complex IV, and enzymes in 2-oxoglutarate metabolism. All of these are known to interact with CL 2. Because it acts on several targets, SS-31 may help in many conditions that involve faulty mitochondria 1.

Evidence check

Well studied in people

This has been through large human trials — the strongest kind of evidence. Scientists have tested it on many people and measured what actually happened.

Every numbered marker on this page links to one of the 20 sources at the bottom.

97/100

Cell Energy Factory (Mitochondria) Protection

Attaches to cardiolipin (a fat molecule) in the inner membrane of the mitochondria, keeping its folded structure and the protein groups that make energy stable. A lab technique that links nearby proteins together found that everything it grips is already known to interact with cardiolipin, including ATP synthase (the enzyme that makes the cell's energy currency) and two other energy-making protein complexes.

94/100

Cellular Energy

By steadying cardiolipin (a fat molecule in the mitochondria) and changing the electrical charge on the membrane, it helps electrons pass along more efficiently and helps make more ATP (cell energy). In patients this has not turned into a measured gain over placebo: the phase 3 trial in 218 adults with mitochondrial myopathy (a muscle disease from faulty cell energy production) missed both main goals.

91/100

Targeted Antioxidant (guards cells from damage)

Works inside the mitochondrion (the cell's energy factory) to stop harmful byproducts (reactive oxygen species) from forming, rather than cleaning them up afterwards. It also prevents damage to cardiolipin (a fat molecule in the mitochondrion's membrane). The evidence is from lab chemistry and animal studies, not a clinical result in people.

What the research points to

The most-asked question

How much SS-31 (Elamipretide) do I take?

The research-reported range is 40 mg, once daily.

  1. Barth syndrome (the approved indication), Primary mitochondrial myopathy (a muscle disease caused by faulty cell energy production; investigational)

    40 mg

    • How often
      Once daily
    • For how long
      Continuous — 24 weeks in the phase 3 trial for muscle disease (myopathy), up to 168 weeks in the Barth syndrome extension
    • How
      Injection under the skin

    40 mg once daily is both the starting dose and the maximum. No human trial went higher, and it is the approved FORZINITY dose for anyone weighing at least 30 kg 8. The same flat 40 mg daily injection under the skin was used in the 12-patient Barth syndrome trial 6, in MMPOWER-2 (30 patients) 11, in the phase 3 MMPOWER-3 (109 on drug, 109 on placebo) 13 and in ReCLAIM-2 (117 on drug, 59 on placebo) 14. There is no weight-based dose for injections under the skin. The mg/kg figures in circulation are IV infusion RATES from MMPOWER-1 12 and the heart-failure study 7, given in hospital over 2 to 4 hours. The label states the product is not approved for IV use 8. Halve the dose to 20 mg once daily in adults with an eGFR below 30 mL/min (a measure of kidney function) who are not on dialysis. It has not been studied in people on dialysis 8.

Adjusting your dose

You're at the right dose if…

Consider going up if…

Go down if…

The ceiling: 40 mg once daily — the highest dose given in any human trial and the approved dose. Halved to 20 mg once daily in adults with an eGFR below 30 mL/min who are not on dialysis 8.

Reconstitution, in plain words

How do I mix SS-31 (Elamipretide)?

Peptides usually arrive as a freeze-dried powder in a small vial. “Reconstitution” just means adding sterile water back in so you can measure a dose. Here's how it works for SS-31 (Elamipretide):

What you need

A worked example

FORZINITY needs no calculation: the vial holds 80 mg/mL, so a 40 mg dose is 0.5 mL 8. For research-grade lyophilised powder, a 50 mg vial reconstituted with 2.5 mL of bacteriostatic water gives 20 mg/mL, so 2 mL (200 units on an insulin syringe) is the 40 mg dose.

Working out your dose

The dose is 40 mg once daily in both cases 8. From the 80 mg/mL approved solution that is 0.5 mL. From research-grade powder at 20 mg/mL it is 2 mL. The reduced renal dose of 20 mg is 0.25 mL of the approved solution, or 1 mL at 20 mg/mL 8.

Or let the calculator do it

Three quick questions — your vial, your water, your dose — and it tells you the exact syringe mark. “Find dose amount” is preloaded with SS-31 (Elamipretide)'s recorded schedule.

SS-31 (Elamipretide)Once daily

How much peptide is in your bottle?

Look at the label on the vial. It’s the number next to the unit — like "5 mg". Labeled in IU? Switch the unit to IU.

Type a number to continue.
0

Injection sites & technique

Where do I inject SS-31 (Elamipretide)?

The best spots

  • Abdominal area (about 2 inches away from the belly button)
  • Front or outer thigh (middle section)
  • Back of the upper arm

How to do it, step by step

  • Wash your hands thoroughly with soap and water
  • Clean the injection site with an alcohol swab and let it air dry completely
  • Pinch about an inch of skin to create a fold of fatty tissue
  • Insert the needle at a 45-90 degree angle (45 if lean, 90 if you have more subcutaneous (under the skin) tissue)
  • Inject the solution slowly and steadily
  • Wait 5-10 seconds before withdrawing the needle
  • Apply light pressure with a clean swab if needed—do not rub

Injection just under the skin (subcutaneous (under the skin))—the standard method used in clinical trials, with approximately 92% bioavailability (92% of the dose reaches the bloodstream)

Timing

When do I take SS-31 (Elamipretide)?

Best time of day

The label sets no time of day — one injection daily, at a consistent time 8. The morning preference previously published here had no source behind it; trials dosed once daily without a specified time 13.

With or without food?

Food is irrelevant to a subcutaneous (under the skin) injection and the label sets no food restriction 8.

Taking it with other peptides

If you are injecting more than one peptide, use separate sites. The SS-31 and NMN pairing often quoted for cell-energy support was tested in aged mice, not people. SS-31 improved how the heart relaxes between beats, NMN improved how it pumps, and the combination produced both effects along with higher NAD(H) levels (a key energy-carrying molecule) 19. No human trial has tested elamipretide alongside another peptide.

The honest list

What side effects could SS-31 (Elamipretide) cause?

Common — usually mild

These show up most often. They usually fade as your body adjusts.

Less common

Worth knowing about, but most people never see these.

Serious — stop and get medical help

Rare, but if any of these happen, stop and contact a medical professional.

Week by week

What should I expect from SS-31 (Elamipretide), and when?

  1. Weeks 1-4

    You might notice
    What's normal
    What's next

  2. Weeks 12-24

    You might notice
    What's normal
    What's next

  3. Week 36 onward

    You might notice
    What's normal
    What's next

How to tell it's actually working

What the trials measured

What has never been measured

Not seeing anything? The usual reasons

Is it right for you?

Who should avoid SS-31 (Elamipretide)?

Do not use it if…

Be extra careful if…

When to stop

Elamipretide is FDA-approved only to improve muscle strength in Barth syndrome, in patients weighing at least 30 kg, and that approval is an accelerated one pending a confirmatory trial. Every other use is investigational. It is a prescription injectable — decisions about starting, stopping or adjusting belong with a prescriber.

What it mixes badly (and well) with

Medications

Other peptides

Supplements

Who it tends to suit

People Focused on Cell Energy Health (mitochondria)

If you're focused on optimizing cellular energy at the most fundamental level, SS-31 targets the actual machinery inside your mitochondria (the power plants inside your cells). It binds to cardiolipin—the special fat molecule that holds your electron transport chain together—keeping your cellular powerhouses running smoothly 12.

Aging Adults Concerned About Cellular Decline

Mitochondrial (the power plants inside your cells) dysfunction is now recognized as a hallmark of aging 18. Your cells' energy factories get less efficient over time, producing more harmful byproducts. SS-31 helps protect and restore mitochondrial function, addressing one of the root causes of age-related decline 1.

Heart Health Supporters

Your heart is one of the most energy-demanding organs, packed with mitochondria (the power plants inside your cells). Clinical trials have studied SS-31 in heart failure patients because cardiac cells are especially vulnerable to mitochondrial dysfunction 1. Supporting heart mitochondria supports overall cardiovascular function.

People Recovering from Cell Stress (oxidative stress)

Intense exercise, illness, or environmental factors all create oxidative stress, which damages your mitochondria (the power plants inside your cells) from the inside. SS-31 works as an antioxidant right where harmful byproducts of energy production (reactive oxygen species) are made, at the inner membrane of the mitochondria, and neutralizes them before they cause harm 1.

The safety picture overall

In the 24-week phase 3 trial in primary mitochondrial (the power plants inside your cells) myopathy (a muscle disease from faulty cell energy production), 98.2% (107 of 109) of people on elamipretide had side effects against 76.1% (83 of 109) on placebo. Injection-site reactions were the only side effect above 10% in the treated group. Serious side effects were 4.6% (5 of 109) against 2.8% (3 of 109), and none were judged treatment-related. Stopping because of a side effect was 7.3% (8 of 109) against 1.8% (2 of 109). There were no deaths and no hospital stays 13. In the 12-patient Barth syndrome crossover trial behind the approval, every patient had an injection-site reaction on elamipretide: 12 of 12 (100%) against 8 of 12 (67%) on placebo. Redness was 100% against 25% and hardened skin 67% against 17% 8. The label carries two warnings: serious allergic reactions, and benzyl alcohol toxicity (the product is not approved in newborns). It also reports that eosinophil counts (a type of white blood cell) rise during treatment, peak around day 90, and return to normal over 6 to 12 months 8.

Every safety figure above comes from company-run trials in diagnosed patients: 218 adults with primary mitochondrial (the power plants inside your cells) myopathy (a muscle disease from faulty cell energy production) over 24 weeks 13, 176 adults with dry age-related macular degeneration (an eye disease) over 48 weeks 14, and 12 patients with Barth syndrome followed into a 168-week open-label extension 610. No elamipretide trial enrolled anyone aged 65 or over, none enrolled healthy people, and there is no human pregnancy data. The label's reassurance there comes from animal studies at 4 to 10 times the clinical exposure 8. Nothing has been published on elamipretide for aging, athletic performance or general cell-energy support, so the safety record above does not extend to those uses.

Keeping it good

How do I store SS-31 (Elamipretide)?

Before mixing (powder)

The approved product, FORZINITY, is a ready-to-use solution — 280 mg in 3.5 mL (80 mg/mL) in single-patient vials, four to a carton. It needs no reconstitution. Store it refrigerated at 2-8°C and do not freeze it 8. Research-grade SS-31 is sold instead as a lyophilised powder; keep that refrigerated at 2-8°C in its sealed vial away from light.

After mixing (liquid)

Once a FORZINITY vial has been opened, it can be kept refrigerated at 2-8°C or at room temperature between 20-25°C, and must be discarded 8 days after first opening 8. Reconstituted research-grade powder is a different product with no label behind it; refrigerate it, never freeze it, and protect it from light.

Signs it has gone bad

Not our opinion — the published record

What the studies actually found about SS-31 (Elamipretide)

2025

Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential

This comprehensive review confirmed SS-31's unique ability to selectively bind cardiolipin (a fat molecule found in mitochondria, the cell's energy factories). That binding steadies the cristae (the folded inner walls of mitochondria), reduces oxidative stress (cell damage from unstable oxygen molecules) and boosts ATP production (cell fuel). Clinical trials such as PROGRESS-HF, TAZPOWER and MMPOWER-3 show significant therapeutic potential across many conditions involving faulty mitochondria.

Tung C, Varzideh F, Farroni E

2020

Mitochondrial protein interaction landscape of SS-31

Using chemical cross-linking and mass spectrometry (methods that find which proteins sit next to each other), researchers mapped exactly which proteins SS-31 interacts with inside mitochondria. All of the interacting proteins are known cardiolipin binders involved in ATP production or other metabolic processes. This confirms that SS-31 acts in a highly targeted way.

Chavez JD, Tang X, Campbell MD

2022

Structure-activity relationships of mitochondria-targeted tetrapeptide pharmacological compounds

This study analyzed how SS-31's specific amino acid sequence affects its activity. It showed that SS-31 changes the electrical charge at membrane surfaces (membrane electrostatics) and can pass into cells to reach mitochondria. All tested peptide variants were pharmacologically active (they had a real effect) in restoring mitochondrial membrane potential (the electrical charge across the mitochondrial membrane) and promoting cell survival under stress.

Mitchell W, Tamucci JD, Ng EL

2025

SS-31: A promising therapeutic agent against bleomycin-induced pulmonary fibrosis in Mice

At 5 mg/kg daily, SS-31 significantly reduced lung fibrosis (scarring) in mice by protecting the structure and function of mitochondria. The peptide reduced markers of oxidative stress (cell damage from unstable oxygen molecules) and inflammatory factors (TNF-alpha, IL-1beta, IL-6), and improved overall lung tissue health, showing its potential beyond heart uses.

Gu Q, Wang Y, Zhang H

2025

Mitochondrial Cardiolipin-Targeted Tetrapeptide, SS-31, Exerts Neuroprotective Effects Within In Vitro and In Vivo Models of Spinal Cord Injury

SS-31 protected neurons from mitochondrial dysfunction and cell death in both laboratory and animal models of spinal cord injury. The peptide reduced cardiolipin loss (loss of a key fat molecule in mitochondria), prevented neurite degeneration (breakdown of nerve cell extensions), and improved behavioral recovery, highlighting its nerve-protecting potential.

Ravenscraft B, Lee DH, Dai H

2021

A phase 2/3 randomized clinical trial followed by an open-label extension to evaluate the effectiveness of elamipretide in Barth syndrome

Twelve patients with Barth syndrome (a rare genetic disease that weakens the heart and muscles) took 40 mg/day elamipretide and placebo for 12 weeks each, in random order, separated by a 4-week washout (a pause with no treatment). Neither primary endpoint (main goal) was met in that blinded phase. Ten patients continued on 40 mg/day in an open-label extension (a follow-up where everyone knows they get the drug). At week 36 there were improvements in 6-minute walk distance (+95.9 m, p=0.024) and on the Barth Syndrome Symptom Assessment (-2.1 points, p=0.031), along with knee extensor strength (strength of the muscles that straighten the knee), patient global impression and some heart measures. The open-label result has no control group.

Reid Thompson W, Hornby B, Manuel R, et al.

2017

Novel Mitochondria-Targeting Peptide in Heart Failure Treatment: A Randomized, Placebo-Controlled Trial of Elamipretide

Thirty-two patients with heart failure and an ejection fraction (the share of blood the heart pumps out with each beat) of 35% or less received a single 4-hour intravenous infusion (a drip into a vein) of elamipretide at 0.005, 0.05 or 0.25 mg/kg/hour (8 per group) or placebo (12). This is an infusion RATE used inside a hospital, not a dose anyone measures out. There were no serious adverse events, and blood pressure and heart rate stayed stable in every group. Compared with placebo, the highest-rate group showed an 18 mL fall in left ventricular end-diastolic volume (the amount of blood in the main pumping chamber when it is full; p=0.009) and a 14 mL fall in end-systolic volume (the amount left after each beat; p=0.005) at the end of the infusion. Elamipretide was undetectable in plasma (the liquid part of blood) 24 hours after the infusion started.

Daubert MA, Yow E, Dunn G, et al.

2025

FORZINITY (elamipretide) injection, for subcutaneous use - FDA prescribing information

FDA prescribing information for FORZINITY (elamipretide), which received accelerated approval (a faster route that requires follow-up proof) in September 2025 to improve muscle strength in adults and children with Barth syndrome who weigh at least 30 kg. The label lists injection site reactions as the most common adverse reactions and reports absolute bioavailability (the share of the dose that reaches the bloodstream) of approximately 92% after injection under the skin. Continued approval may depend on proof of clinical benefit in a confirmatory trial (a follow-up study that must confirm it works).

U.S. Food and Drug Administration

2025

Elamipretide: The first cardiolipin-directed mitochondrial therapeutic for Barth syndrome approved under accelerated approval

On 19 September 2025 the FDA granted accelerated approval (a faster route that requires follow-up proof) to elamipretide for Barth syndrome, the first approved therapy aimed at the mitochondrial cause of the disease. The paper notes that in the randomised, double-blind, placebo-controlled crossover trial (people were assigned by chance, neither patients nor doctors knew who got the drug, and each person took both drug and placebo in turn), elamipretide produced no significant improvement in the 6-minute walk test or fatigue scores. The lasting benefits were seen in the 168-week open-label extension. The most common adverse events were mild injection-site reactions. A confirmatory trial is a condition of the approval.

Drug Discoveries & Therapeutics

If this isn't the right fit

What people use instead of SS-31 (Elamipretide)

Supplements that support cell energy

  • CoQ10 (Ubiquinol)
  • PQQ (Pyrroloquinoline quinone)
  • NAD+ precursors (NMN, NR)
  • Alpha-lipoic acid

Cellular energy and anti-aging

  • Epithalon
  • MOTS-c
  • Humanin
  • NAD+ IV therapy

Heart and vascular support

  • BPC-157
  • Thymosin Beta-4
  • CoQ10
  • Omega-3 fatty acids

Your questions

SS-31 (Elamipretide) FAQ

What makes SS-31 different from other supplements for the cell's energy factories (mitochondria), like CoQ10?

CoQ10 is an electron carrier that participates in the electron transport chain, while SS-31 targets the structural foundation—cardiolipin—that holds the entire energy-producing machinery together 12. Think of CoQ10 as providing fuel, while SS-31 repairs and maintains the engine itself. They work through completely different mechanisms and can actually complement each other.

Is SS-31 FDA approved?

Yes, elamipretide (the pharmaceutical name for SS-31) received FDA approval in September 2025 for treating Barth syndrome, a rare genetic mitochondrial (the power plants inside your cells) disorder 8. This makes it the first FDA-approved medication specifically targeting mitochondria 9. For other uses like general anti-aging or performance, it remains a research compound.

How long does it take to feel effects from SS-31?

No trial has measured how quickly a healthy person feels anything, because no trial has enrolled healthy people. In patients, the controlled phases came back empty. The 4-week crossover trial (where each person tries both drug and placebo) in mitochondrial (the power plants inside your cells) myopathy missed its walking goal 11. The 12-week Barth syndrome crossover missed both of its main goals 6. The 24-week phase 3 trial missed both of its own 13. The gains that were reported came later and without a comparison group: 6-minute walk distance improved by a total of 96.1 m over 168 weeks of open-label treatment (everyone knew they were on the drug) in Barth syndrome 10. Anyone promising an effect in two to four weeks is not quoting a trial.

Can I take SS-31 if I don't have a mitochondrial disease (a disease of the cell's energy factories)?

SS-31's FDA approval is specifically for Barth syndrome, but research interest extends to general mitochondrial (the power plants inside your cells) dysfunction associated with aging, heart failure, and other conditions 18. For healthy individuals interested in mitochondrial optimization, it remains a research compound and should only be used under medical supervision.

Why is SS-31 injected rather than taken orally?

As a peptide, SS-31 would be broken down by digestive enzymes if taken orally. Subcutaneous (under the skin) injection allows the full molecule to enter your bloodstream intact, achieving approximately 92% bioavailability (how much actually gets absorbed and used) 8. The peptide then crosses cell membranes and concentrates specifically in mitochondria (the power plants inside your cells) 3.

Does SS-31 have any effects on weight or body composition?

SS-31 isn't a weight loss compound, but by improving mitochondrial (the power plants inside your cells) function it could theoretically support better metabolism. Some research in cancer cachexia (muscle wasting) showed SS-31 helped preserve muscle mass by maintaining mitochondrial energy production 20. However, it's not marketed or studied primarily for weight management.

Can SS-31 help with brain health and cognitive function?

Research shows SS-31 has neuroprotective (protecting brain cells) effects in models of spinal cord injury and neurodegeneration 5. Your brain cells are packed with mitochondria (the power plants inside your cells) and highly sensitive to energy deficits. By protecting brain mitochondria, SS-31 could theoretically support cognitive health, though more human studies are needed.

Is it safe to use SS-31 long-term?

The longest published follow-up is 168 weeks: ten Barth syndrome patients entered an open-label extension on 40 mg daily and eight reached week 168, with injection-site reactions the most common adverse event throughout 10. The 24-week phase 3 trial in 218 adults found serious adverse events in 4.6% on elamipretide against 2.8% on placebo, none treatment-related, and no deaths or hospitalisations 13. That record is from diagnosed patients under trial supervision. There is no long-term data in healthy people, and none in anyone over 65 — no elamipretide trial enrolled that age group 8.

20 sources

References

Every numbered marker on this page points to one of these. Same sources, same numbering as the SS-31 (Elamipretide) research profile on Peptide Initiative.

  1. Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic PotentialTung C, Varzideh F, Farroni E · 2025
  2. Mitochondrial protein interaction landscape of SS-31Chavez JD, Tang X, Campbell MD · 2020
  3. Structure-activity relationships of mitochondria-targeted tetrapeptide pharmacological compoundsMitchell W, Tamucci JD, Ng EL · 2022
  4. SS-31: A promising therapeutic agent against bleomycin-induced pulmonary fibrosis in MiceGu Q, Wang Y, Zhang H · 2025
  5. Mitochondrial Cardiolipin-Targeted Tetrapeptide, SS-31, Exerts Neuroprotective Effects Within In Vitro and In Vivo Models of Spinal Cord InjuryRavenscraft B, Lee DH, Dai H · 2025
  6. A phase 2/3 randomized clinical trial followed by an open-label extension to evaluate the effectiveness of elamipretide in Barth syndromeReid Thompson W, Hornby B, Manuel R, et al. · 2021
  7. Novel Mitochondria-Targeting Peptide in Heart Failure Treatment: A Randomized, Placebo-Controlled Trial of ElamipretideDaubert MA, Yow E, Dunn G, et al. · 2017
  8. FORZINITY (elamipretide) injection, for subcutaneous use - FDA prescribing informationU.S. Food and Drug Administration · 2025
  9. Elamipretide: The first cardiolipin-directed mitochondrial therapeutic for Barth syndrome approved under accelerated approvalDrug Discoveries & Therapeutics · 2025
  10. Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWERHornby B, Reid Thompson W, Almuqbil M, et al. · 2024
  11. A randomized crossover trial of elamipretide in adults with primary mitochondrial myopathy (MMPOWER-2)Karaa A, Haas R, Goldstein A, et al. · 2020
  12. Randomized dose-escalation trial of elamipretide in adults with primary mitochondrial myopathy (MMPOWER-1)Karaa A, Haas R, Goldstein A, et al. · 2018
  13. Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical TrialKaraa A, Bertini E, Carelli V · 2023
  14. ReCLAIM-2: A Randomized Phase II Clinical Trial Evaluating Elamipretide in Age-related Macular Degeneration, Geographic Atrophy Growth, Visual Function, and Ellipsoid Zone PreservationAllingham MJ, Mettu PS, Cousins SW, et al. · 2024
  15. The mitochondria-targeted peptide SS-31 binds lipid bilayers and modulates surface electrostatics as a key component of its mechanism of actionMitchell W, Ng EA, Tamucci JD · 2020
  16. Cardiolipin, the Mitochondrial Signature Lipid: Implication in CancerAhmadpour ST, Maheo K, Servais S · 2020
  17. Role of cardiolipin in skeletal muscle function and its therapeutic implicationsYoo Y, Yeon M, Yoon MS · 2025
  18. Interactions between mitochondrial dysfunction and other hallmarks of aging: Paving a path toward interventions that promote healthy old ageLi Y, Berliocchi L, Li Z · 2023
  19. SS-31 and NMN: Two paths to improve metabolism and function in aged heartsWhitson JA, Bitto A, Zhang H · 2020
  20. Pharmacological targeting of mitochondrial function and reactive oxygen species production prevents colon 26 cancer-induced cardiorespiratory muscle weaknessSmuder AJ, Roberts BM, Wiggs MP · 2020

Want the deep science?

Read the full SS-31 (Elamipretide) research profile

Every claim on this page traces back to the research database behind Peptide Initiative — studies, citations, clinical trial data, and the technical detail we deliberately left out here.

Open the research profile

More cell energy guides

This guide is education, not medical advice. SS-31 (Elamipretide) is a research compound that is not FDA-approved for human use. Talk to a clinician before taking anything.