SS-31 (Elamipretide)

Elamipretide · Bendavia · MTP-131

Rank#999
Anti AgingNot ApprovedPhase IIIResearchSubQ

Popular for:Mitochondrial function, anti-aging, cardiac protection

3

Total Studies

3

Human Studies

Phase III

Evidence Level

Not Approved

FDA Status

Overview

SS-31 (Elamipretide, also known as Bendavia or MTP-131) is a synthetic aromatic-cationic tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) that targets the inner mitochondrial membrane. It is one of the most promising mitochondria-targeted therapeutics, designed to restore mitochondrial function by stabilizing cardiolipin — a critical phospholipid in the electron transport chain.

**Originally developed for: **Barth syndrome (genetic mitochondrial cardiomyopathy caused by cardiolipin deficiency) and primary mitochondrial myopathy. Developed by Stealth BioTherapeutics. Also studied for cardiac ischemia-reperfusion injury, age-related mitochondrial dysfunction, and heart failure.

Mechanism of Action

SS-31 readily penetrates cell membranes and concentrates 1,000-5,000x in mitochondria. It binds to cardiolipin on the inner mitochondrial membrane, stabilizing the electron transport chain complexes (particularly Complex III and IV), reducing electron leak, decreasing reactive oxygen species (ROS) production, and restoring ATP synthesis efficiency. It also prevents cardiolipin peroxidation, preserving cristae structure.

Key Research Benefits

Primary Benefits:

Restores mitochondrial function — Stabilizes cardiolipin and electron transport chain efficiency (PNAS, 2020)
Reduces oxidative stress — Decreases mitochondrial ROS production without acting as a traditional antioxidant
Improved exercise tolerance — Reversed age-related exercise decline in mice (PMC6588449)
Cardiac protection — Improved cardiac function in Barth syndrome patients (48-week trial, Nature Scientific Reports, 2024)

Secondary/Emerging Benefits:

Anti-aging — Reverses age-related mitochondrial dysfunction; may slow cellular aging
Kidney protection — Studies show renal protective effects in ischemia models
Neuroprotection — Potential benefits for neurodegenerative diseases via mitochondrial support
Skeletal muscle function — Improves muscle quality and mitochondrial content in aging

Clinical Evidence Summary

Research Pipeline

Preclinical
Animal
Phase I
Phase II
Phase III
Approved

3

Total Studies

3

Human Studies

- TAZPOWER Trial — Phase 2 trial in Barth syndrome. 40 mg/day for 48 weeks showed improvement in 6-Minute Walk Test and cardiac function.

- Neurology (2018) — Randomized dose-escalation trial in primary mitochondrial myopathy. Doses of 5-50 mg/day were well-tolerated.

- PNAS (2020) — Mapped the mitochondrial protein interaction landscape of SS-31, revealing binding to ATP synthase and other key complexes.

- Campbell et al. (2019, PMC6588449) — SS-31 reversed age-related redox stress and improved exercise tolerance in aged mice.

> Clinical trial status: Multiple Phase 2 trials completed for Barth syndrome, mitochondrial myopathy, and heart failure. Stealth BioTherapeutics has faced regulatory setbacks. The compound has strong preclinical data but has not yet achieved FDA approval. Development continues.

Key Studies / PubMed References

Therapeutic Approaches Involving Mitochondria in the Treatment of Acute Kidney Injury.

Review

Patel PS, Pabla NS, Bajwa A · Seminars in nephrology · 2026

PMID: 41027799

Innovative technologies for the treatment of dry age-related macular degeneration (AMD) - modern therapeutic perspectives and their future.

Review

Ciszewski P, Drelichowska A, Pikor D, et al. · Romanian journal of ophthalmology · 2025

PMID: 40330967

Potential Therapeutic Candidates for Age-Related Macular Degeneration (AMD).

Review

Nashine S · Cells · 2021

PMID: 34572131

Side Effects & Safety

Common Side Effects (from clinical trials):

Injection site reactions (pain, redness, swelling)
Headache
Nausea (mild)
Generally well-tolerated in clinical trials at doses up to 50 mg/day

Rare but Serious Risks:

Limited long-term safety data beyond clinical trial durations
Theoretical concern: altering mitochondrial function could have unforeseen effects with chronic use

> Contraindications: Not established due to limited data. Use caution in individuals with known mitochondrial disorders (could alter disease progression unpredictably). Not recommended during pregnancy/breastfeeding.

Known Interactions

No curated interaction entry is live for SS-31 (Elamipretide) yet.

Until the interaction table is fully populated, use the interaction checker and related peptides below to explore adjacent compounds and likely research pairings.

Frequently Asked Questions

Research Disclaimer

This page is for research and educational purposes only. The information presented is based on published scientific literature and does not constitute medical advice, diagnosis, or treatment recommendations. SS-31 (Elamipretide) is not approved by the FDA for human therapeutic use. Always consult a qualified healthcare professional before making any health-related decisions. The studies referenced are linked to their original PubMed sources for verification.