What is SS-31?
SS-31 (elamipretide, brand: Bendavia) is a mitochondria-targeted tetrapeptide (D-Arg-2′6′-Dmt-Lys-Phe-NH2) that selectively concentrates in the inner mitochondrial membrane. It has FDA Breakthrough Therapy designation for Barth syndrome and primary mitochondrial myopathy. Phase III trials for heart failure (PROGRESS-HF) and primary mitochondrial myopathy demonstrated significant functional improvements. Not yet FDA-approved for any indication.
Mechanism of Action
Selective binding to cardiolipin in the inner mitochondrial membrane; stabilizes cristae structure and electron transport chain supercomplexes; reduces mitochondrial reactive oxygen species (ROS); restores ATP synthesis efficiency without changing membrane potential
Target: Cardiolipin (inner mitochondrial membrane), electron transport chain
Research / educational reference. Educational research index only — not medical advice. Literature maturity is not a verdict on whether a compound works in people. Community reports are not evidence of efficacy.
Evidence at a glance
Derived · maturity-1.0Human efficacy is unproven unless an approved label or completed published efficacy program says otherwise. Counts reflect indexed literature volume/kind — never a verdict on effect.
Literature maturity
moderate 61/100
PubMed hits
562
CT.gov trials
31
Strong-human apps
0
Sample papers
8
Sample articles by era
- 2018-20202
- 2021-20233
- 2024-20266
Application grades (curated)
- Human-grade apps1
- Animal / in-vitro0
- Mechanistic0
Does literature support studied applications?
Grades reflect cited literature posture — not a treatment recommendation. Community notes are never efficacy evidence.
| Application | Cited evidence | Grade | Community |
|---|---|---|---|
| Mitochondrial targeting / organ protection (clinical exploration) | Elamipretide (SS-31) has clinical exploration in mitochondrial and cardio-renal contexts; many endpoints remain investigational. | Limited human | Community reports vary; not evidence of efficacy. |
Pharmacology
Mechanism of action
- •Selective binding to cardiolipin in the inner mitochondrial membrane; stabilizes cristae structure and electron transport chain supercomplexes; reduces mitochondrial reactive oxygen species (ROS); restores ATP synthesis efficiency without changing membrane potential
- •Primary target framing: Cardiolipin (inner mitochondrial membrane), electron transport chain
Half-life
~1.5 hours
Identity & chemistry
- CAS
- 736992-21-5
- PubChem
- CID 11764719
- Formula
- C32H49N9O5
- Molar mass
- 639.8 Da
- InChIKey
- SFVLTCAESLKEHH-WKAQUBQDSA-N
Identity cross-checked with PubChem where available. Compass HTML used only as a bootstrap checklist — not republished as product copy.
Storage & stability
- Lyophilized
- 2–8°C Refrigerated
- Reconstituted
- Refrigerate after reconstitution; follow supplier beyond-use dating
- Tell-tale degradation
- !Cloudiness, clumping, or particles after mixing
- !Discoloration versus the expected clear/colorless (or labeled) solution
- !Failed or incomplete reconstitution of lyophilized cake
Educational estimates. Prefer product labeling and peptide shelf-life tool.
Lab handling posture
Research / educational handling notes only. Not a substitute for an SDS.
- •Use PPE appropriate for peptide powder/solution handling
- •Avoid inhalation of lyophilized powder; handle spills per institutional policy
- •Do not present research materials as medicines
Sample indexed literature
- Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential.
International journal of molecular sciences · 2025 · PMID 39940712
- Targeting mitochondrial dysfunction with elamipretide.
Heart failure reviews · 2022 · PMID 35037146
- Elamipretide (SS-31) improves mitochondrial dysfunction, synaptic and memory impairment induced by lipopolysaccharide in mice.
Journal of neuroinflammation · 2019 · PMID 31747905
- Elamipretide: First Approval.
Drugs · 2026 · PMID 41335372
- SS-31@Fer-1 Alleviates ferroptosis in hypoxia/reoxygenation cardiomyocytes via mitochondrial targeting.
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2025 · PMID 39848110
- Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial.
Neurology · 2023 · PMID 37268435
Research Indications
Research supports improvements in mitochondrial bioenergetics and ATP production
May improve insulin sensitivity and glucose metabolism
Early research suggests potential effects on cellular aging markers
Research Protocols
These are commonly discussed research protocols — not medical advice. Consult a healthcare provider before use.
| Goal | Dose | Frequency | Route |
|---|---|---|---|
| Starting Dose | Low dose | Per protocol | Varies |
| Standard Dose | Titrated | Per protocol | Varies |
Peptide & Drug Interactions
Always consult your healthcare provider before combining with other compounds. Use our Interaction Checker for reference.
How to Reconstitute & Inject
Use bacteriostatic (BAC) water only. Avoid saline — may cause precipitation. Refrigerate and use within 28 days.
- 1
Remove SS-31 vial from refrigeration and allow to reach room temperature (15–20 minutes)
- 2
Clean vial top with alcohol swab and allow to air dry completely
- 3
Using a sterile syringe, draw the calculated volume of bacteriostatic water (BAC water)
- 4
Inject BAC water slowly down the side of the vial — do not aim directly at the powder
- 5
Gently swirl in circular motions — DO NOT shake vigorously as this degrades the peptide
- 6
Allow 2–3 minutes for full dissolution — solution should be clear and colorless
- 7
Draw calculated dose into an insulin syringe for subcutaneous injection
- 8
Inject into abdomen, thigh, or upper arm. Rotate injection sites to prevent lipodystrophy
- 9
Store reconstituted solution refrigerated (2–8°C) and use within 28 days
What to Expect
Week 1–2
Initial effects and adaptation period. Monitor for any adverse reactions.
Week 2–4
Primary effects begin to manifest. Adjust dosing as recommended by your provider.
Week 4–8
Main therapeutic effects should be established. Assess progress with your provider.
Week 8+
Evaluate results and determine continuation, cycling, or dose adjustments.
Side Effects & Safety
- Injection site reactions (redness, bruising, mild pain)
- Potential for allergic reaction — discontinue if rash or hives occur
- Individual reactions vary — start at the lowest dose and monitor carefully
- Consult your healthcare provider before use and report any unusual symptoms
FDA Status & Regulatory Info
SS-31 (elamipretide, brand: Bendavia) is a mitochondria-targeted tetrapeptide (D-Arg-2′6′-Dmt-Lys-Phe-NH2) that selectively concentrates in the inner mitochondrial membrane. It has FDA Breakthrough Therapy designation for Barth syndrome and primary mitochondrial myopathy. Phase III trials for heart failure (PROGRESS-HF) and primary mitochondrial myopathy demonstrated significant functional improvements. Not yet FDA-approved for any indication.
Frequently Asked Questions
Research References
External links for education only. We do not control third-party content.
Community-reported data
The information below reflects self-reported experiences from PeptIQ app users. It is not clinical evidence and should not replace professional medical advice.
Community Intelligence
What 59 users report
Overall experience
From check-in ratings — separate from side effects logged below. Side effects are logged separately from overall experience. A favorable check-in can still include nausea, fatigue, or injection-site reactions.
Favorable 2% · Mixed 2% · Unfavorable overall 96%
Most reported benefits
Benefits users selected when logging a favorable or mixed check-in.
Most logged side effects
Side effects are logged separately from overall experience. A favorable check-in can still include nausea, fatigue, or injection-site reactions.
Self-reported dose per injection
Median bucket: 5+ mg · Most common: 5+ mg
Reports span 0.025 to ≥ 5 mg (open-ended top bucket)
Anonymized self-reports from PeptIQ users — not prescribing guidance. Buckets group similar logged amounts; open-ended top buckets mean “at least” that dose.
Commonly stacked with
How repeat users are trending
Among repeat reporters, 92% said they felt similar to their last entry, 8% more positive, and 0% more negative.
Overall, repeat reporters leaned more positive than their previous entry.
Median gap between entries: 73 days · Based on 37 repeat reporters
Share Your Experience
Rate SS-31 in the PeptIQ app and help the community make informed decisions.
Educational information only
This page is for educational reference. It is not medical or legal advice. PeptIQ does not sell peptides or list vendors. Consult the FDA and a licensed healthcare professional for current regulations and individualized guidance.