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therapeutic · Compound Profile

SS-31

Elamipretide · Bendavia · MTP-131

SS-31 (also known as elamipretide, Bendavia, or MTP-131) is a mitochondria-targeted tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) that selectively concentrates in the inner mitochondrial membrane. Developed by Dr. Hazel Szeto at Weill Cornell Medical College, SS-31 stabilizes cardiolipin — a phospholipid critical for electron transport chain function — and has been studied in clinical trials for heart failure, mitochondrial myopathy (Barth syndrome), age-related macular degeneration, and kidney disease.

anti aging
Reviewed against editorial standards · Updated 2026-01-28

Who Researches This?

Who Researches SS-31?

SS-31 is researched by people focused on anti-aging at the cellular level — specifically mitochondrial health. If you're interested in longevity science and targeting the root cause of age-related decline (mitochondrial dysfunction) rather than just symptoms, SS-31 is one of the most targeted tools in this space. It's also being studied for heart, kidney, and muscle conditions linked to mitochondrial failure. It complements NAD+ and epitalon in anti-aging stacks.

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What Is SS-31?

SS-31 belongs to the Szeto-Schiller (SS) peptide class — aromatic-cationic peptides that selectively accumulate in mitochondria independent of mitochondrial membrane potential. This selectivity is remarkable: SS-31 concentrates ~5,000-fold in the inner mitochondrial membrane compared to cytoplasmic concentrations.

The clinical development of SS-31 (as elamipretide) has advanced furthest among mitochondria-targeted therapies. Stealth BioTherapeutics (now Larimar Therapeutics) conducted clinical trials for multiple indications related to mitochondrial dysfunction, and the compound received both Breakthrough Therapy and Fast Track designations from the FDA for Barth syndrome (a rare genetic mitochondrial disease).

Mechanism of Action

  • Cardiolipin stabilization: SS-31 binds to cardiolipin, a phospholipid found exclusively in the inner mitochondrial membrane. Cardiolipin is essential for the structural organization and function of electron transport chain complexes. Age and disease cause cardiolipin peroxidation and dysfunction.
  • Electron transport optimization: By stabilizing cardiolipin, SS-31 optimizes electron transfer between respiratory complexes, improving ATP production efficiency
  • ROS reduction: Improved electron transport reduces electron leakage and superoxide production — reducing oxidative stress at its source
  • Mitochondrial bioenergetics: Restores mitochondrial membrane potential and ATP synthesis capacity in dysfunctional mitochondria

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Clinical Evidence

  • Barth syndrome: FDA Breakthrough Therapy designation. Phase 2/3 trials showed improvements in the 6-minute walk test and cardiac function in Barth syndrome patients
  • Heart failure: Phase 2 trials (EMBRACE) in patients with heart failure showed improvements in left ventricular volumes, though primary endpoints in larger trials were mixed
  • Primary mitochondrial myopathy: Improvements in exercise tolerance and fatigue scores
  • Age-related macular degeneration: Phase 1/2 trials explored subcutaneous elamipretide for geographic atrophy

Dosage Overview

Clinical trial dosing:

  • Subcutaneous: 40 mg daily (clinical trial dose for Barth syndrome)
  • IV (acute settings): 0.05 mg/kg/hour infusion (heart failure trials)
  • Research: 0.5–5 mg subcutaneous (extrapolated from animal studies)

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Side Effects & Safety

  • Injection site reactions: Most common adverse event in clinical trials
  • Generally well-tolerated across multiple clinical trials
  • No significant cardiac safety signals in heart failure patients (an important finding given the cardiac indication)
  • Mild headache reported in some trial participants

FAQ

Frequently Asked Questions

References

  1. [1] Szeto HH. First-in-class cardiolipin-protective compound as a therapeutic agent to restore mitochondrial bioenergetics. British Journal of Pharmacology, 2014.
  2. [2] Sabbah HN, et al.. Chronic therapy with elamipretide (MTP-131), a novel mitochondria-targeting peptide, improves left ventricular and mitochondrial function in dogs with advanced heart failure. Circulation: Heart Failure, 2016.

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Austin Danner

Founder & Editor in Chief

Founder of Peptides Insider. Independent researcher focused on translating peer-reviewed peptide research into practical, evidence-based guides.

Reviewed against Peptides Insider editorial standards · Last reviewed 2026-01-28.