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Mitochondrial

SS-31

30mg vial

SS-31 (also known as Elamipretide, MTP-131 or Bendavia) is a synthetic aromatic-cationic tetrapeptide (D-Arg-2',6'-dimethyltyrosine-Lys-Phe-NH₂) that selectively concentrates in the inner mitochondrial membrane at levels up to 1,000-fold higher than in the cytosol. It binds cardiolipin - a phospholipid unique to mitochondria - stabilising cristae architecture, protecting electron-transport-chain integrity and restoring ATP production in dysfunctional mitochondria. It has progressed through Phase 3 clinical trials for Barth syndrome, primary mitochondrial myopathy, dry AMD and heart failure with preserved ejection fraction (HFpEF).

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Researched for

  • Cardiolipin stabilisation and cristae-architecture preservation
  • Restored ATP synthesis in dysfunctional mitochondria
  • Reduced mitochondrial ROS generation at source (not just downstream scavenging)
  • Phase 2/3 data in Barth syndrome, primary mitochondrial myopathy and dry AMD
  • Investigated for HFpEF, ischaemia-reperfusion injury and diabetic nephropathy
  • Emerging research signals in age-related mitochondrial decline and sarcopenia

Mechanism of action

Selectively binds cardiolipin in the inner mitochondrial membrane, stabilising cristae structure and optimising the supercomplex assembly of Complexes I–IV. This restores efficient electron flow, reduces mitochondrial reactive oxygen species (ROS) generation at source, preserves the inner-membrane potential and rescues ATP synthesis. Uniquely, uptake does not require an active membrane potential - allowing it to enter and rescue already-injured mitochondria.

Research protocol

Common research protocols use 3–5mg subcutaneously once daily. Clinical trial dosing has ranged from 4mg to 40mg/day SC across indications (Barth syndrome, mitochondrial myopathy, HFpEF). Cycles typically run 4–12 weeks; longer daily-use protocols are cited in mitochondrial-disease research. Rotate injection sites.

Half-life

Plasma half-life approx. 2–4 hours; mitochondrial tissue residence and biological effect persists significantly longer through cardiolipin binding.

Reconstitution

Reconstitute a 30mg vial with 3mL bacteriostatic water for a 10mg/mL working concentration (0.1mL = 1mg). Swirl gently down the side of the vial - do not shake.

Storage

Lyophilised: 2–8°C, stable approx. 24 months; -20°C for long-term. Avoid freeze-thaw cycles. Reconstituted: 2–8°C, protect from light, use within 30 days.

Research considerations
  • • Injection-site reactions (redness, itching, induration) are the most common event across clinical trials.
  • • Phase 3 MMPOWER-3 (primary mitochondrial myopathy) missed its primary endpoint; efficacy varies by indication.
  • • Not FDA-approved; some Phase 3 programs remain ongoing. Long-term human safety data beyond trial durations remains limited.

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For research use only