SS-31
Also known as: Elamipretide · Bendavia · MTP-131
Contents
MW
639.8 Da
Amino Acids
4 AA
Half-Life
3-4 hours
Route
SubQ, IV
CAS
736992-21-5
Formula
C32H49N7O5
Amino Acid Sequence
D-Arg-Dmt-Lys-Phe-NH2
Mechanism of Action
SS-31 (Elamipretide, Bendavia, MTP-131) is a tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) that selectively targets the inner mitochondrial membrane, concentrating >1,000-fold in mitochondria due to its alternating aromatic-cationic structure.
PRIMARY MECHANISM — CARDIOLIPIN STABILIZATION: Binds cardiolipin — the signature phospholipid of the inner mitochondrial membrane. Cardiolipin is essential for organizing electron transport chain (ETC) complexes and maintaining cristae structure. SS-31 stabilizes the cardiolipin-cytochrome c interaction → restores efficient electron transport → reduces electron leak → reduces ROS production AT THE SOURCE.
FUNDAMENTALLY DIFFERENT FROM ANTIOXIDANTS: Traditional antioxidants (vitamin C, E, glutathione) scavenge ROS after they form. SS-31 prevents ROS production by optimizing the mitochondrial ETC. This is upstream intervention — more effective than downstream scavenging.
MITOCHONDRIAL AGING: Age-related cardiolipin oxidation disrupts ETC complex organization → increased electron leak → increased ROS → more cardiolipin damage (vicious cycle). SS-31 breaks this cycle by protecting cardiolipin from oxidation.
Dosing Protocol
Low Dose
███ – ███ mcg/day
Standard Dose
███ mcg/day
High Dose
███ – ███ mcg/day
Dosing protocols are for paid members
Get exact dosing ranges, injection frequency, timing rationale, and reconstitution math.
Get Clinical Access — $79/moFrequency
Daily SubQ or IV.
Half-Life
3-4 hours
Reconstitution Guide
Full reconstitution protocol with BAC water volumes, concentration math, and units-to-draw per dose is available on the Clinical plan.
Unlock reconstitution guide →Clinical Warnings
Investigational — not FDA approved.
Phase III trials had mixed results.
Injection site reactions.
Long-term mitochondrial effects unknown.
Extremely expensive as research compound.
Contraindications
Absolute
Pregnancy
Relative Cautions
Severe cardiac disease
Renal impairment
Side Effect Profile
Mild
- ●Injection site reaction
- ●Mild headache
Moderate
- ●Dizziness
- ●Nausea
Synergistic Peptides
Common Stacks
NAD+
CoQ10
Research Status
PHASE II/III. PMID 26387082 (Szeto 2014): Cardiolipin binding mechanism defined. PMID 31514573 (Gibson 2019): EMPOWER-HF Phase II heart failure. PMID 32641218 (Sweetwyne 2017): Mitochondrial aging reversal. Phase III mixed results for some endpoints.
Frequently Asked Questions
How does SS-31 work?
SS-31 (Elamipretide, Bendavia, MTP-131) is a tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) that selectively targets the inner mitochondrial membrane, concentrating >1,000-fold in mitochondria due to its alternating aromatic-cationic structure. PRIMARY MECHANISM — CARDIOLIPIN STABILIZATION: Binds cardiolipin — the signature phospholipid of the inner mitochondrial membrane. Cardiolipin is essential for organizing electron transport chain (ETC) complexes and maintaining cristae structure. SS-31 stabilizes
What is the standard dose of SS-31?
SS-31 dosing protocols are available with a ClinPep Clinical subscription. Dosing varies by indication and patient factors — consult a licensed healthcare provider. General frequency: Daily SubQ or IV.
What is the half-life of SS-31?
The half-life of SS-31 is 3-4 hours. This determines optimal dosing frequency and timing.
Who should not use SS-31?
SS-31 is absolutely contraindicated in: Pregnancy. Use with caution in: Severe cardiac disease; Renal impairment.
What are the side effects of SS-31?
Common mild side effects include: Injection site reaction, Mild headache. Moderate effects: Dizziness, Nausea.
What peptides stack well with SS-31?
SS-31 is commonly stacked with: NAD+, Epithalon, 5-Amino-1MQ.
How do you reconstitute SS-31?
SS-31 is reconstituted with bacteriostatic water. Exact volumes, concentrations, and units-to-draw calculations are available in the ClinPep Clinical plan. Always follow your compounding pharmacy's instructions.
How long should you cycle SS-31?
SS-31 cycle protocols vary by indication. Detailed cycle length, on/off schedules, and monitoring guidelines are available with ClinPep Clinical access. Consult your healthcare provider for personalized cycling guidance.
References & Citations
10 PubMed studies · 3 clinical trials
Therapeutic Approaches Involving Mitochondria in the Treatment of Acute Kidney Injury.
Patel Prisha S, Pabla Navjot S, Bajwa Amandeep. Seminars in nephrology. 2026
Acute kidney injury (AKI) continues to pose a significant clinical burden, characterized by high morbidity and mortality rates. Emerging evidence has established mitochondrial dysfunction as a central
Elamipretide in the Management of Barth Syndrome: Current Evidence and a Case Report.
Jacob Neil, Schecter Daniel, Marshall Molly, Bansal Neha et al.. Molecular genetics and metabolism. 2025
Barth syndrome is an exceedingly rare and potentially fatal X-linked mitochondrial disease arising from pathogenic variants in TAFAZZIN (TAZ), leading to defects in mature cardiolipin synthesis and it
Mitochondrial Cardiolipin-Targeted Tetrapeptide, SS-31, Exerts Neuroprotective Effects Within In Vitro and In Vivo Models of Spinal Cord Injury.
Ravenscraft Baylen, Lee Do-Hun, Dai Heqiao, Watson Abbie Lea et al.. International journal of molecular sciences. 2025
Spinal cord injury (SCI) affects millions globally, leading to severe motor and sensory deficits with no effective clinical treatment. Cardiolipin (CL), a mitochondria-specific phospholipid, plays a c
Elamipretide: A Review of Its Structure, Mechanism of Action, and Therapeutic Potential.
Tung Cheryl, Varzideh Fahimeh, Farroni Emanuele, Mone Pasquale et al.. International journal of molecular sciences. 2025
Mitochondria serve an essential metabolic and energetic role in cellular activity, and their dysfunction has been implicated in a wide range of disorders, including cardiovascular conditions, neurodeg
Cadmium-cardiolipin disruption of respirasome assembly and redox balance through mitochondrial membrane rigidification.
Romanova Nadiya, Sule Kevin, Issler Travis, Hebrok Daniel et al.. Journal of lipid research. 2025
The environmental pollutant cadmium (Cd) poses a threat to human health through the consumption of contaminated foodstuffs culminating in chronic nephrotoxicity. Mitochondrial dysfunction and excessiv
New insight for SS‑31 in treating diabetic cardiomyopathy: Activation of mitoGPX4 and alleviation of mitochondria‑dependent ferroptosis.
Xiong Lie, Hu Huilin, Zhu Fuxiang, Shi Hanqiang et al.. International journal of molecular medicine. 2024
SS‑31 is a mitochondria‑targeting antioxidant that exhibits promising therapeutic potential for various diseases; however, its protective effect on diabetic cardiomyopathy (DCM) remains
SS-31 treatment ameliorates cardiac mitochondrial morphology and defective mitophagy in a murine model of Barth syndrome.
Russo Silvia, De Rasmo Domenico, Rossi Roberta, Signorile Anna et al.. Scientific reports. 2024
Barth syndrome (BTHS) is a lethal rare genetic disorder, which results in cardiac dysfunction, severe skeletal muscle weakness, immune issues and growth delay. Mutations in the TAFAZZIN gene, which is
Beneficial effects of SS-31 peptide on cardiac mitochondrial dysfunction in tafazzin knockdown mice.
Russo Silvia, De Rasmo Domenico, Signorile Anna, Corcelli Angela et al.. Scientific reports. 2022
Barth Syndrome (BTHS), a genetic disease associated with early-onset cardioskeletal myopathy, is caused by loss-of-function mutations of the TAFAZZIN gene, which is responsible for remodeling the mito
Registered Clinical Trials
ReCLAIM-2 Study to Evaluate Safety,Efficacy & Pharmacokinetics of Elamipretide in Subjects With AMD With Non-central GA
Safety, Tolerability, Efficacy of MTP-131 for Treatment of Mitochondrial Disease in Subjects From the MMPOWER Study
A Trial to Evaluate Safety, Tolerability and Efficacy of Elamipretide in Subjects With Barth Syndrome
Symptom Indications
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Complete SS-31 Protocol
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This information is for educational and research reference purposes only. ClinPep does not provide medical advice, diagnosis, or treatment recommendations. All protocols should be reviewed by a licensed healthcare provider.