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No. 038 · Longevity & Immune · Longevity Peptide

SS-31

ElamipretideForzinityMTP-131Bendavia

S Tier S · Approved how tiers work →
  • FDA approved 2025
  • WADA — not listed
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Fingerprint 4 residues
SS-31 sequence fingerprint
  • Nonpolar 1
  • Positive charge 1
  • Modified / non-standard 2

Each dot is a residue placed around the ring from N- to C-terminus; its distance from the centre reflects its chemistry.

01

Evidence

  1. D In vitro
  2. C Animal
  3. B Human pilot
  4. A RCT
  5. S Approved

TIER S — Approved by the FDA or EMA for at least one indication.

FDA granted accelerated approval in September 2025 (Forzinity) to improve muscle strength in Barth syndrome. Continued approval depends on a confirmatory randomized trial.

Tiers rate the strength of published evidence — not effectiveness, safety, or a recommendation.

02

At a glance

Residues
4 amino acids, N→C
Molecular weight
639.8 Da
Formula
C32H49N9O5
Routes studied
Subcutaneous, Intramuscular Routes used in published research
FDA
Approved (2025) Forzinity Accelerated approval to improve muscle strength in adults and children with Barth syndrome who weigh at least 30 kg.
WADA
Not on the Prohibited List
03

Sequence

N → C · 4 residues · hover, tap, or use arrow keys to inspect

Note Dmt = 2′,6′-dimethyl-L-tyrosine; N-terminal D-arginine; C-terminal phenylalaninamide. Marketed as the hydrochloride salt.

04

Overview

A mitochondria-targeted tetrapeptide (elamipretide, brand Forzinity) that binds cardiolipin in the inner mitochondrial membrane. FDA granted it accelerated approval in September 2025 to improve muscle strength in Barth syndrome.

Research status FDA accelerated approval (Forzinity, 2025) for Barth syndrome based on the TAZPOWER trial and its open-label extension; phase 3 MMPOWER-3 in primary mitochondrial myopathy missed its primary endpoints

05

Mechanism

SS-31 (Elamipretide) is a cell-permeable aromatic-cationic tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) that concentrates 1000-fold in the inner mitochondrial membrane. It binds cardiolipin, stabilizing its interaction with cytochrome c and restoring electron transport chain efficiency. This reduces electron leak and reactive oxygen species production at the source.

06

Effects reported in research

Reported outcomes, not promises. Some come from controlled human trials; others may be from smaller or preclinical studies — check the studies below.

  • Restored mitochondrial electron transport
  • Reduced reactive oxygen species production
  • Improved cardiac function in heart failure
  • Protected against age-related mitochondrial decline
07

Safety & unknowns

FDA-approved (Forzinity, accelerated approval 2025) for Barth syndrome; continued approval depends on a confirmatory randomized trial. Per the FDA label, the most common adverse reactions are injection site reactions. Use outside Barth syndrome is investigational.

Unknowns. Trial safety data apply to the populations, formulations and conditions studied.

Informational only — not medical advice. peptidemeta publishes no dosing, protocols, or sourcing. Talk to a qualified clinician about any treatment decision.

08

Studies [2]

  1. Clinical trial 2024

    Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER

    Thompson WR, Manuel R, Abbruscato A, et al. Genetics in Medicine

    Open-label extension of the TAZPOWER trial reporting sustained tolerability and improvements in functional assessments and cardiac function with elamipretide in Barth syndrome over 168 weeks.

    [pubmed] [doi]

  2. Clinical trial 2023

    Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial

    Karaa A, Bertini E, Carelli V, et al. Neurology

    Phase 3 randomized placebo-controlled trial in primary mitochondrial myopathy in which elamipretide did not improve the primary endpoints (6-minute walk distance and fatigue scores) versus placebo.

    [pubmed] [doi]

10

Status sources

Sources behind the tier, regulatory status, sequence and dates on this page.

11

Cite this entry

$ cite --format=apa

peptidemeta. (2026). SS-31. In peptidemeta: The peptide library, ranked by evidence. Retrieved November 8, 2026, from https://peptidemeta.com/p/ss-31/

$ cite --format=bibtex 
@misc{peptidemeta-ss-31,
  title = {SS-31},
  author = {{peptidemeta}},
  year = {2026},
  howpublished = {\url{https://peptidemeta.com/p/ss-31/}},
  note = {Accessed 2026-11-08}
}

Accessed date reflects when you opened this page. Cite primary studies for scientific claims.

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