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Bioregulator Compounds · Checked

SS-31 (Elamipretide)

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Bioregulator Compounds

Cardiolipin-binding mitochondrial-targeted tetrapeptide

Mitochondria-targeting tetrapeptide (D-Arg-Dmt-Lys-Phe-NH₂) that binds cardiolipin on the inner mitochondrial membrane. FDA-approved as FORZINITY for Barth syndrome. Studied for cardioprotection, aging muscle, and neurodegenerative disease research.

A synthetic 4-residue peptide (D-Arg-Dmt-Lys-Phe-NH₂) engineered to concentrate more than a thousand-fold at the inner mitochondrial membrane, where it binds cardiolipin in in-vitro assays. FDA-approved as FORZINITY (2025) for Barth syndrome. For laboratory characterisation only.

SS-31 (Elamipretide) — clinical & mechanistic profile

SS-31 (elamipretide) is a mitochondria-targeting tetrapeptide that binds cardiolipin on the inner mitochondrial membrane. FDA-approved for Barth syndrome (FORZINITY). 2025-2026 preclinical data shows neuroprotection: upregulates mitochondrial biogenesis against Aβ in Alzheimer's models, protects dopaminergic neurons in Parkinson's, and improves retinal survival in diabetic models. AMD trials slowed progressive ellipsoid zone degradation.

Studied applications

Cardiolipin binding
stabilizes cardiolipin content, prevents peroxidation and oxidation critical for mitochondrial structure and ETC function
Membrane stabilization
protects cristae structure and prevents destabilization during apoptosis
mPTP inhibition
inhibits mitochondrial permeability transition pore opening, accelerates ATP supply
Calcium stress reduction
modulates surface electrostatics of mitochondrial membranes, reducing calcium stress
FDA approval
approved as FORZINITY for Barth syndrome (2025)
Selective action
rapidly improves physiological function in aging and mitochondrial disorders, no effect on healthy mitochondria

Research constraints & safety notes

FDA approved only for Barth syndrome—other indications still investigational
Clinical trials for primary mitochondrial myopathy showed mixed Phase 3 results
Selective for dysfunctional mitochondria—no benefit in healthy tissue
Subcutaneous administration required for chronic use
Cost and availability limitations as orphan drug

SS-31 is a synthetic cell-permeable tetrapeptide (D-Arg-Dmt-Lys-Phe-NH2) engineered to concentrate more than a thousand-fold inside the inner mitochondrial membrane. It has molecular formula C32H49N9O5 and mass 639.76 Da. Common synonyms in the literature include Elamipretide, Bendavia, MTP-131, and FORZINITY. SS-31's defining feature is a rationally designed alternating aromatic–cationic motif — a 2′,6′-dimethyltyrosine residue paired with D-arginine — that exploits the negative membrane potential of energized mitochondria (Δψₘ ≈ −180 mV) to selectively accumulate at the cristae, where it binds reversibly to cardiolipin, a phospholipid unique to mitochondrial membranes.

What it’s studied for

Research into SS-31 is clinical-investigational, with several completed and ongoing human trials. It became the first mitochondria-targeted therapeutic to receive FDA approval when Bendavia/FORZINITY was cleared in 2025 for Barth syndrome, a rare paediatric cardiomyopathy driven by cardiolipin dysfunction. Beyond that indication, published work referencing SS-31 spans Barth syndrome (FDA approved): Clinical trials demonstrated improved energy production, protein complex assembly, and exercise tolerance in Barth syndrome patients. Participants showed functional improvements such as walking 1 mile without breaks. FDA approval was granted based on these meaningful clinical benefits in this rare mitochondrial disorder, Primary mitochondrial myopathy trials: Phase 1/2 IV dose-escalation trial (Class I evidence) showed dose-dependent 6-minute walk test improvement (+51.2 meters at highest dose vs. +3.0 meters placebo, p=0.0297). Phase 3 MMPOWER-3 trial (NCT03323749) evaluated subcutaneous dosing with mixed results on primary endpoints, and Heart failure research: Studies in heart failure models showed improved stroke volume, ejection fraction, cardiac output, and reduced left ventricular end-diastolic pressure. Biomarkers including natriuretic peptides were reduced. Normalized bioenergetics observed in failing cardiac tissue. Proposed mechanisms cited across the primary literature include Cardiolipin interaction: binds reversibly to cardiolipin, stabilizing content and preventing peroxidation/oxidation, Cristae protection: maintains cristae structure and prevents destabilization during apoptosis, and mPTP regulation: inhibits mitochondrial permeability transition pore opening, promotes electron transfer while reducing electron leakage. A defining property, replicated across multiple in-vitro and animal models, is selectivity: SS-31 restores function in stressed, aged, or diseased mitochondria while leaving healthy mitochondria unchanged — a pharmacological profile rarely seen in bioenergetic research tools. None of this material describes therapeutic outcomes for buyers, and No vendor listed here provides dosing guidance for SS-31 outside laboratory research.

Related research

For the full mechanistic profile, published references, cardiolipin-binding structural detail, and constraint notes on SS-31, see the SS-31 (Elamipretide) research page. For a deeper mechanism-focused review covering the tetrapeptide's cardioprotection, neuromuscular, and age-Related compounds studied alongside it include MOTS-c, studied for exercise-mimetic signalling and metabolic health. All references cited on the research pages are peer-reviewed primary literature.

For research use only. This summary is a research-scientific overview compiled from peer-reviewed sources. It is not medical advice and is not intended for human or veterinary consumption.

Mechanism of action

Receptor engagement in the primary literature

Binding and functional-assay data for SS-31 (Elamipretide), from peer-reviewed in-vitro pharmacology publications. Values are receptor activity parameters — not clinical outcomes.

CL
CardiolipinSelective binder (in vitro)

Isothermal titration calorimetry and NMR studies report reversible binding of SS-31 to cardiolipin, the phospholipid unique to the inner mitochondrial membrane. This is the defining biochemical feature of the molecule.

Source: Mitchell et al., PNAS 2020

ETC
Electron transport chainModulator (in vitro)

Isolated mitochondria studies report improved coupling of Complex IV and reduced electron leak with SS-31 pretreatment. Proposed mechanism is cardiolipin-mediated cristae stabilisation.

Source: Birk et al., J Am Soc Nephrol 2013

In-vitro / preclinical characterisation only — no clinical or therapeutic claim is expressed or implied. Research use only.

Study framework

Investigational context

Study designs referencing this compound in the published literature. Descriptions cover framework only — phase, participant count, duration, and citation — not outcomes. Click a card to review the source directly.

Reference chemistry

Specifications

SS-31 (Elamipretide) specifications
AttributeValue
Molecular FormulaC32H49N9O5
INNelamipretide
Trade nameFORZINITY (Stealth BioTherapeutics)
FDA statusaccelerated approval, Sep 2025 · NDA 215244
Molecular Weight639.76 g/mol
SequenceD-Arg-Dmt-Lys-Phe-NH2
Sequence length4 residues
Physical formLyophilized powder
PubChem CID11785459 ↗

Chemistry comparison — mitochondrial-targeted research peptides

Two published mitochondrial-targeted peptides with distinct primary targets in the inner mitochondrial membrane. Reference chemistry only.

Reference chemistry comparison
Compound Sequence MW Half-life (lit.) Reference
SS-31 (Elamipretide)peptide 4 residues 639.76 g/mol ~3 hours (lit.) Szeto Br J Pharmacol 2014
MOTS-cpeptide 16 residues 2174.5 g/mol in-vitro dependent Lee Cell Metab 2015

Reference chemistry only. Receptor-binding indications are qualitative (compound engages / does not engage the receptor in in-vitro assays as reported in the cited literature). No comparative-effectiveness claim is expressed or implied.

Cited sources

Peer-reviewed literature

[1]
SS-31 mitochondrial mechanisms in aging muscle
PMID: 26631564
View source ↗
[2]
Elamipretide cardiolipin interaction (PNAS 2020)
PMID: 32341003
View source ↗
[3]
Phase 2 trial in primary mitochondrial myopathy (Neurology 2018)
PMID: 29241563
View source ↗
[4]
Heart failure mechanisms and clinical potential
PMID: 30127997
View source ↗
[5]
PMC9192202
SS-31 comprehensive mechanisms review
Citation only
Questions

FAQ

What is SS-31 (elamipretide) and how does it work?
SS-31 (elamipretide, also known as Bendavia and MTP-131) is a synthetic cell-permeable tetrapeptide designed to concentrate over a thousand-fold in the inner mitochondrial membrane. It binds reversibly to cardiolipin — a phospholipid unique to mitochondrial membranes — stabilizing cristae architecture, protecting cardiolipin from peroxidation, and supporting electron-transport-chain efficiency. It was approved by the FDA in 2025 as FORZINITY for Barth syndrome. PMID 32341003 ↗
How is SS-31 different from other mitochondrial peptides like MOTS-c?
SS-31 is a rationally designed 4-residue peptide that concentrates directly at the inner mitochondrial membrane and acts by binding cardiolipin. MOTS-c is a naturally encoded 16-mer mitochondrial-derived peptide (from the 12S rRNA locus) whose primary published mechanism is exercise-mimetic AMPK signalling in muscle. Different sequences, different targets, different research contexts — they are frequently studied together for mitochondrial energetics.
What research contexts is SS-31 most cited in?
The primary literature covers cardioprotection in ischemia-reperfusion models, chronic heart failure with reduced ejection fraction, primary mitochondrial myopathy (MMPOWER trials), age-related muscle bioenergetics, retinal survival in diabetic models, and neuroprotection in Alzheimer's and Parkinson's animal models. Its FDA-approved indication is Barth syndrome. PMID 26631564 ↗ · PMID 29241563 ↗ · PMID 30127997 ↗
How is SS-31 stored?
The sealed lyophilized vial should be kept at 2–8 °C prior to first reconstitution. After reconstitution with bacteriostatic water, single-use aliquots stored at −20 °C are preferred over repeated freeze–thaw of the working stock. Avoid vortexing — gentle swirling is enough to dissolve the powder given SS-31's high aqueous solubility at physiological pH.
Do I get a Certificate of Analysis with SS-31?
Yes. Every lot ships with a batch-specific Certificate of Analysis produced by an ISO-accredited third-party lab. The COA documents HPLC purity, mass-spectrometry confirmation of the target monoisotopic mass, endotoxin (LAL) testing, and residual-solvent panels. The lot number on the outer label matches the COA published on /coa-library so purity is independently verifiable before you open the vial.
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