SS-31 (Elamipretide)
Elamipretide · Bendavia
Mitochondria-targeted peptide that stabilizes cardiolipin; researched for metabolic and renal disease.
Key takeaways
- Cardiolipin-binding peptide that targets the inner mitochondrial membrane.
- Multiple randomized phase 2/3 trials, but key trials missed primary endpoints.
- Not approved for any indication despite a large development program.
- Trials used 40 mg SubQ daily; the plotter's 2–8 mg range reflects community use.
Reported dosing protocols
Protocols reported in research literature and clinic/community use — informational context, not a dosing recommendation.
| Use case | Dose | Route | Frequency | Duration |
|---|---|---|---|---|
| Mitochondrial myopathy (MMPOWER-3 trial) | 40 mg | SubQ | Once daily | 8 weeks |
| Mitochondrial support (community) | 2–8 mg | SubQ | Once daily | 4–12 weeks |
Pharmacokinetic summary
- Model tier
- Simple (t½ + F, Tmax estimated)
- Half-life
- 1.9 hours
- Bioavailability
- 50%
- Typical dose
- 2–8 mg
Frequently asked questions
Is elamipretide approved for anything?
No. It's been tested in randomized trials for primary mitochondrial myopathy, heart failure, and Barth syndrome, and it received orphan-drug and fast-track designations, but the FDA has not approved it. The MMPOWER-3 trial missed its primary endpoints.
How does SS-31 differ from other mitochondrial peptides like MOTS-c?
SS-31 is synthetic and works directly on the mitochondrial membrane by binding cardiolipin. MOTS-c is a natural signaling peptide encoded in mitochondrial DNA that works through AMPK and metabolic gene regulation. Different origins, different mechanisms.
Why do community doses differ so much from trial doses?
Trials used 40 mg daily based on dose-finding work, while community protocols of 2–8 mg daily are vendor-driven convention with no published rationale. There's no evidence the lower community doses do anything.
References
- Estimated — Cardiolipin-binding mitochondrial peptide; half-life ~hours.
- Karaa et al., Neurology 2023 — MMPOWER-3 randomized trial in primary mitochondrial myopathy — Phase 3 randomized trial of elamipretide 40 mg/day; primary endpoints not met.
- Daubert et al., J Card Fail 2020 — elamipretide in heart failure (PROGRESS-HF) — Randomized trial assessing left ventricular function in HFrEF patients.
Related compounds
MOTS-c
Mitochondrial-derived peptide that regulates metabolic homeostasis and AMPK signaling.
Human Growth Hormone (HGH)
Recombinant growth hormone; supports lipolysis, recovery, IGF-1 elevation.
Semaglutide Injection (Ozempic/Wegovy)
Long-acting GLP-1 receptor agonist for type 2 diabetes and weight loss; weekly injection.
Protocols featuring SS-31 (Elamipretide)
Comments
Loading comments…