Elamipretide vs MOTS-c
Written by Aaron CuhaReviewed Sep 2026
The short answer
Two peptides aimed at the cell's power plants, at opposite ends of the evidence. Elamipretide (Forzinity) was FDA approved in September 2025 for Barth syndrome. MOTS-c has no finished human trial of whether it works, and only a July 2026 advisory committee vote behind it.
- Elamipretide people
- 487
- Elamipretide nulls
- 3
- MOTS-c people
- 30
- MOTS-c nulls
- 0
Dose
Approved medicine. No human dose established for unlabelled uses
Labeled amounts sit on the prescribing information. This page records what trials measured, not a personal dose.
FDA-approved September 19, 2025 as Forzinity for Barth syndrome, a rare inherited disease. It was an early, conditional (accelerated) approval. Other uses are investigational
Dose
No human dose established
No published trial has given MOTS-c to people as a drug. Human papers on this page measure circulating MOTS-c, not a dose from a vial.
Commonly reported amounts, in mg. No human dosing trial has been published.
Amounts commonly reported by people buying MOTS-c, recorded for this archive's reconstitution calculator, are 5 and 10 mg. They are self-reports rather than trial doses, and this archive does not recommend any of them. No human dose has been established for MOTS-c.
| Reported amount | Where the number comes from |
|---|---|
| 5 mg | Commonly reported, no published human dosing trial |
| 10 mg | Commonly reported, no published human dosing trial |
First-hand reports are counted on each profile and never added together. This page sets two published records side by side. It does not pick a winner.
Column A
ElamipretideElamipretide (SS-31, mitochondrial-targeted peptide)
Approved in 2025 for one rare genetic disease, Barth syndrome, on a result its own main study missed. In a large final-stage study in an inherited muscle disease, it clearly did not help.
Column B
MOTS-cMitochondrial ORF of the 12S rRNA type-c
A tiny peptide made from the DNA in the cell's power plants. In people there are real studies: a gene variant common in Northeast Asia, blood levels measured across age and illness, and a change with exercise. One study with a dummy group is signing people up. None of this shows that taking it as a drug helps.
Side by side, on the facts we can check
| What we compare | Elamipretide | MOTS-c |
|---|---|---|
| Category | Anti-aging | Longevity |
| FDA status | FDA-approved September 19, 2025 as Forzinity for Barth syndrome, a rare inherited disease. It was an early, conditional (accelerated) approval. Other uses are investigational | Not FDA-approved. In April 2026 the FDA took it off Category 2, its list of pharmacy ingredients with safety worries. In July 2026 the FDA's Pharmacy Compounding Advisory Committee voted 7 to 5 in favor of letting pharmacies make it. The FDA's own reviewers had advised against that. The FDA has not acted yet. One mid-stage study is signing people up (NCT07505745) |
| Half-life | ~2-3 hours | Short |
| Molecular weight | 639.8 Da | ~2,174 Da |
| How it works | It sticks to cardiolipin, a fat in the inner wall of mitochondria. That helps hold the folds of the wall in shape, so the cell's power plant makes energy (ATP) better. | In animals, under stress MOTS-c moves into the cell's control center and changes which genes are switched on. Part of how it does that is by slowing the folate cycle and the making of purines, building blocks for DNA. That switches on AMPK, an energy sensor, which changes how muscle handles sugar and fat. No receptor has been found. The FDA's 2026 review notes that nobody knows exactly what it acts on, so nobody can predict which organs a shot of MOTS-c would affect. In a dish, MOTS-c mixed with human blood broke down fast into smaller pieces. So it is not clear a shot under the skin could keep enough of it working in the body. |
| Studies in people | 5 | 8 |
| Evidence | Moderate: 5 completed trials, 487 people given it | Limited: 1 completed trial, 30 people given it |
| Legal status, US | FDA-approved (Forzinity, Barth syndrome only), prescription only; other uses investigational | Not approved; research use only |
Frequently asked questions
What is the difference between Elamipretide and MOTS-c?
Elamipretide: Approved in 2025 for one rare genetic disease, Barth syndrome, on a result its own main study missed. In a large final-stage study in an inherited muscle disease, it clearly did not help. MOTS-c: A tiny peptide made from the DNA in the cell's power plants. In people there are real studies: a gene variant common in Northeast Asia, blood levels measured across age and illness, and a change with exercise. One study with a dummy group is signing people up. None of this shows that taking it as a drug helps.
Which has stronger research evidence, Elamipretide or MOTS-c?
Each compound gets a band worked out from facts we counted, with the math shown. Elamipretide is Moderate (5 completed trials, 487 people given it). MOTS-c is Limited (1 completed trial, 30 people given it). That counts how much has been done in people. It does not rate whether either one works, and neither one is called the winner.
Are Elamipretide and MOTS-c FDA-approved?
Elamipretide: FDA-approved September 19, 2025 as Forzinity for Barth syndrome, a rare inherited disease. It was an early, conditional (accelerated) approval. Other uses are investigational. MOTS-c: Not FDA-approved. In April 2026 the FDA took it off Category 2, its list of pharmacy ingredients with safety worries. In July 2026 the FDA's Pharmacy Compounding Advisory Committee voted 7 to 5 in favor of letting pharmacies make it. The FDA's own reviewers had advised against that. The FDA has not acted yet. One mid-stage study is signing people up (NCT07505745).
Related posts
Blog articles that cover Elamipretide or MOTS-c, newest first.
- Longevity / Sep 27, 2026 / 12 minPeptides for Longevity: What the Evidence Actually Shows in 2026
- Safety / Sep 27, 2026 / 9 minPeptide Side Effects by Class: What Is Documented, What Is Anecdotal
- Safety / Sep 27, 2026 / 8 minHow to Read a Peptide Certificate of Analysis: HPLC Purity, Mass Spec Identity, Endotoxin, and Janoshik Verification
- Metabolic / Sep 27, 2026 / 7 minSLU-PP-332 and 5-Amino-1MQ: Two 'Peptides' That Are Not Peptides, and What the Mouse Data Actually Show
Reviewed Sep 2026. This page puts two published records side by side. It is for learning, and it is not medical advice. When this site shows a dose, it is the dose a trial or a clinic actually used, or what people say they did, with the source attached. None of it tells you what to take.