How does elamipretide work?
Elamipretide sticks to cardiolipin, a fat in the inner wall of mitochondria (the power plants of cells). That steadies the folds of that wall and helps the cell make energy (ATP) more efficiently. The body clears half of it in about 2 to 3 hours. Its molecular weight is 639.8 daltons. Other names are SS-31 and MTP-131. The FDA gave it fast-track (accelerated) approval on September 19, 2025, as Forzinity, for Barth syndrome (a rare inherited disease) in patients who weigh 30 kg or more. The approval was based on a muscle strength measure, and a follow-up study to confirm it is required. That approval does not cover longevity, tiredness, or research-grade SS-31. MMPOWER-3, a large final-stage study in 218 people with a muscle disease caused by faulty mitochondria, missed both of its main goals. On a six minute walk, people on the drug did 3.2 metres worse than people on a dummy shot (minus 3.2 metres), which is strong evidence of no effect on walking or tiredness at 24 weeks. A follow-on in ten Barth patients, where everyone got the drug, reported they walked 96.1 metres further at week 168, with no untreated group to compare. In rats, SS-31 stuck to cardiolipin and sped up energy recovery after blood flow to the kidney was cut off. Those animal findings do not transfer into a counted longevity mechanism. This FAQ does not invent a dose. Full record at /compounds/elamipretide.
Studies in people from the compound pages this answer belongs to
- Elamipretide
- Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial 2023 PMID 37268435
- Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension results of TAZPOWER 2024 PMID 38602181
- ReCLAIM-2: A Randomized Phase II Clinical Trial Evaluating Elamipretide in Age-related Macular Degeneration, Geographic Atrophy Growth, Visual Function, and Ellipsoid Zone Preservation 2025 PMID 39605874
Educational use only. This database summarizes published research and is not medical advice. Where a dose appears it is a record of what a trial or clinic ran, or what people describe doing, with its source attached. Nothing here is a recommendation for personal use.
Part of immune and longevity peptides. Thymosin alpha-1, thymalin, epitalon, MOTS-c, humanin, and the bioregulator family.