How does elamipretide work?

Elamipretide binds cardiolipin in the inner mitochondrial membrane, stabilizing cristae structure and improving electron transport efficiency and ATP production. Half-life is about 2 to 3 hours. Molecular weight is 639.8 daltons. Aliases are SS-31 and MTP-131. FDA accelerated approval on September 19, 2025 as Forzinity for Barth syndrome in patients weighing 30 kg or more, on a muscle strength endpoint, with a confirmatory trial required. That approval does not cover longevity, fatigue, or research-grade SS-31. MMPOWER-3, a Phase 3 trial in 218 people with primary mitochondrial myopathy, missed both primary endpoints: six minute walk difference minus 3.2 metres, favouring placebo, Class I evidence of no effect on walking or fatigue at 24 weeks. The TAZPOWER open-label extension in ten Barth patients reported a 96.1 metre walk-distance improvement at week 168 with no untreated comparison group. SS-31 binds cardiolipin and accelerated ATP recovery after renal ischemia in rats. Those animal findings do not transfer into a counted longevity mechanism. This FAQ does not invent a dose. Full record at /compounds/elamipretide.

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.