FDA Approved (Barth, Sep 2025)For LongCardiolipin-targeted+1 more

SS-31 (Elamipretide)

A four-amino-acid peptide that binds cardiolipin in the inner mitochondrial membrane. We read all 60 studies. The protocol is below.

Updated 20 May 2026Read 11 minEvidence ●●●●○Citations 60

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The SS-31 (Elamipretide) Report · $19

Everything you need to start: dose, sourcing, safety, our verdict.

One purchase · yours forever

Built from 60 cited studies.

Status

FDA

Class

For Long

Evidence

4/ 5●●●●○

Phase 2 / 3 trials

$19 ↓

FDA approval (Forzinity, Barth syndrome)

Sep 19, 2025 (accelerated)

On-label population

$19 ↓

Read this if

you have a primary mitochondrial disease (Barth, MELAS) and you've been tracking elamipretide trials
you have dry AMD with geographic atrophy and want to know what the phase 3 readout means
you're an aggressive longevity hobbyist already running MOTS-c and humanin

Skip this if

**you're buying RUO 'SS-31' and your COA doesn't show chiral HPLC** — the activity depends on a specific stereochemistry (the D-Arg form: (D-Arg)2,2',6,6'-tetramethyltyrosine sequence). RUO vendors sometimes ship the racemic mixture or an all-L knock-off; mass spec alone can't catch it because the molecular weight is identical. Chiral HPLC is the only honest verification — if the COA can't show it, treat the vial as identity-unverified
you want an approved drug — it's not approved for healthy adults (Forzinity is Barth-only)
you're shopping it as a generic "anti-aging" peptide without a mitochondrial indication
you're not okay with the supply-chain identity question on a peptide this hard to synthesize

The 4 ways you can buy SS-31 (Elamipretide)

Full breakdown ↓

Brand

✓

FDA-approved Sept 2025

~$200,000+/year via specialty pharmacy

Lowest molecular. Ultra-rare-disease pricing; only realistic for diagnosed Barth patients with ins…

Compounded 503A

✗

Not available

Not meaningfully available

Post-approval, 503A compounding is closed; brand or RUO are the only realistic channels.

RUO (research-only)

✓

Sold 'for research only'

$80–$300/mo at community 1–4mg/d

The D-amino acid stereochemistry matters for activity; RUO product made with all-L is a different …

Gray market

✓

Unregulated overseas import

$25–$125/mo

Crypto/Wise pay; same D-stereochemistry concern as RUO; identity verification by mass spec alone i…

Click any lane for the full Sourcing breakdown. Prices and lane availability vary by molecule — this is the per-peptide snapshot, not a generic table.

First 90 days · SS-31 (Elamipretide)

What we'd actually do

Weeks 1–2

Nothing perceptible. Longevity peptides are not 'feel something' molecules. If a vendor says you'll notice an effect this fast, they're selling you on placebo.

Weeks 4–8

Possibly subtle shifts in biomarkers (inflammation, sleep, recovery). Subjective changes in this window are usually placebo and confounded with whatever else you changed.

Week 12 — decide

Bloodwork or biomarker check. If the protocol can't be defended on a labeled change at 12 weeks, it can't be defended on hope.

Quit if

Any unusual symptoms — especially the cancer-mechanism flag for angiogenic peptides.
12 weeks of continuous use with no objective biomarker support to keep going.
Tolerance signal (the protocol needs escalating doses to feel the same).

Identity

What it is.

SS-31 is elamipretide, a four-amino-acid designed to bind cardiolipin — a phospholipid that lives almost exclusively in the inner mitochondrial membrane. By stabilizing cardiolipin, the peptide is meant to keep the electron-transport chain organized and reduce reactive-oxygen-species leakage. It's mitochondrial scaffolding.

It was developed by Hazel Szeto's lab and licensed to Stealth BioTherapeutics, which has been running clinical programs for over a decade in conditions where mitochondrial dysfunction is central: Barth syndrome, mitochondrial myopathy, dry age-related macular degeneration, heart failure.

It's not . Stealth has filed and been rejected, filed again, and continues running trials. Available as online; the clinical version is investigational.

TL;DR

TL;DR. 30-second version.

The compressed verdict — what SS-31 (Elamipretide) actually is, what the human evidence shows, and the watch-for in three bullets. Locked.

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Mechanism

Mechanism.

Mechanism · in the SS-31 (Elamipretide) report

How the molecule actually works — receptor profile, downstream signaling, what to expect mechanistically.

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Evidence

Evidence. What we actually know in humans.

Evidence · in the SS-31 (Elamipretide) report

The trial breakdown — phase, n, primary endpoint, who funded, what hit, what didn't.

Get the report · $19 ↓

Human-Evidence Factbox

Phase 2 / 3 trials

$19 ↓

FDA approval (Forzinity, Barth syndrome)

Sep 19, 2025 (accelerated)

On-label population

$19 ↓

Cardiolipin binding

$19 ↓

Half-life

$19 ↓

SS-31 chirality identity risk

$19 ↓

WADA status

$19 ↓

IGF-1 / GH effect

$19 ↓

Dose

Dose. The actual protocol.

Dose · in the SS-31 (Elamipretide) report

The specific protocol — dose, titration schedule, cycle pattern, frequency, route.

We read 60 studies to write this report.

Get the report · $19 ↓

Sourcing

Sourcing. Where the cohort actually buys.

Sourcing · in the SS-31 (Elamipretide) report

Sourcing breakdown — vendor methodology, red flags, our published test results, COA checklist.

We read 60 studies to write this report.

Get the report · $19 ↓

Safety

Safety. Side effects.

Safety · in the SS-31 (Elamipretide) report

The watch-for list — contraindications, drug interactions, monitoring labs, when to stop.

Get the report · $19 ↓

Editorial Position

Editorial position.

Editorial Position · in the SS-31 (Elamipretide) report

Our editorial position — explicit yes / no / depends, with the reasoning behind it.

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Citations

Citations.

+Show all 60 citations

The SS-31 (Elamipretide) Report · $19

Everything you need to start.

Dose, sourcing, safety, our verdict. One purchase. Yours forever.

Built from 60 cited studies.

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