SS-31 (Elamipretide)_Dosage, benefits & legal status
Also known as elamipretide, Forzinity, MTP-131, Bendavia, SS-31, BioAmplify
A mitochondrial peptide, approved in 2025 for the rare genetic disease Barth syndrome.
Common vial size is what vendors typically sell, not a recommendation. Enter your own vial in the calculator.
What is SS-31 (Elamipretide)?
Plain language first. The technical label stays, but it never stands alone.Overview
It helps damaged mitochondria make energy again. It also cuts down harmful waste from that process. It is in real trials for mitochondrial and heart disease.
SS-31 (elamipretide) is a mitochondria-targeted tetrapeptide that binds and stabilizes cardiolipin, a fat in the inner wall of your cells' power plants.
What it's used for
A shot that targets your cells' energy factories to fight fatigue and support aging muscle, heart, and eyes. It is in real clinical trials for mitochondrial disease.
How does SS-31 (Elamipretide) work?
What it does in the body, and where.SS-31 targets one specific molecule inside your mitochondria: cardiolipin, a fat that makes up part of the inner wall where energy is actually produced.
- 01It concentrates inside mitochondriaThe peptide is built to accumulate there rather than spread through the cell, which is unusual and is the reason it works at low doses.
- 02It binds and stabilises cardiolipinWhen cardiolipin is damaged, the energy-producing machinery attached to it stops working properly. Stabilising it restores the structure.
- 03Approved for one rare diseaseIt was approved in 2025 as Forzinity for Barth syndrome, a rare genetic mitochondrial condition. Broader anti-aging use is not what it was approved for.
A schematic of the compound's mechanism, not a diagnostic image.
What else is it used for?
Each use below carries its own evidence level. Approved means regulators have cleared it for that purpose. Investigational means it is in trials. Early research means it is being studied and is not established. Tested and failed means a trial measured the outcome but did not show a benefit in the people studied.
- Improving muscle strength in Barth syndrome, a rare inherited disease. This is its approved useFDA-approved
- Other mitochondrial diseasesInvestigational
- Age-related muscle decline and eye conditionsInvestigational
- Fatigue, which is why most people seek it outTested and failed
What happened when fatigue was actually measured
Fatigue is a common reason people look up this compound. MMPOWER-3 randomly assigned 218 adults with primary mitochondrial myopathy to elamipretide 40 mg daily or placebo for 24 weeks. Walking distance and fatigue were co-primary endpoints. Neither was met.
| Outcome | Elamipretide vs placebo |
|---|---|
| Six-minute walk test | -3.2 metres (95% CI -18.7 to 12.3), p = 0.69 |
| Total fatigue score | -0.07 points (95% CI -0.1 to 0.26), p = 0.37 |
The published study calls this Class I evidence that elamipretide did not improve walking distance or fatigue compared with placebo in this population. Karaa et al., MMPOWER-3, Neurology (2023) ↗
The earlier, smaller trial reported less fatigue than placebo on the same assessment (p = 0.0006), a secondary result that helped motivate the larger trial. Earlier trial ↗
A later genotype analysis explored a walking-distance signal in some nuclear-DNA subgroups; this does not reverse the overall fatigue result. Genotype analysis ↗
This trial tested people with a genetic mitochondrial disease, not healthy adults with ordinary tiredness. It does not establish an effect for general fatigue. The approved use is Barth syndrome, a different condition.
Our guide on SS-31 and tiredness examines the trial reports and the “repair stage” explanation.
The largest trial to measure fatigue in primary mitochondrial myopathy as a co-primary outcome did not meet it. Approval for Barth syndrome concerns a different population.
The published record
Papers and trials about SS-31 (Elamipretide)
Searched: SS-31, elamipretide, Forzinity, MTP-131, Bendavia, BioAmplify.
190 papers tagged human · 83 not reviews or lab · 16 clinical trial publications
30 registered trials · 14 with posted results
Furthest stage reached: Approved in the US
Counted from Europe PMC indexing, not read by a person; a human tag can land on reviews, commentary or lab papers; clinical trial publications is the narrower count. 442 papers and 30 trials indexed in detail.
At a glance
Four things to know about SS-31 (Elamipretide)
Evidence
FDA-approved
Category
Longevity and energy
Common vial
10 mg
Half-life
Not stated on the label
How much, and do you cycle it?
The range, and whether you take breaks.2 to 5 mg per day (community-reported), daily. Not cycled Community practice
Taken continuously for as long as it is working. Neither the label nor clinical practice describes an on/off schedule.
Not stated on the labelNo figure
The Forzinity label has no half-life in it. Section 12.3 gives time to peak concentration of 0.5 to 1 hour, 92 percent bioavailability, and near-complete recovery in urine by 48 hours, which points to a short half-life without stating one. The 2 to 3 hour figure circulating online does not come from the label.
You can compare this against the whole library to see where it sits.
How do I dose and price it?
Enter your vial and your dose. Pick a mix. We show the draw and the cost.The vial holds a fixed amount of drug. Adding more water does not make more drug, it just spreads it thinner, so you draw a bigger number on the syringe for the same dose.
Two different dose contexts
2–5 mg per day
Reports range from about 1 to 10 mg per day. These are reports, not an approved or established dose. The calculator starts with an empty dose field.
40 mg per day
For the FDA-approved Forzinity product in eligible patients. Not a general starting dose for SS-31 research vials.
Forzinity prescribing information →There is currently no established dose for general mitochondrial support or longevity.
Choose your mix
Measuring the water1 mL = one full 100-unit syringe.
SS-31 (Elamipretide) starts at $15.92 across 105 vendors, typically $2.69 – $8.00 per mg.
158 listings, last read Oct 24, 2026. Shipping and card fees are not included.
How do you store it?
Before mixing, and after.Follow the label that came with it.
This is an approved product, and its own label sets how long it keeps once mixed. Those windows vary enormously between products, from use-immediately to about a month, so the label is the only thing worth following here. Vials of the same compound sold by peptide vendors arrive with no label and no established holding time.
What are the side effects and cautions?
Known cautions and warnings for this compound.Who should avoid it
- Serious hypersensitivity to elamipretide or any ingredient in the product, which is the only contraindication on the label
- Neonates, because the approved product contains benzyl alcohol at 20 mg per mL and is not approved for that age group
- Pregnancy, where there are no human data, though animal reproduction studies showed no developmental harm
Stop and get help
- Signs of a serious allergic reaction such as trouble breathing, swelling, or a severe rash, which has required permanent discontinuation in rare cases
Common effects
- Injection-site reactions, which are the most common effect
- Otherwise generally well tolerated in trials
Where this page says nothing is established, that means nobody has studied it, not that a compound is safe.
Is SS-31 (Elamipretide) approved?
And where the numbers on this page come from.Yes. SS-31 (Elamipretide) is FDA approved and available on prescription in the United States.
- Approval statusFDA-approved
- RouteUnder the skin (subcutaneous)
- Checked12 October 2026
- DoseFrom community reports. No regulator or trial established this dose. The approved label sets a different dose: 40 mg per day for Barth syndrome.
- Vial sizeFrom what vendors typically list; not a recommendation.
- Sources
What has happened recently
Granted FDA accelerated approval on 19 September 2025 as Forzinity, for Barth syndrome in patients weighing at least 30 kg. This followed a rejection in May 2025. Accelerated approval means confirmatory data is still required.
What regulators say
From official documentsEnforcement naming this compound
Vendor product named as an unapproved new drug (Royal Peptides, August 2026)
This is a finding about one seller's vial, not about the compound or any approved product containing it.
Read the letter
You can compare this against the whole library, or read how to check a seller.
What else is like SS-31 (Elamipretide)?
Others in Longevity and energy, side by side.If you're weighing SS-31 (Elamipretide), it's worth reading FOXO4-DRI, Vitamin B12, and Cardiogen in the same class.
A mitochondrial peptide, approved in 2025 for the rare genetic disease Barth syndrome.
- Dose
- 2 to 5 mg per day (community-reported)
- How often
- Daily
An experimental senolytic that clears aging cells, with no human safety data.
- Dose
- Research only
- How often
- Cycled
The vitamin sold in peptide vials, at prices from $20 to $83 for the same thing.
- Dose
- Prescription products are dosed by a clinician
- How often
- Varies by product and by why it is being given
A lab-made 4 amino acid peptide aimed at the heart muscle.
- Dose
- Research only
- How often
- Daily, in 10-20 day courses
Guides for this compound
- How to Reconstitute a Peptide
Mix peptide powder with bacteriostatic water, step by step.
- How to Read an Insulin Syringe
Read the units, convert to millilitres, and draw the exact dose.
- mcg vs mg: The Peptide Dosing Mistake to Avoid
Your vial says mg and your protocol says mcg. Here is the conversion and how to check it.
Sources
- FDA review documents, Forzinity(2025)FDA integrated review supporting accelerated approval for Barth syndrome.
- Karaa et al., MMPOWER-3 randomized clinical trial(2023)Fatigue and walking-distance co-primary endpoints were not met in primary mitochondrial myopathy.
Beyond these, 472 records are indexed. Browse the records