SS-31

Price and cost-per-mg comparison

SS-31 (elamipretide; Szeto-Schiller peptide 31; MTP-131; bendavia) is a synthetic cardiolipin-targeting tetrapeptide that selectively concentrates in the inner mitochondrial membrane through electrostatic interaction with cardiolipin, where it stabilizes cristae ultrastructure, preserves electron transport chain assembly, and reduces mitochondrial reactive oxygen species production to protect against ischemic and metabolic mitochondrial injury. By binding cardiolipin at the inner mitochondrial membrane, SS-31 maintains the protein-lipid interactions required for efficient electron transport chain supercomplex formation, preserving cytochrome c association with complexes I–IV, reducing electron leak, and sustaining the proton gradient required for ATP synthase activity — thereby protecting energy production in cardiomyocytes, neurons, and renal tubular cells under ischemic or oxidative stress. A randomized, placebo-controlled trial published in Circulation Heart Failure demonstrated that elamipretide improved cardiac function in patients with heart failure with reduced ejection fraction, and a Phase 2a trial published in Circulation Cardiovascular Interventions provided additional human evidence of mitochondrial protection in the context of renal artery stenosis revascularization. On 19 September 2025 the FDA granted accelerated approval to Forzinity (elamipretide) injection, the first treatment for Barth syndrome, for patients weighing at least 30 kg, administered subcutaneously once daily; the approval was granted to Stealth Biotherapeutics Inc. The accelerated approval is based on improved strength of the muscle used to straighten the leg at the knee — a measure the FDA considers reasonably likely to predict patient benefit but which does not directly assess that benefit — and as a condition of approval the FDA is requiring a post-approval randomized, double-blind, placebo-controlled trial to confirm that this translates into patient benefit. The application received priority review, and Forzinity was granted a rare pediatric disease designation. The most common side effects identified in clinical trials were mild-to-moderate injection site reactions; serious reactions have also been reported. This approval is specific to Barth syndrome: elamipretide is not FDA-approved for heart failure, primary mitochondrial myopathy, or geographic atrophy, and research-grade "SS-31" offered by research-chemical vendors is not the approved product and is not a substitute for it. Regulatory status verified against FDA sources on 25 July 2026.

105 listings · 50 vendors · updated 28 Sept 2026 · how prices are computed · educational only, not medical advice