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Longevity · Compound

SS-31 (elamipretide) in the Philippines

Elamipretide, a mitochondria-targeted tetrapeptide that binds cardiolipin in the inner mitochondrial membrane, studied in phase 2 and phase 3 trials in rare mitochondrial disease.

Philippines Peptides editorial deskUpdated Trial data checked 23 September 202610 min read

The strongest evidence found for SS-31 comes from phase 3 human trials, and every finding below carries its evidence level.

What is SS-31

SS-31, also known by its international nonproprietary name elamipretide, is a synthetic peptide of four amino acids. It was developed by Hazel Szeto and Peter Schiller, and SS stands for Szeto-Schiller. The research datasets class it as a mitochondria-targeted tetrapeptide. Browse the full peptide library for related longevity compounds.

SS-31 in the Philippines is sold as a research vial, not as a registered medicine. Its human evidence comes from trials in primary mitochondrial myopathy and Barth syndrome, rare inherited diseases of the mitochondria, and from earlier phase 2 work in heart failure. The evidence dataset rates elamipretide at "Phase 3 human" (checked 3 November 2026): One completed phase 3 trial, MMPOWER-3 (218 adults with primary mitochondrial myopathy, 24 weeks), which missed both primary endpoints, and the phase 2/3 TAZPOWER crossover in 12 people with Barth syndrome, which did not show a significant difference from placebo on its primary endpoints.

Two other compounds in the same part of the library work by different routes: MOTS-c is a peptide encoded in mitochondrial DNA, and NAD+ is a coenzyme of cellular energy metabolism. Each guide states its own evidence level.

How it works

Elamipretide, also called SS-31, is a four-amino-acid peptide that concentrates in mitochondria and binds cardiolipin, a phospholipid of the inner mitochondrial membrane. In rat and cell-free studies the bound complex blocked the peroxidase activity of cytochrome c and preserved mitochondrial structure after blocked blood flow.

Target: Cardiolipin, a phospholipid of the inner mitochondrial membrane. The binding and structure findings come from rat and cell-free studies (PubMed, checked 3 November 2026). They describe what the peptide does to mitochondria in those models, not an effect shown in healthy people.

Benefits studied

  • Walking distance in mitochondrial myopathy (not shown)

    Phase 3 human

    In MMPOWER-3, a phase 3 trial in adults with primary mitochondrial myopathy over 24 weeks, elamipretide did not significantly improve six-minute walk distance or the total fatigue score against placebo. Both primary endpoints were missed. Source: Karaa A et al. Neurology 2023 (MMPOWER-3), PubMed 37268435

  • Walking distance and fatigue in Barth syndrome (not shown)

    Phase 2 human

    In TAZPOWER, a phase 2/3 trial in males aged 12 and over with Barth syndrome over 28 weeks, the double-blind crossover part showed no significant difference from placebo on either primary endpoint. Source: ClinicalTrials.gov NCT03098797 (TAZPOWER)

  • Mitochondrial structure after blocked blood flow

    Animal and cell

    In rats with blocked blood flow to the kidney, SS-31 given beforehand preserved mitochondrial structure, and in cell-free work it bound cardiolipin. This is animal and cell evidence only. Source: Birk AV et al. J Am Soc Nephrol 2013, PubMed 23813215

Side effects reported

No human trial in the datasets reports adverse-event rates for Elamipretide, whose human evidence is limited to phase 3 human (2 completed randomised trials identified). Without controlled data, its safety in people is unknown rather than established.

The trial record, including the misses

MMPOWER-3 was a 24-week phase 3 trial of 218 adults with genetically confirmed primary mitochondrial myopathy. Its primary endpoints were change from baseline in six-minute walk test distance and in the Primary Mitochondrial Myopathy Symptom Assessment total fatigue score. Elamipretide missed both: neither improved significantly against placebo. It is the only completed phase 3 trial of elamipretide in the datasets this site reads (PubMed; registry NCT03323749; checked 3 November 2026).

TAZPOWER was a 28-week phase 2/3 trial of 12 participants (males aged 12 and over with Barth syndrome). Its primary endpoints were six-minute walk test distance and the Barth Syndrome Symptom Assessment total fatigue score, in a placebo-controlled crossover of two 12-week periods. The double-blind crossover part did not show a statistically significant difference from placebo on either primary endpoint (ClinicalTrials.gov NCT03098797, checked 3 November 2026). The US accelerated approval described below rests on a secondary measure from this trial, knee extensor muscle strength, and is conditional on a confirmatory trial. On safety, the results posted for TAZPOWER on ClinicalTrials.gov list injection-site reactions (redness, pain, hardening and itching) as the most frequent adverse events on elamipretide, more often than on placebo. The synced datasets hold no adverse-event rates by arm for either trial, so no rate is shown here.

Elamipretide was also studied in phase 2 programmes in heart failure. In PROGRESS-HF, a short phase 2 placebo-controlled trial in adults with heart failure with reduced ejection fraction, the change in left ventricular end-systolic volume, its primary endpoint, did not differ significantly from placebo (J Card Fail 2020, PubMed 32068002, checked 3 November 2026). That trial is not in the synced trials dataset, so no figure from it is shown here. Nothing in the record above shows an effect of SS-31 on energy, ageing or exercise capacity in healthy adults, and no such claim is made here.

SS-31 in the Philippines

FDA Philippines: Not established: the FDA Philippines verification portal was not reachable when this SKU was added on 3 November 2026. No Philippine registration for elamipretide is on record here, checked 3 November 2026. No FDA Philippines advisory in this site's regulation dataset, checked 23 September 2026, names SS-31 or elamipretide. Registration is what separates a medicine a Philippine pharmacist can dispense from anything else on offer, so SS-31 in the Philippines is best treated as what it is sold as: a research compound.

US FDA: Approved under accelerated approval for Barth syndrome in patients weighing at least 30 kg (checked 3 November 2026). FDA press announcement, September 2025. The accelerated approval rests on knee extensor muscle strength in TAZPOWER, and FDA requires a confirmatory randomised, placebo-controlled trial. It covers the approved prescription medicine for its labelled use only, never a vial of the same substance sold for research use. Prescribing belongs with a licensed Philippine physician. A US approval for one rare disease does not make a research vial a medicine, here or in the United States.

Primara Labs is our partner and supplier. It lists SS-31 as "Lyophilized powder, 10 mg / vial". The legal research behind this site found no Philippine FDA, DOH, BOC or DDB document that addresses products labelled research use only. Primara has published no batch report for SS-31, so this page makes no testing or purity statement about it. For the cost per milligram of any vial, use the peptide cost calculator; this site publishes no dosing for SS-31.

Regulatory status

FDA Philippines
Not publishedNot established: the FDA Philippines verification portal was not reachable when this SKU was added on 3 November 2026.
US FDA
Approved under accelerated approval for Barth syndrome in patients weighing at least 30 kg.FDA press announcement, September 2025. The accelerated approval rests on knee extensor muscle strength in TAZPOWER, and FDA requires a confirmatory randomised, placebo-controlled trial. It covers the approved prescription medicine for its labelled use only, never a vial of the same substance sold for research use.
European Medicines Agency
Not publishedNot checked: the EMA medicines report was not read for this compound on 3 November 2026.
Next milestone
A confirmatory randomised, placebo-controlled trial in Barth syndrome, required by FDA as a condition of the accelerated approval

Checked 3 November 2026. Primary source

How Philippine registration and prescription rules work, and what an unregistered product is under the law, is covered in the regulation hub, and every compound's status side by side is on the status page. This is general information, not legal advice.

Everything above is research framing. For the material itself, our partner and supplier lists SS-31 10mg at Primara Labs for ₱2,210 (₱1,990 with 10% off), from stock inside the Philippines.

FAQ

What is SS-31?

SS-31, or elamipretide, is a synthetic four-amino-acid peptide developed by Hazel Szeto and Peter Schiller. Elamipretide, also called SS-31, is a four-amino-acid peptide that concentrates in mitochondria and binds cardiolipin, a phospholipid of the inner mitochondrial membrane. In rat and cell-free studies the bound complex blocked the peroxidase activity of cytochrome c and preserved mitochondrial structure after blocked blood flow.

Did elamipretide work in its phase 3 trial?

No. MMPOWER-3 was a 24-week phase 3 trial of 218 adults with genetically confirmed primary mitochondrial myopathy, and it missed both primary endpoints: change from baseline in six-minute walk test distance and in the Primary Mitochondrial Myopathy Symptom Assessment total fatigue score did not improve significantly against placebo (PubMed, checked 3 November 2026).

Is SS-31 approved anywhere?

Not in the Philippines. FDA Philippines: Not established: the FDA Philippines verification portal was not reachable when this SKU was added on 3 November 2026. No Philippine registration for elamipretide is on record here, checked 3 November 2026. US FDA: Approved under accelerated approval for Barth syndrome in patients weighing at least 30 kg (checked 3 November 2026). FDA press announcement, September 2025. The accelerated approval rests on knee extensor muscle strength in TAZPOWER, and FDA requires a confirmatory randomised, placebo-controlled trial. It covers the approved prescription medicine for its labelled use only, never a vial of the same substance sold for research use. That approval covers the prescription medicine for its labelled use only. Prescribing belongs with a licensed Philippine physician.

Is SS-31 legal to buy in the Philippines?

This site has no Philippine registration on record for SS-31 or elamipretide. DOH-FDA-BOC Joint Circular No. 1, dated 22 June 2015, lets travellers bring listed FDA-regulated products into the Philippines without prior FDA clearance if the products are for personal use and within set limits. For prescription drugs, Joint Circular No. 1 sets the allowed quantity as the amount stated on a prescription that carries the physician's PRC licence number or a foreign equivalent. Joint Circular No. 1 does not say whether its prescription-drug allowance covers drugs without a Philippine CPR. No FDA circular that answers this was found. The Bureau of Customs lists pharmaceutical products as regulated imports that require a valid Certificate of Product Registration and/or an FDA License to Operate as importer. This is general information, not legal advice.

How is SS-31 different from MOTS-c and NAD+?

They are different molecules. SS-31 is a synthetic tetrapeptide that binds cardiolipin in the inner mitochondrial membrane. MOTS-c is a peptide encoded in mitochondrial DNA, and NAD+ is a coenzyme. SS-31 is the only one of the three with a completed phase 3 trial, and that trial missed its primary endpoints. This page makes no claim that any of them is better than the others.

Is there a batch report for SS-31?

Primara Labs has published no batch report for SS-31, so this site makes no testing, purity or identity claim about it. Reports for other compounds are on the COA page.

Where to get SS-31 in the Philippines

The supply index covers what to ask a seller before paying, and why quoted prices vary so widely.

View Supply Index

Risk · Disclosure · Editorial Status

This page is editorial information for adults researching peptide therapy. It is not medical advice, not a prescription, and not an endorsement of any specific product, supplier, or protocol. Side effects can be serious and individual response varies. Talk to a licensed physician (ideally one with peptide-specific clinical experience) before starting any compound, adjusting a dose, or discontinuing therapy.

In the Philippines, GLP-1 medications are prescription-only under FDA Philippines regulation. Research-grade peptides occupy a regulatory gray area: import for personal research use is generally tolerated, but the Bureau of Customs reserves the right to inspect and detain shipments. Do not import for resale.

Editorial Status
Non-clinical
Affiliation
Not a clinic · Not a pharmacy
Last Updated
November 3, 2026

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