Batch 001 - Live Allocation
Next Release: Aug 2026
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Compound Reference

MITOCHONDRIAL PROTECTANTApproved (Barth)

SS-31

Elamipretide · 10mg

Vial size
Status
Approved (Barth)
Route
SubQ / IV
Half-life
~2 hours plasma
Class
Synthetic tetrapeptide
MechanismCardiolipin Stabilization
Cohort48 active prescriptions
Educational reference only - not a prescription or dosing recommendation. Some compounds are investigational or used off-label; suitability, dose, and monitoring are determined by your supervising physician. See Informed Consent & Disclaimer.
V-Series Member
$85 USD/vial
À-la-carte: $95 USD/vial · Save 11%
Vials per allocation
Member total (1×)$85
À-la-carte total$95
Flat per-vial pricing. Quantity is allocated and dispensed within your physician-supervised protocol - not a direct sale.
What this is

Cardiolipin-binding peptide that stabilizes the inner mitochondrial membrane. Standalone 10mg vial; the V-04 longevity protocol uses the 50mg vial.

Elamipretide · 10mg per vial · dispensed after a physician review.

Janoshik Verified
HPLC + MS purity, every batch
Independent third-party lab
COA Per Batch
Lot-level certificates published
Labeled vs actual mg disclosed
Protocol Reviewed
Used in V-Series clinical stacks
Phase 1 supervision onboarding
SS-31 · Mitochondrial Protectant
◆ Certificate of Analysis · SS-31
JANOSHIK ANALYTICALHPLC + MS · Independent third-party
Batch 001 · lot VL-SS3-2026-07A

Every 100 units are drawn from one lot and tested once. The certificate below is the one that applies to this batch - when it closes, the next opens with a new lot and a new certificate.

Lot · SS-31-2026-07-30
99.759%
Labeled
10 mg
Actual (HPLC)
7.68 mg
Why actual differs from label
The 7.68 mg actual against a 10 mg label is a larger gap than Vivre’s other published lots. Labeled-vs-actual variance in lyophilized peptides is normally attributed to fill-weight tolerance at vialing, moisture loss during lyophilization, or recovery efficiency in the assay itself - this is exactly why Vivre publishes actual, not labeled, on every certificate. Purity (99.76%) measures what’s in the vial, not how much of it; dose accordingly from the actual figure, not the label claim.
Method
HPLC + MS
Tested
Jul 30, 2026
Endotoxin
not tested for this lot
Heavy metals
not tested for this lot
Verify independently at janoshik.com/verificationPurity - code DUJPS4ZVCR3Y
Clinical Overview
SS-31

SS-31 (Elamipretide, formerly MTP-131 / Bendavia) is a 4-amino-acid mitochondrially-targeted peptide that selectively accumulates in the inner mitochondrial membrane. FDA-approved September 2025 as Forzinity (Stealth BioTherapeutics) to improve muscle strength in genetically confirmed Barth syndrome at weight ≥30kg - the first FDA-approved mitochondria-targeted therapeutic.

That approval is accelerated, rests on an intermediate endpoint, and requires a confirmatory trial. It covers one ultra-rare genetic disease and no other indication.

Vivre does not dispense Forzinity; use in longevity/mitochondrial-support contexts such as V-04 is off-label and uses a research-grade compound, not the approved product.

Mitochondrial Structure
Binds cardiolipin; stabilizes inner-membrane cristae.
ETC Protection
Protects electron transport chain; reduces ROS.
Clinical Status
FDA-approved (Barth, 2025); aging use off-label, broad Phase 3 failed.
Mechanism
How It Works

Selectively binds cardiolipin in the inner mitochondrial membrane, stabilizing cristae structure and protecting electron transport chain function. Reduces ROS generation and improves ATP synthesis efficiency.

Selectively concentrates in damaged mitochondria.

Structural vs. signaling - how this peptide acts
SS-31 works structurally and fast: it reaches peak levels within roughly 30–60 minutes of a subcutaneous dose and clears from the blood within a couple of hours, but its effect on the cell - reinforcing the mitochondrial membrane - begins almost immediately and is physical rather than signal-based. Think of it as repairing the machinery itself. (Contrast with MOTS-c, which works by signaling.) How long any benefit persists after stopping, and whether to cycle at all, are physician decisions - Vivre does not publish a fixed schedule.
Patient Bloodwork Guide
Bloodwork for Longevity & Mitochondrial Protocols

Cellular / mitochondrial - SS-31, MOTS-c, Epithalon, NAD+, V-04

These protocols target cellular energy, mitochondrial function, and markers of biological aging. Monitoring here is less about week-to-week safety and more about confirming the protocol is moving the deeper markers it is meant to.

Incremental approach. V-04 is introduced in phases (structural support first, then signaling, then a short telomere overlay) at conservative doses. Re-testing at the 6-month mark is how progress is judged.

Biological-age markers
Horvath methylation clockAn epigenetic estimate of biological age - the headline longevity marker, retested over months.
Telomere lengthTracks cellular aging at the chromosome level.
Mitochondrial & oxidative
Lactate (fasting & post-exercise)Healthy mitochondria clear lactate quickly. A high or slow-clearing level suggests cells are leaning on less-efficient anaerobic energy; a downward trend over time points to improving mitochondrial efficiency.
Lipid-peroxidation markers (MDA, 4-HNE)Signals of oxidative damage to cell membranes. Relevant to SS-31, which works by protecting the mitochondrial membrane lipid (cardiolipin) - a fall in these markers is a sign that structural protection is taking hold.
Fasting insulin & HOMA-IRA measure of how efficiently muscle takes up glucose. Relevant to MOTS-c, which supports muscle glucose uptake via the AMPK pathway - improvement shows as lower fasting insulin and a lower HOMA-IR score.
8-OHdGA marker of oxidative stress / DNA damage.
CoQ10A cofactor your mitochondria use to move electrons and produce energy.
Functional capacity
VO₂max / Zone-2 thresholdThe functional read-out of mitochondrial fitness - measured during graded exercise testing. As mitochondria adapt, the point where your body shifts from burning fat to burning carbohydrate moves, reflecting better aerobic capacity. A physical metric, not a blood test.
Routine safety
Fasting glucose & CMPStandard metabolic and organ-function checks.
When the tests happen
BaselineHorvath clock, telomere length, 8-OHdG, CoQ10, lactate/pyruvate, CMP.
Through the protocolSymptom and energy tracking; routine glucose/CMP.
Month 6Repeat Horvath clock + key markers to judge progress.

Educational only - not medical advice or a dosing instruction. Your physician orders the tests, sets your dose, interprets results, and decides if a protocol is right for you. See the Informed Consent & Disclaimer for full terms.

Technical Profile
Measurable Properties
ClassMitochondria-targeted tetrapeptide (elamipretide-class)
Studied mechanismCardiolipin interaction; mitochondrial bioenergetic stabilisation
Human pharmacokineticsInvestigated in clinical trials (elamipretide); context-dependent
Evidence baseModerate - clinical trial programmes exist with mixed endpoint results
FormLyophilized powder, reconstituted under clinical protocol
Regulatory statusInvestigational; physician-supervised use only
Certificate of Analysis (per batch)
Analytical method: UHPLC-MS. Batch COA available on request - link to be populated per shipment.
COA link - pending per batch
Trial-stage; endpoint results mixed. Educational only; not a dosing instruction.
§
Clinical Literature
Peer-Reviewed References

Long-term efficacy and safety of elamipretide in patients with Barth syndrome: 168-week open-label extension of TAZPOWER

Thompson WR, et al. · 2024 · Genetics in Medicine 2024

Findings

TAZPOWER was a 28-week randomized, double-blind, placebo-controlled trial in Barth syndrome (a rare genetic mitochondrial disorder), followed by a 168-week open-label extension. Elamipretide (40mg SubQ daily) was well tolerated, with injection-site reactions the most common adverse event; Critically, the randomized phase FAILED its primary endpoints - it did not significantly improve 6-minute walk distance or total fatigue score versus placebo. Knee extensor muscle strength improved during the open-label extension, and it was that intermediate clinical endpoint - not the randomized primary endpoints - on which the FDA granted accelerated approval (September 2025), explicitly accepting more uncertainty than it would for a commoner disease. Continued approval is contingent on a required confirmatory trial (SPIBA-401, NCT07531251). Small population: 12 randomized, 10 entered the extension, 8 reached week 168 - a rare-disease dataset, not a broad-population trial.

View on publisher

Efficacy and Safety of Elamipretide in Individuals With Primary Mitochondrial Myopathy: The MMPOWER-3 Randomized Clinical Trial

Karaa A, et al. · 2023 · Neurology 2023;100:e1313–e1326

Findings

Pivotal Phase 3 RCT (N=218) of elamipretide 40mg/day SubQ vs placebo over 24 weeks in genetically confirmed primary mitochondrial myopathy. The trial did NOT meet its primary endpoints - no significant difference vs placebo on the 6-minute walk test or total fatigue score. A post-hoc nuclear-DNA-defect subgroup showed 6MWT improvement, described by the authors as hypothesis-generating, not confirmatory. The key honesty point: strong preclinical and rare-disease (Barth) data did not translate to this broader population.

View on publisher

Phase 2a Clinical Trial of Mitochondrial Protection (Elamipretide) During Stent Revascularization in Patients With Atherosclerotic Renal Artery Stenosis

Saad A, Herrmann SMS, Eirin A, et al. · 2017 · Circ Cardiovasc Interv 2017;10(9):e005487

Findings

KIDNEY - this is the complete human renal dataset, and it is small and old. Phase 2a, 14 patients total (6 elamipretide, 8 placebo), given as an intravenous adjunct before and during stent revascularization for atherosclerotic renal artery stenosis. At 3 months, estimated glomerular filtration rate increased more in the elamipretide arm (P=0.003) and systolic blood pressure fell. A single procedural-adjunct study from 2017 - not a chronic kidney disease trial. There is no ongoing kidney programme: the sponsor's live pipeline is primary mitochondrial myopathy and dry age-related macular degeneration. No renal indication is approved anywhere, and elamipretide cannot be prescribed for kidney protection outside a trial.

View on publisher

The mitochondrial-targeted compound SS-31 re-energizes ischemic mitochondria by interacting with cardiolipin (mechanistic basis)

Szeto HH, Birk AV, et al. · 2014 · J Am Soc Nephrol / Br J Pharmacol (foundational mechanism)

Findings

Foundational mechanistic and preclinical work establishing that SS-31 selectively binds cardiolipin on the inner mitochondrial membrane, stabilizing cristae structure, reducing reactive oxygen species, and restoring electron transport chain function. Preclinical models across muscle aging, ischemia-reperfusion (kidney), and neurodegeneration showed rapid restoration of mitochondrial energetics. These are animal/mechanistic findings - the basis for the human program, not human outcome evidence themselves.

View on publisher
SS-31 (elamipretide) has the most consequential evidence arc of Vivre's mitochondrial compounds, and Vivre presents it honestly in both directions. It is FDA-approved (September 2025) for Barth syndrome, a rare genetic mitochondrial disorder - that approval is narrow and specific. The approval is also narrower than it sounds: the randomized TAZPOWER phase MISSED its primary endpoints, and approval rested on knee extensor muscle strength - an intermediate endpoint - seen in the open-label extension, with continued approval contingent on a confirmatory trial. Its broad Phase 3 trial in primary mitochondrial myopathy (MMPOWER-3) also did NOT meet its primary endpoints, and the muscle-aging / endurance / neuroprotection data remain preclinical (animal). On kidney: the entire human renal dataset is one 14-patient Phase 2a from 2017 in which elamipretide was an IV adjunct during renal-artery stenting - there is no ongoing kidney programme and no renal indication is approved anywhere. Within V-04, SS-31 is used off-label for mitochondrial support; this is not the approved Barth indication and is not supported by a positive broad-population human outcome trial. Safety across trials has been favourable, with mild injection-site reactions the most consistent adverse event. Allocation under physician supervision with explicit informed consent addressing the off-label, evidence-tiered status.
Clinical Applications
Indications
  • Barth syndrome, weight ≥30kg (the only FDA-approved indication)
  • Mitochondrial support - off-label, e.g. V-04 longevity protocol
  • Kidney: NOT an indication - investigational only; one 14-patient Phase 2a (2017) in renal artery stenosis, no ongoing programme
  • Primary mitochondrial myopathy (Phase 3 MMPOWER-3 did not meet primary endpoints)
  • Heart failure / dry-AMD (in development)
Pharmacokinetics
Half-Life & Duration of Action
Half-life is how long a compound stays at active plasma concentration in your body. Most peptides in this catalogue have short plasma half-lives - they clear from your bloodstream within hours, sometimes minutes. The long-half-life compounds in this catalogue are the approved-class incretins (Tirzepatide, Semaglutide, Retatrutide), which are designed for once-weekly dosing - that's the molecular engineering choice that makes weekly dosing work.
Plasma Half-Life
~2 hours plasma (single dose). Cardiolipin-stabilising effects persist longer through mitochondrial membrane incorporation.
Why this matters for you
If you don't tolerate a compound or need to discontinue a protocol, short-half-life peptides are out of your bloodstream within hours - not days or weeks. That said, the biological effects they initiate (tissue repair signalling, mitochondrial signalling, gene expression changes) often persist longer than the peptide itself, through downstream cellular cascades. This is normal peptide pharmacology and is important context - the molecule clears fast, but the biology takes longer to wind down.
Evidence Base
FDA-approved for Barth syndrome (2025). Broad primary-mitochondrial-myopathy Phase 3 (MMPOWER-3) failed its primary endpoints; muscle-aging and neuroprotection data are preclinical. Favourable safety profile (mild injection-site reactions most common). Off-label use under physician oversight.
Dosing protocols, administration frequency, and titration schedules are physician-determined at consultation - not published on these public pages. Vivre maintains a separate internal clinical reference for treating physicians.
Commonly Paired
Compounds Often Prescribed With SS-31
Clinical co-allocation patterns observed in Vivre's allocation history. Pairings are not prescriptions - the physician determines suitability per patient at consultation.
Metabolic Signaler
MOTS-c
Mitochondrial-Derived Peptide · 10mg
◆ mitochondrial pair
SS-31 and MOTS-c pair structural and metabolic mitochondrial support - SS-31 stabilises the inner membrane and cardiolipin to restore electron-transport efficiency, while MOTS-c drives AMPK-mediated biogenesis and metabolic signalling. Both sit in the V-04 longevity protocol. The pairing is a mechanistic rationale, not a trial-validated stack; physician-determined.
View MOTS-c detail →
Pineal Regulator
Epithalon
Tetrapeptide · 10mg
◆ longevity trio
Completes Vivre's V-04 mitochondrial-longevity triad with Epithalon's pineal-axis regulation.
View Epithalon detail →
READY TO PROCEED

Start with the Biological Audit

SS-31 is verified and lot-tested, dispensed following a Biological Audit. The Audit is complimentary for the Batch 001 cohort.

$85 USD/vial
SS-31 · Member rate
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DEMO SITE - PRESENTATION PURPOSES ONLY. All protocols verified and lot-tested, dispensed after comprehensive medical evaluation. Compounds sourced from registered cGMP compounding pharmacies. Individual results vary. MSO structures and revenue models are illustrative for partner conversations. Regulatory outcomes reference publicly disclosed FDA processes and are anticipated but not guaranteed.

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