Research & Reconstitution Library

SS-31 / Elamipretide BAC Water & Reconstitution Guide

SS-31, also known as elamipretide, is a mitochondria-targeted tetrapeptide that has been investigated for mitochondrial bioenergetics, mitochondrial myopathy, cardiovascular disease, ophthalmic disease and Barth syndrome. In the United States, elamipretide is now an FDA-approved prescription drug under the name Forzinity for improving muscle strength in patients with Barth syndrome who weigh at least 30 kg.

Quick research answer: There is no universal BAC-water volume that applies to every SS-31 research quantity. Concentration is determined mathematically by dividing the total peptide quantity by the liquid volume. For example, a mathematical 5 mg quantity corresponds to 5 mg/mL in 1 mL, 2.5 mg/mL in 2 mL, and 1 mg/mL in 5 mL. These are concentration calculations and should not be interpreted as instructions for administering elamipretide.
Compound SS-31 / Elamipretide
Compound Class Mitochondria-targeted aromatic-cationic tetrapeptide
Research Category Mitochondrial / Bioenergetics Research
FDA Status FDA approved for Barth syndrome
Human Evidence Multiple clinical trials
FDA Product Forzinity 280 mg / 3.5 mL
FDA Product Concentration 80 mg/mL
Last Reviewed September 10, 2026
Concentration Mathematics

How Much BAC Water for SS-31 / Elamipretide?

There is not necessarily one universal BAC-water volume for an SS-31 research quantity. The liquid volume selected determines the resulting mathematical concentration.

Total peptide quantity ÷ Liquid volume = Concentration

Adding more liquid produces a lower concentration, while adding less liquid produces a higher concentration, assuming the total peptide quantity remains constant.

Important distinction: These mathematical examples are not manufacturer-specific reconstitution instructions, clinical doses, injection volumes, or treatment recommendations.
SS-31 elamipretide mitochondrial research illustration Conceptual scientific illustration showing SS-31 elamipretide targeting the mitochondrial inner membrane and interacting with cardiolipin. SS-31 / Elamipretide mitochondria-targeted peptide research Cardiolipin interaction Research focuses on mitochondrial membrane structure and bioenergetics.
Figure 1. Conceptual illustration of SS-31 / elamipretide targeting mitochondrial membranes and interacting with cardiolipin. This is an educational schematic rather than a molecular structure rendering.
Mathematical examples

SS-31 / Elamipretide BAC Water Concentration Chart

The following table demonstrates the mathematical concentration resulting from different liquid volumes. The 5 mg, 10 mg and 20 mg quantities are calculation examples and are not claimed to be standardized commercial SS-31 vial strengths.

Peptide Quantity 1 mL 2 mL 2.5 mL 3 mL 5 mL
5 mg SS-31 5 mg/mL 2.5 mg/mL 2 mg/mL 1.67 mg/mL 1 mg/mL
10 mg SS-31 10 mg/mL 5 mg/mL 4 mg/mL 3.33 mg/mL 2 mg/mL
20 mg SS-31 20 mg/mL 10 mg/mL 8 mg/mL 6.67 mg/mL 4 mg/mL

Need a different vial quantity or liquid volume?

Use the BacScience Universal BAC Water Calculator for custom concentration calculations.

Open BAC Water Calculator

Calculation note: Concentration = total peptide quantity ÷ liquid volume. These calculations do not establish sterility, stability, compatibility, biological activity, clinical suitability, or an administration dose.

How Much BAC Water Should Be Added to SS-31 / Elamipretide?

There is no single BAC-water quantity that should be presented as a universal SS-31 reconstitution instruction. The answer depends on the starting quantity and the target concentration. The mathematical relationship is straightforward:

Total SS-31 quantity (mg) ÷ Liquid volume (mL) = Concentration (mg/mL)

How much BAC water for 5 mg of SS-31?

As a mathematical example, 5 mg divided by 1 mL produces 5 mg/mL; 5 mg divided by 2 mL produces 2.5 mg/mL; and 5 mg divided by 5 mL produces 1 mg/mL.

How much BAC water for 10 mg of SS-31?

For mathematical concentration purposes, 10 mg divided by 1 mL produces 10 mg/mL, while 10 mg divided by 2 mL produces 5 mg/mL and 10 mg divided by 5 mL produces 2 mg/mL.

How does BAC-water volume change SS-31 concentration?

Increasing liquid volume decreases the calculated concentration. Decreasing liquid volume increases the calculated concentration, assuming the total peptide quantity remains unchanged.

Important: FDA-approved Forzinity is a specific pharmaceutical formulation supplied as an 80 mg/mL sterile aqueous solution. It should not be confused with a hypothetical lyophilized research vial. The FDA-approved product therefore has product-specific formulation and administration instructions.
SS-31 concentration calculation illustration Mathematical visualization showing the same amount of SS-31 distributed in 1, 2.5 and 5 milliliters, producing different concentrations. Same Peptide Quantity • Different Concentration Example using 5 mg of SS-31 1 mL 5 mg/mL 2.5 mL 2 mg/mL 5 mL 1 mg/mL Concentration Formula Peptide quantity ÷ liquid volume = mg/mL
Figure 2. Mathematical visualization showing how changing liquid volume changes concentration while the total peptide quantity remains constant.
Concentration ≠ dose

Understanding SS-31 Concentration

Concentration and dose are different scientific concepts. Concentration describes how much compound exists per unit volume. Dose describes an amount administered to a subject within a defined experimental or clinical protocol.

Quantity

Total amount of peptide represented by a sample, expressed for example in mg.

Concentration

Amount of compound per volume, commonly expressed as mg/mL.

Dose

Amount administered within a specific research or approved clinical protocol.

Do not interchange these terms. A mathematical concentration does not determine a safe human dose, route, injection volume or treatment schedule.

What Is SS-31 / Elamipretide?

SS-31, also known as elamipretide, is a mitochondria-targeted aromatic-cationic tetrapeptide. Scientific literature describes the compound as a peptide that can localize to the inner mitochondrial membrane and interact with cardiolipin, a phospholipid that is particularly abundant in the inner mitochondrial membrane.

Research has examined whether this mitochondrial targeting can influence membrane organization, oxidative stress, ATP production, mitochondrial respiration and cellular bioenergetics.

SS-31 Elamipretide MTP-131 Mitochondrial peptide Cardiolipin Bioenergetics

How Does SS-31 / Elamipretide Work?

Molecular mechanism

Mitochondrial targeting

SS-31 is an aromatic-cationic peptide that can preferentially localize to mitochondria and associate with the inner mitochondrial membrane.

Membrane biology

Cardiolipin interaction

Research indicates that SS-31 interacts with cardiolipin and can alter membrane surface electrostatics and lipid packing under experimental conditions.

Bioenergetics

Mitochondrial function

Experimental studies have investigated ATP production, mitochondrial respiration, oxidative stress and mitochondrial membrane function following elamipretide exposure.

Evidence distinction: A proposed molecular mechanism does not automatically establish clinical efficacy. Human trials must be evaluated separately from molecular, cellular and animal experiments.

What Is SS-31 / Elamipretide Being Studied For?

FDA-approved indication

Barth Syndrome

FDA approved Forzinity (elamipretide) in 2025 to improve muscle strength in adult and pediatric patients with Barth syndrome weighing at least 30 kg.

FDA accelerated approval
Clinical research

Primary mitochondrial myopathy

Elamipretide has been evaluated in randomized trials of primary mitochondrial myopathy. The MMPOWER-3 Phase 3 study did not meet its primary endpoints for walking performance and fatigue.

Phase 3 evidence
Investigational research

Cardiovascular & ophthalmic disease

Studies have also evaluated elamipretide in heart failure, age-related macular degeneration and other conditions. These research indications should not be confused with the FDA-approved Barth syndrome indication.

Investigational

FDA Status of Elamipretide

FDA APPROVED — 2025

Forzinity (elamipretide)

On September 19, 2025, the U.S. Food and Drug Administration granted accelerated approval to Forzinity (elamipretide) as the first FDA-approved treatment for Barth syndrome in patients weighing at least 30 kg.

The approved indication is specifically to improve muscle strength in adult and pediatric patients with Barth syndrome weighing at least 30 kg. The approval was based on an intermediate clinical endpoint and requires confirmatory evidence of clinical benefit.

FDA labeling identifies Forzinity as a sterile aqueous solution containing 280 mg in 3.5 mL, equivalent to 80 mg/mL.

Important formulation distinction: FDA-approved Forzinity is supplied as an aqueous solution. It should not be represented as a generic lyophilized research vial that universally requires BAC-water reconstitution.

Human Clinical Research

Elamipretide has been evaluated in multiple human clinical programs. Importantly, outcomes differ by disease and trial. Evidence from one condition cannot automatically be transferred to another.

Study Population Dose Studied Route Duration Key Finding
MMPOWER-2 30 adults with primary mitochondrial myopathy 40 mg/day SC 4 weeks Primary 6MWT endpoint did not reach statistical significance; secondary symptom measures showed signals.
MMPOWER-3 218 adults with genetically confirmed PMM 40 mg/day SC 24 weeks Primary 6MWT and fatigue endpoints were not improved versus placebo.
HFrEF Phase 2 71 patients with HFrEF 4 or 40 mg/day SC 28 days No significant improvement in LV end-systolic volume.
TAZPOWER Patients with Barth syndrome 40 mg/day SC Multiple treatment periods Clinical development supporting the eventual FDA accelerated approval for Barth syndrome.
ReCLAIM Adults with dry AMD / geographic atrophy 40 mg/day SC 24–48 weeks depending on study Investigational ophthalmic research; not an FDA-approved indication.
Research-dose disclaimer: The doses in this table are doses reported in clinical research. They are not BacScience recommendations. The FDA-approved Forzinity dose applies specifically to its labeled Barth syndrome indication and should not be generalized to other conditions.

Doses Studied in Published Research

Elamipretide has been evaluated through several administration routes and dosing schedules. Examples include intravenous infusion studies, subcutaneous clinical trials and the current FDA-approved pharmaceutical formulation.

Human research

40 mg/day SC

This dose has been investigated in multiple subcutaneous clinical trials, including MMPOWER-2, MMPOWER-3 and Barth syndrome studies.

Cardiovascular research

4–40 mg/day

A Phase 2 heart-failure study compared subcutaneous elamipretide doses of 4 mg and 40 mg daily with placebo.

FDA product

80 mg/mL

FDA-approved Forzinity is supplied as a sterile aqueous solution at 80 mg/mL in a 280 mg/3.5 mL vial.

These are not interchangeable: a historical clinical dose, a pharmaceutical product concentration and a mathematical research concentration represent different concepts.

Preclinical & In-Vitro Research

Before and alongside clinical development, SS-31 was investigated in cellular, biochemical and animal models. These studies have examined mitochondrial respiration, membrane structure, oxidative stress, ATP production and tissue-specific mitochondrial function.

Cellular research

Mitochondrial membrane biology

Biophysical research has examined how SS-31 associates with lipid membranes and alters membrane electrostatics and lipid packing.

Bioenergetics

ATP & respiration

Research has examined mitochondrial ATP production, oxygen consumption, membrane potential and ADP sensitivity.

Animal research

Disease models

Animal models have investigated mitochondrial protection in conditions including ischemic injury, neurodegeneration, kidney disease and spinal cord injury.

Translation limitation: Cellular and animal findings are useful for understanding mechanisms and generating hypotheses, but they do not by themselves establish human efficacy or dosing.

SS-31 Research Reconstitution & Concentration

When a research sample is described by a total peptide quantity and a liquid volume, concentration can be calculated using the following equation:

Concentration (mg/mL) = Total SS-31 (mg) ÷ Liquid Volume (mL)

Worked mathematical examples

Example 1

5 mg ÷ 1 mL

5 mg/mL

Example 2

10 mg ÷ 2.5 mL

4 mg/mL

Example 3

20 mg ÷ 5 mL

4 mg/mL
Calculation limitation: This equation describes concentration only. It does not establish peptide purity, sterility, stability, compatibility, potency, biological activity or a safe route of administration.

BAC Water vs. SS-31 Concentration

More liquid

Lower concentration

More liquid distributes the same total peptide quantity through a larger volume, producing a lower mg/mL value.

Less liquid

Higher concentration

Less liquid distributes the same total peptide quantity through a smaller volume, producing a higher mg/mL value.

Total quantity

Does not change

Changing the mathematical liquid volume does not change the total amount of peptide represented by the starting quantity.

Calculate a custom SS-31 concentration

Enter your own peptide quantity and liquid volume.

Use BAC Water Calculator

Research Limitations & Safety

Approved pharmaceutical use is indication-specific

FDA approval of Forzinity does not mean that elamipretide is FDA-approved for every condition investigated in research. The approved indication is specifically improving muscle strength in patients with Barth syndrome who weigh at least 30 kg.

Clinical research does not equal a general treatment protocol

  • Different trials used different populations and endpoints.
  • Route and formulation varied among studies.
  • Results in primary mitochondrial myopathy cannot automatically be transferred to other diseases.
  • Historical experimental doses are not general dosing advice.
  • A mathematical concentration does not determine a clinically appropriate dose.
Research-use disclaimer: This BacScience page is intended to explain scientific literature and concentration mathematics. It does not prescribe elamipretide, recommend self-administration, or establish a treatment protocol.
Frequently Asked Questions

SS-31 / Elamipretide BAC Water FAQ

How much BAC water should be used for SS-31?
There is no universal BAC-water volume for every SS-31 research quantity. The appropriate mathematical volume depends on the desired concentration and starting quantity. Concentration is calculated by dividing peptide quantity by liquid volume.
How much BAC water for 5 mg of SS-31?
Mathematical examples include 1 mL producing 5 mg/mL, 2 mL producing 2.5 mg/mL, 2.5 mL producing 2 mg/mL, 3 mL producing approximately 1.67 mg/mL and 5 mL producing 1 mg/mL. These are concentration calculations, not administration instructions.
How much BAC water for 10 mg of SS-31?
Mathematically, 10 mg divided by 1 mL equals 10 mg/mL; 2 mL equals 5 mg/mL; 2.5 mL equals 4 mg/mL; 3 mL equals approximately 3.33 mg/mL; and 5 mL equals 2 mg/mL.
What is the SS-31 reconstitution formula?
For concentration mathematics: concentration in mg/mL = total peptide quantity in mg divided by liquid volume in mL.
Is SS-31 the same thing as elamipretide?
Yes. SS-31 is a name used for elamipretide, also known in development as MTP-131.
Is elamipretide FDA approved?
Yes. FDA granted accelerated approval to Forzinity (elamipretide) in September 2025 to improve muscle strength in adult and pediatric patients with Barth syndrome weighing at least 30 kg.
What concentration is FDA-approved Forzinity?
FDA labeling identifies Forzinity as a sterile aqueous solution containing 280 mg in 3.5 mL, equivalent to 80 mg/mL.
Does FDA-approved Forzinity need BAC-water reconstitution?
The FDA-approved Forzinity product is supplied as a sterile aqueous solution rather than a generic lyophilized powder requiring BAC-water reconstitution.
Has SS-31 been studied in humans?
Yes. Elamipretide has been studied in multiple human clinical trials involving conditions including primary mitochondrial myopathy, Barth syndrome, heart failure and age-related macular degeneration.
Did elamipretide work in the Phase 3 mitochondrial myopathy trial?
The MMPOWER-3 Phase 3 trial did not meet its primary endpoints for the six-minute walk test and total fatigue score at 24 weeks compared with placebo.
Does adding more liquid change the total amount of SS-31?
No. In a basic concentration calculation, changing liquid volume changes concentration but does not change the total starting quantity of peptide.
Where can I calculate a custom SS-31 concentration?
Use the BacScience Universal BAC Water Calculator for custom peptide quantities and liquid volumes.

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Scientific References

1
U.S. Food & Drug Administration — Forzinity (elamipretide) Prescribing Information
FDA-approved labeling identifying the indication, formulation and dosage form.
View FDA prescribing information
2
FDA — Accelerated Approval of Forzinity for Barth Syndrome
FDA announcement dated September 19, 2025.
View FDA announcement
3
Karaa et al. — MMPOWER-3 Randomized Clinical Trial
Neurology. 2023. Phase 3 randomized clinical trial of elamipretide in primary mitochondrial myopathy.
View PubMed record
4
Karaa et al. — MMPOWER-2
Randomized crossover trial of subcutaneous elamipretide in adults with primary mitochondrial myopathy.
View PubMed record
5
Daubert et al. — Elamipretide in Heart Failure
Randomized placebo-controlled study of elamipretide in heart failure with reduced ejection fraction.
View PubMed record
6
Elamipretide in Primary Mitochondrial Myopathy — Mechanistic / Mitochondrial Research
Research examining mitochondrial function, ATP production, ADP sensitivity and mitochondrial bioenergetics.
View PubMed record
7
Mitchell et al. — SS-31 and Mitochondrial Membranes
Biophysical research investigating SS-31 binding to lipid bilayers and mitochondrial membrane electrostatics.
View PubMed record
8
TAZPOWER / Barth Syndrome Clinical Research
Clinical research evaluating 40 mg/day subcutaneous elamipretide in Barth syndrome.
View PubMed record
9
Long-Term Barth Syndrome Elamipretide Research
Long-term open-label extension data from the TAZPOWER program.
View PubMed record

Last Scientifically Reviewed

September 10, 2026

This page was reviewed against current FDA information and published scientific literature concerning SS-31 / elamipretide, including FDA-approved Forzinity labeling, clinical trials and mechanistic mitochondrial research.

Scientific reviewer: BacScience Scientific Content Team
Content scope: Research education, concentration mathematics, regulatory status and scientific literature interpretation.