elamipretide + unfractionated heparin

Elamipretide (also known as SS-31 or MTP-131) is a first-in-class, mitochondria-targeting tetrapeptide that selectively binds to cardiolipin in the inner mitochondrial membrane. By stabilizing cardiolipin, it prevents its oxidation, promotes mitochondrial cristae structure, and optimizes the electron transport chain, thereby reducing reactive oxygen species (ROS) production and increasing ATP synthesis. Unfractionated heparin (UFH) is a heterogeneous mixture of sulfated glycosaminoglycans that acts as a rapid-onset anticoagulant by binding to and activating antithrombin III, which subsequently inactivates thrombin (Factor IIa), Factor Xa, and other proteases in the coagulation cascade. The combination of elamipretide and heparin has been investigated in clinical trials for acute cardiovascular conditions, such as ST-elevation myocardial infarction (STEMI), where elamipretide is intended to reduce ischemia-reperfusion injury during procedures requiring heparin-based anticoagulation. A critical clinical consideration for this combination is their physical incompatibility; elamipretide is a polycationic peptide and heparin is a polyanionic molecule, which leads to the formation of a white precipitate if they are mixed in the same intravenous line.

Other names

SS-31 + heparinMTP-131 + heparinBendavia + heparin