Comparison
Calcitonin (Lachs) vs. Elamipretide
Two peptides side-by-side — identity, evidence base, legal status and known adverse events.
Identity
Category
Research other
Research other
CAS no.
47931-85-1
736992-21-5
Molecular weight
3431.85 g/mol
639.8 g/mol
Half-life
1 h
no data
Sequence
Cys-Ser-Asn-Leu-Ser-Thr-Cys-Val-Leu-Gly-Lys-Leu-Ser-Gln-Glu-Leu-His-Lys-Leu-Gln-Thr-Tyr-Pro-Arg-Thr-Asn-Thr-Gly-Ser-Gly-Thr-Pro-NH2D-Arg-Dmt-Lys-Phe-NH2Mechanism of action
Calcitonin (Lachs)
Salmon calcitonin binds the calcitonin receptor, which is particularly densely expressed on bone-resorbing osteoclasts. The literature describes that receptor activation inhibits osteoclast activity and motility, thereby reducing bone resorption. This results in reduced release of calcium and phosphate from bone into the blood, which is regarded as the mechanistic basis for the calcium-lowering effect. The salmon variant binds the receptor more strongly and for longer than human calcitonin, which explains its higher potency. Central nervous system mechanisms are additionally discussed in relation to its pain effect in fractures, the basis of which is regarded in the literature as not fully elucidated.
Elamipretide
Elamipretide is a cell-permeable tetrapeptide with alternating aromatic and basic residues that selectively concentrates on cardiolipin — a phospholipid found almost exclusively in the inner mitochondrial membrane that is important for cristae curvature and the organisation of the respiratory-chain complexes. By binding cardiolipin, elamipretide is proposed to stabilise cristae architecture, support electron transport and ATP production, and reduce the formation of reactive oxygen species. These mechanistic models derive largely from cell and animal models and biophysical work; the extent to which they explain clinical efficacy in humans is, given the mixed trial results, a matter of ongoing research.
Evidence base
Highest evidence
Human RCT
Human RCT
Studies
4
4
of which in humans
4
4
Effects recorded
4
4
Open conflicts
1
1
Documented adverse events
2
1
Legal status
Full entries
Frequently asked questions
- What is the difference between Calcitonin (Lachs) and Elamipretide?
- Calcitonin (Lachs) is classified as "Research other", while Elamipretide is classified as "Research other". Calcitonin (Lachs): Salmon calcitonin is a synthetically produced 32-amino-acid peptide hormone that corresponds to the body's own calcitonin but exhibits higher biological potency than the human hormone. In the scientific literature it is studied in the context of inhibiting osteoclast-mediated bone resorption and lowering elevated calcium levels. It was historically broadly approved for the treatment of postmenopausal osteoporosis; following European safety reviews, however, its use was restricted. Elamipretide: Elamipretide (SS-31, MTP-131, formerly Bendavia) is a synthetic, mitochondria-targeting tetrapeptide (sequence D-Arg-Dmt-Lys-Phe-NH2) that binds cardiolipin on the inner mitochondrial membrane and is proposed to stabilise cristae structure and support mitochondrial bioenergetics. It was investigated clinically by Stealth BioTherapeutics across several indications, including primary mitochondrial myopathy, Barth syndrome, heart failure, and dry age-related macular degeneration (geographic atrophy). The trial record is mixed, with several pivotal studies missing their primary endpoints. In September 2025 elamipretide (brand name Forzinity) received accelerated FDA approval in the United States solely for the ultra-rare Barth syndrome; for all other investigated indications it remains investigational and it is not approved as a medicine outside the United States. This page contrasts both neutrally and source-based — with no usage or dosing recommendation.
- Which peptide is better supported by science, Calcitonin (Lachs) or Elamipretide?
- The highest available evidence level is "Human RCT" for Calcitonin (Lachs) and "Human RCT" for Elamipretide. A higher evidence level means more robust data, but says nothing about suitability for an individual. The full body of evidence is on each peptide's own page.
- What is the legal status of Calcitonin (Lachs) and Elamipretide in Germany and the United States?
- Germany: Calcitonin (Lachs) — Prescription, Elamipretide — Unapproved. United States: Calcitonin (Lachs) — Prescription, Elamipretide — Prescription. These are factual summaries with source and review date on the individual pages.