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After symptoms resolve, a slower re-escalation can be attempted, perhaps increasing by smaller increments than the standard protocol specifies

Is the acetate salt of a synthetic cyclic heptapeptide with the sequence cyclo-(Ac-Nle4-cyclo[Asp5-His6-D-Phe7-Arg8-Trp9-Lys10])-NH2, representing a conformationally constrained, metabolically stabilised derivative of the -MSH(4-10) pharmacophore core in which the Asp5 and Lys10 side chains are bridged by a lactam bond to form the cyclic backbone, Nle4 replaces methionine to prevent oxidative inactivation, and D-Phe7 replaces native phenylalanine to confer endopeptidase resistance and stabilise the receptor-binding pharmacophore conformation

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