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In about 1/10th of individuals with Epstein-Barr virus , Ross River virus , or Coxiella burnetti are more prone to develop symptoms meeting criteria for CFS (also known as post-infective fatigue syndrome), associated mainly with the severity of the infection

Patients with compromised liver function or those who are pregnant should exercise additional caution, as the risk of adverse effects may be heightened

The evidence-based starting dose of 0.25mg activates MC1R-mediated melanogenesis without oversaturating MC4R, allowing gradual receptor adaptation during titration