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The clinical dosage range spans 2.510 mg per subcutaneous injection, titrated over 4 weeks before reaching a maintenance dose of 510 mg, five times weekly

CPEO and carnitine deficiency overlapping in MELAS syndrome

Physiological oral mucosal melanin hyperpigmentation Physiological oral mucosal melanin hyperpigmentation manifests clinically as asymptomatic, single or multiple, well-demarcated or ill-defined patchy or uniform macules which range in colour from light to dark brown or black, and are of variable size and configuration

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This is why medical caution is advised and individual provider assessment is essential for your specific situation