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There is no restriction on its availability in this form in the US, Philippines and Japan

Delayed refrigeration after delivery wastes some of the room temperature tolerance that protected the peptide during shipping

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Other options include pasireotide (which requires blood glucose monitoring due to hyperglycaemia risk), metyrapone , or ketoconazole (used off-label for Cushing's with liver function monitoring)

It is currently in Phase 3 for alcohol use disorder (the RENEW-ALC-1 and RENEW-ALC-2 trials, 1,100 patients each) and in earlier-stage development for bipolar disorder, major depressive disorder, smoking withdrawal, asthma, cardiovascular and liver disorders, and obesity