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Arbitrary limits invite appeals and frustration

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NA, Synonyms: , Chemical name: (3S,9S,12S,15S,18S,21S,24S,27S,30S,33S,36S,42S,45S,48S,51S,78R)-51-(((6S,12S,15S,18S,21S,24S,27S,30S,33S)-21-((1H-indol-3-yl)methyl)-1-amino-30-benzyl-27-((S)-sec-butyl)-35-carboxy-6-((carboxymethyl)carbamoyl)-12-(3-guanidinopropyl)-1-imino-18-isobutyl-15-isopropyl-24-methyl-8,11,14,17,20,23,26,29,32-nonaoxo-2,7,10,13,16,19,22,25,28,31-decaazapentatriacontan-33-yl)carbamoyl)-3-(2-((S)-2-amino-3-(1H-imidazol-5-yl)propanamido)-2-methylpropanamido)-42-(3-amino-3-oxopropyl)-12-benzyl-21-(carboxymethyl)-33-(4-hydroxybenzyl)-9,15-bis((R)-1-hydroxyethyl)-18,27,30-tris(hydroxymethyl)-36-isobutyl-24-isopropyl-45,48-dimethyl-4,7,10,13,16,19,22,25,28,31,34,37,40,43,46,49,57,66,75,80-icosaoxo-59,62,68,71-tetraoxa-5,8,11,14,17,20,23,26,29,32,35,38,41,44,47,50,56,65,74,79-icosaazahexanonacontane-1,78,96-tricarboxylic acid.

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The highest dose wins on paper, but only by 1.4 percentage points over 10 mg, while gastrointestinal side effects keep rising and discontinuation creeps up