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The guidelines state, Anesthesiologists should recognize that these conditions can increase the likelihood of regurgitation and pulmonary aspiration and should modify these guidelines based upon their clinical judgment. A previous version states, The guidelines may not apply to, or may need to be modified for, patients with coexisting diseases or conditions that can affect gastric emptying or fluid volume (e.g., pregnancy, obesity, diabetes, hiatal hernia, gastroesophageal reflux disease, ileus or bowel obstruction, emergency care, or enteral tube feeding) and patients in whom airway management might be difficult. Requiring patients to abstain from food for longer than 8 hours, even if the optimal duration was unknown, would have been the most cautious approach, even if it was unenjoyable for patients

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References 1 Am J Clin Dermatol Afamelanotide: A Review in Erythropoietic Protoporphyria (Kim & Garnock-Jones, 2016)Reviews afamelanotide as a synthetic -MSH analogue and first-in-class MC1R agonist administered as a biodegradable 16 mg subcutaneous controlled-release implant

I couldnt find any scientific literature that could suggest the precise cycling durations, but considering how the peptide works, I think once you have gotten the gold-textured skin, to persist with the skin color, you may have to use your dose every 2 to 3 days