Yes it could technically be used to replace PCS as they have the same main active. I think though sustain alpha also contains a weak AI. This technically would not allow it to fit into the OTC protocol because the reversetrol is used prior to adding in an AI in the last week of regular PCT. So it comes down to how close you are trying to follow the OTC protocol. I personally don't think it would be a huge deal to interchange the two because I question the strength of the AI in Sustain.
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