1-Oxa-2,7-diazaspiro[4.4]non-2-ene-8-carboxamide,7-[(2S)-2-[(2-cyclohexylacetyl)amino]-3,3-dimethyl-1-oxobutyl]-N-[(1S)-1-[2-(cyclopropylamino)-2-oxoacetyl]butyl]-3-[3,5-dimethyl-4-(1-methylethoxy)phenyl]-, (5S,8S)-