If your pen has been exposed to temperatures below freezing or above 86F for more than a few hours, chemical stability may be compromised even if the liquid still appears clear
When tirzepatide remains at room temperature beyond the recommended 21-day period or is exposed to temperatures exceeding 86F (30C), the primary concern is peptide degradation

Seek medical attention if you experience: Severe or persistent nausea and vomiting that prevents you from eating or drinking adequately, as this may lead to dehydration Severe abdominal pain , particularly if it radiates to the back, as this could indicate pancreatitis a rare but serious side effect of GLP-1 receptor agonists [1] [2] Signs of dehydration , such as dark urine, dizziness, dry mouth, or reduced urination Frequent hypoglycaemia (low blood sugar episodes), especially if you are also taking sulphonylureas or insulin Unexplained weight loss that seems excessive or concerning Visual changes or symptoms of diabetic retinopathy worsening, which should be monitored in patients with existing eye complications [1] [2] Allergic reactions , such as rash, itching, swelling, or difficulty breathing Upper right abdominal pain, fever or yellowing of the skin or eyes , which could indicate gallbladder problems Reduced urine output, swelling or confusion , which might suggest acute kidney injury Call 999 immediately if you experience severe chest pain, a severe allergic reaction (anaphylaxis) with breathing difficulties, or severe sudden abdominal pain with vomiting

The studies summarized below are presented with these contextual limitations made explicit