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If youre unsure about how long a pen has been out of the fridge, talk to your pharmacist

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hypoglycemia risk if on insulin) eGFR below 30 (tirzepatide exclusion in SURMOUNT-5) Recent cardiac event or NYHA Class IV heart failure Active suicidal ideation (trials excluded PHQ-9 scores of 15 or above) If your tirzepatide vs semaglutide question is pure weight loss without comorbidities, tirzepatide wins on the numbers

Even if you boil it, maintaining sterility during storage is impossible without proper containers and technique