Key references include the Stark et al
This channel is especially significant in markets where GLP-1 receptor agonists are first introduced during inpatient or specialty outpatient consultations

Contact your healthcare provider if you experience: Severe or expanding redness erythema extending beyond 2-3 inches from the injection site or worsening after 48 hours Signs of infection increasing warmth, purulent drainage, fever, or systemic symptoms suggesting cellulitis or abscess formation Persistent nodules or lumps firm masses that do not resolve within several weeks may indicate lipohypertrophy or sterile abscess Widespread rash or hives urticaria beyond the injection site suggests possible systemic hypersensitivity Angioedema swelling of the face, lips, tongue, or throat, which may indicate a serious allergic reaction requiring emergency care Blistering or skin breakdown vesiculation or ulceration at injection sites is abnormal and requires evaluation Seek immediate emergency care (call 911 or go to the nearest emergency department) for: Difficulty breathing, wheezing, or throat tightness Rapid onset of generalized urticaria or angioedema Dizziness, syncope, or signs of anaphylaxis Severe, persistent abdominal pain (may radiate to the back) with or without vomiting (to exclude pancreatitis) If you suspect a serious hypersensitivity reaction, discontinue tirzepatide immediately and seek urgent medical care

A single expired dose is unlikely to cause immediate harm, but you may experience reduced appetite suppression and weight loss results
J Clin Endocrinol Metab (1994) 79(6):18716.10.1210/jcem.79.6.7527416 232 ScharfJRamadoriGBraulkeTHartmannH
Kaur H, Bose C, Mande SS