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A compounding pharmacy might produce tirzepatide in small batches without the controlled environment, stability testing, or contamination protocols that Eli Lilly's facilities maintain

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If fewer than 4 days have passed since your missed dose: Administer the missed dose as soon as you remember Resume your regular weekly schedule from that injection No dose adjustment is necessary Ensure at least 72 hours (3 days) elapse between doses if this changes your weekly injection day If 4 or more days have passed since your missed dose: Skip the missed dose entirely Administer your next dose on the next regularly scheduled day Do not double up or take extra medication to "catch up" Resume your normal weekly injection schedule This four-day threshold is specified in the FDA Prescribing Information to maintain therapeutic drug levels while avoiding potential overlap of doses