How to Draw Compounded Tirzepatide from a Vial

Gather the following supplies before beginning your injection:

Your compounded tirzepatide vial (check the concentration on the label) A new, sterile U-100 insulin syringe (appropriate size for your unit count) Alcohol swabs (at least two — one for the vial stopper, one for the injection site) A sharps disposal container

Before drawing, calculate or confirm your unit count using the formula: units = (dose in mg / concentration in mg per mL) x 100. Write it down or check it against your dosage chart. Know exactly how many units you need before touching the syringe.

Step 1: Wash your hands thoroughly with soap and water for at least 20 seconds.

Step 2: Clean the rubber stopper on the vial with an alcohol swab. Let it air dry for a few seconds. Do not blow on it or wipe it dry.

Step 3: Remove the syringe from its sterile packaging. Pull the plunger back to draw air into the syringe equal to the number of units you plan to withdraw. For example, if you need 50 units, pull the plunger to the 50-unit mark.

Step 4: With the vial upright on a flat surface, insert the needle straight through the center of the rubber stopper. Push the plunger to inject the air into the vial. This air replacement prevents a vacuum from building inside the vial, which makes drawing easier.

Step 5: Without removing the needle, invert the vial so the stopper faces down and the needle tip is submerged in the liquid. Slowly pull the plunger back to your target unit mark.

Step 6: Check for air bubbles in the syringe barrel. If you see any, tap the side of the syringe firmly with your finger to move the bubbles toward the needle. Gently push the plunger to expel the bubbles back into the vial, then pull the plunger again to reach the correct unit mark.

Step 7: Verify the unit count one final time. The flat edge of the plunger's rubber tip (not the domed top) should align exactly with your target marking. Remove the needle from the vial.

Tirzepatide is injected subcutaneously — into the fatty tissue just beneath the skin. The three recommended injection sites are:

Abdomen: Anywhere on the belly except within two inches of the navel. The abdomen typically has the most subcutaneous tissue and is the most commonly used site. Avoid areas with scars, bruises, or stretch marks.

Thigh: The front or outer side of the upper thigh, at least four inches above the knee and four inches below the hip. Avoid the inner thigh.

Upper arm: The back or outer area of the upper arm. This site can be harder to reach for self-injection and may require assistance.

Rotate injection sites each week. Even within the same general area, vary the exact spot by at least one inch to prevent skin irritation, lumps, or lipodystrophy (changes in fat tissue).

Clean the chosen injection site with a fresh alcohol swab and let it air dry. Pinch a fold of skin between your thumb and forefinger to lift the subcutaneous tissue.

Insert the needle at a 90-degree angle (straight in) with a quick, firm motion. If you are using a short needle (5/16 inch) and have minimal subcutaneous tissue, a 45-degree angle may be more appropriate — ask your provider.

Slowly push the plunger all the way down until the syringe is empty. Hold the needle in place for five to ten seconds to allow the full dose to absorb and minimize leakage. Withdraw the needle at the same angle you inserted it.

If you see a small drop of blood or medication at the injection site, apply gentle pressure with a clean cotton ball or gauze. Do not rub the area. A small amount of bruising or a tiny drop of liquid at the surface is normal and does not mean the dose was lost.

Immediately place the used syringe in a sharps container. Never recap the needle, as this increases the risk of accidental needlestick injury. Do not throw used syringes in household trash or recycling.

Return the vial to the refrigerator. Check the beyond-use date on the label and note how many doses remain so you can plan your refill.

Record the date, dose (in mg and units), injection site, and any observations (such as bruising, redness, or discomfort) in a medication log. This information is valuable for your provider when evaluating your treatment progress and adjusting doses.

Common post-injection sensations include mild stinging, slight redness, or a small bump at the injection site. These typically resolve within minutes to hours. Contact your provider if you experience persistent pain, significant swelling, signs of infection (warmth, spreading redness, pus), or an allergic reaction (hives, difficulty breathing).