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A Novel, Widespread Impurity in Mass-Compounded Tirzepatide/B12 Products: Patient Safety Implications

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Concurrent administration with cysteine or N-acetylcysteine enhances hepatic sulfate production, which could alter acetaminophen metabolism and should be considered when treating patients with chronic pain requiring frequent analgesia

The following formula illustrates the relationship: Concentration (mg/mL) = Vial content (mg) Volume of bacteriostatic water added (mL) Illustrative examples: 2 mg vial + 1 mL bacteriostatic water = 2 mg/mL 2 mg vial + 2 mL bacteriostatic water = 1 mg/mL 5 mg vial + 2 mL bacteriostatic water = 2.5 mg/mL Note that the concentrations in the examples above differ from one another