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The 28-day post-reconstitution timeline begins the moment you first mix tirzepatide with bacteriostatic water, regardless of how many injections you've taken from the vial

Plain sterile water contains no preservative once the septum is punctured, bacterial contamination risk increases with each use

One documented case showed a teenage athlete recovering from ACL reconstruction in 5-6 months rather than the projected 9-12 months

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