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Watch for: Unusual injection site reactions (excessive redness, swelling, pain, or injection site reactions beyond normal ) Gastrointestinal symptoms that seem disproportionate to your dose ( unexpected diarrhea , severe nausea, headaches ) Signs of inadequate blood sugar control (for diabetes patients) Allergic-type reactions (hives, difficulty breathing, rapid heartbeat) Most people who use recently expired tirzepatide experience nothing more than slightly reduced effectiveness