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Compounded tirzepatide is custom-made by a compounding pharmacy

Pharmacokinetics, pharmacodynamics, safety, and tolerability of a single-dose of NN2211, a long-acting glucagon-like peptide 1 derivative, in healthy male subjects

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This leads to big safety concerns

It is not licensed by the MHRA, is unavailable through NHS or regulated private prescribing, and there is no peer-reviewed clinical evidence supporting its use for building skeletal muscle

Mechanistically, delayed gastric emptying is due to cholinergic inhibition of parasympathetic outflow and nitric oxide (NO) release in a cAMP/PKA-dependent manner [37]