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The opened-vial window can never run past the printed expiration date, and any vial that stops looking perfectly clear gets discarded no matter what the calendar says

If foam appears, set the vial aside for 15 minutes and let it settle before checking clarity

Injection technique for back pain Subcutaneous injection remains the standard administration route for most back pain peptides

Check also whether tirzepatide needs refrigeration and how long tirzepatide lasts in the fridge for specific timelines

Dig Dis Sci 2019

Room temperature vs refrigerated after puncture: USP guidance describes the 28-day window under controlled room temperature conditions