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There is currently no established pharmacological mechanism by which tirzepatide would be expected to cause or exacerbate RLS symptoms

10.1126/scitranslmed.3007653 Sci

Bacteriostatic water is generally restricted to intramuscular, subcutaneous, or intravenous routes where small amounts of benzyl alcohol are well-tolerated in adults

Prior to the ITC experiments, concentrated ShD14, ShHTL1, ShHTL4, and ShHTL7 were exchanged into a buffer consisting of 20 mM HEPES (pH 8.0) and 150 mM NaCl to remove dithiothreitol and were then adjusted to a final concentration of 150 M

In these cases, switching to semaglutide may be an option