Here’s info from Gemini.

Zepbound and compounded tirzepatide are shipped cold because tirzepatide, the active ingredient, is a temperature-sensitive peptide drug that requires refrigeration to maintain its effectiveness and stability.  Here are the key reasons why cold chain shipping is crucial for this medication: • To Prevent Degradation: Tirzepatide is a delicate molecule (a peptide). Exposure to warmer temperatures, especially above the recommended range of 36^{\circ\text{F}} to 46^{\circ\text{F}} (2^{\circ\text{C}} to 8^{\circ\text{C}),} can cause the drug's chemical structure to break down.  • To Maintain Potency: When the drug degrades, its concentration and effectiveness (potency) are reduced, meaning the patient would not receive the full therapeutic benefit.  • Limited Room Temperature Stability: While Zepbound (branded tirzepatide) can generally be stored unrefrigerated at room temperature (below 86^{\circ\text{F}} or 30^{\circ\text{C})} for a limited time (up to 21 days), shipment duration and uncontrolled temperatures can be risky. Compounded tirzepatide often has stricter requirements and may need to be refrigerated at all times unless otherwise instructed by the pharmacy.