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Mn(III) is in a triangular bipyramidal coordination environment, in which one axial coordinate is water molecule, the other axial direction is occupied by the coordination group His-28, and the other three ligands His-83, His- 170 and Asp-166 are located on the equatorial plane

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The compounded tirzepatide chart starts at 1.5 mg twice weekly (3 mg per week) from the 12 mg starter vial and steps up monthly only if tolerated: 6 mg, 8.5 mg, 11 mg, 14 mg, then a 16.5 mg-per-week maintenance strength at month 6