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Usually only 1 - and the times when you would need 2, the second syringe would likely be a different formulation, or brand, of filler

A person who inherits a sickle hemoglobin gene from one parent and a normal hemoglobin gene from the other parent is said to have sickle cell trait

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Important storage note: Because this bottle allows more light exposure, store it in a cool, dark cabinet, drawer or closet when not in use

Our guide to tirzepatide with methylcobalamin covers this distinction in depth, and our cyanocobalamin tirzepatide guide covers the more common formulation