HealthRX.com · Printable symptom log
Quit-aid and Zepbound dose-step record: nausea, sleep and pulse
Agree a quit date and quit aid, then each week note your Zepbound dose, how much nicotine you still use, nausea, sleep changes and your resting pulse. The patch label's warnings and the EAGLES findings sit beside it for the conversation with your prescriber.
Before the quit date
Every nicotine product used nowcigarettes, vape, pouches, gum, patch
How much a day, and how soon after waking
Quit date agreed
Quit aid agreed, and its starting dose
Heart historyheart disease, recent heart attack, irregular heartbeat, high blood pressure
Zepbound dose on the quit date
Week by week after the quit date
| Week | Zepbound dose (mg) | Quit aid and dose | Nicotine still used per day | Nausea: none, mild or severe | Sleep: normal, insomnia or vivid dreams | Resting pulse |
|---|---|---|---|---|---|---|
From EAGLES and the two labels
- EAGLES: varenicline gave higher odds of confirmed quitting in weeks 9 to 12 than placebo (odds ratio 3.61), the nicotine patch (1.68) or bupropion (1.75).[1]
- EAGLES: the commonest side effect was nausea with varenicline (25%), insomnia with bupropion (12%) and abnormal dreams with the patch (12%).[1]
- Patch label: nicotine can raise heart rate and blood pressure; ask a doctor before use with heart disease, a recent heart attack, an irregular heartbeat or uncontrolled high blood pressure.[2]
- Patch label: vivid dreams or other sleep problems mean taking the patch off at bedtime.[2]
- Zepbound label: average heart rate rose by 1 to 3 beats per minute compared with placebo in the weight trials.[3]
Stop and ask, or call now
- Palpitations or an irregular heartbeat, or signs of too much nicotine such as nausea, vomiting, dizziness, weakness and a fast heartbeat: stop the patch and ask a doctor.[2]
- Severe stomach pain that will not go away, with or without nausea or vomiting: stop Zepbound and call your healthcare provider right away.[3]
- Nausea, vomiting or diarrhea that does not go away: tell your healthcare provider right away.[3]
For the prescriber
- Which quit aid fits best while my Zepbound dose is still rising?
- If nausea gets worse, how do we tell whether it is Zepbound, the quit aid or nicotine withdrawal?
- Should the quit date move away from a Zepbound dose increase?
- Is my resting pulse something to watch with my heart history?
- If I slip back to smoking, what should I tell you?
Sources for the facts on this sheet
- Anthenelli RM, Benowitz NL, West R, et al. Neuropsychiatric safety and efficacy of varenicline, bupropion, and nicotine patch in smokers with and without psychiatric disorders (EAGLES): a double-blind, randomised, placebo-controlled clinical trial. Lancet 2016. PMID 27116918. https://pubmed.ncbi.nlm.nih.gov/27116918/
- Haleon US Holdings, via DailyMed. NicoDerm CQ (nicotine transdermal system) stop smoking aid: Drug Facts. Effective 2025-07-14. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=93b2d1b9-83c1-40b5-b6af-90c38c8d6cef
- Eli Lilly and Company, via DailyMed. Zepbound (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-28. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.