Intranasal Midazolam (Versed®) :: Nationwide Children's Hospital

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Intranasal Midazolam (Versed®) – Prefilled Syringe

Midazolam (mid AZ o lam) is the generic name for Versed®. Midazolam is given through the nose and is absorbed quickly. This medicine is used for both cluster and prolonged seizures. It works in the brain to help stop seizures. Cluster seizures are seizures that happen close together. Prolonged seizures are seizures that last more than 5 minutes. During a seizure, it can be hard to give your child medicine in his or her mouth. The seizures should stop within 5 minutes after giving the medicine.

Picture 1: Using the MAD device

Giving this medicine

  • Read the label carefully and make sure you are giving your child the right dose of the right medicine.
  • Stay with your child until he or she has received the dose of medicine.
  • Midazolam is given through the nose. You will have a syringe filled with midazolam and a Mucosal Atomization Device (MAD), also known as an atomizer.
  • The atomizer creates a fine spray to give the medicine into your child’s nose.

If using ONE prefilled syringe – do the following:

How to prepare the medicine

  1. Remove tip cap from the midazolam syringe by twisting off. Discard tip cap.
  2. Attach the atomizer to the syringe using a twisting motion. If needed, press in the plunger to discard some medicine to get to the prescribed TOTAL dose.

How to Give this Medicine

  1. If your child has a runny nose, clean the nose before giving the medicine.
  2. Hold the child’s head steady with your free hand. Insert the head of the atomizer into one nostril snugly. (Picture 1)
  3. Quickly press in the plunger to deliver HALF the dose into that nostril.
  4. Insert the atomizer head into the other nostril.
  5. Quickly press the plunger fully to deliver the other half of the dose.

If using TWO prefilled syringes - do the following:

How to prepare the medicine

  1. Remove tip cap from both midazolam syringes by twisting off. Discard tip caps.
  2. Attach an atomizer to each syringe using a twisting motion.

How to give this medicine

  1. If your child has a runny nose, clean the nose before giving the medicine.
  2. Hold the child’s head steady with your free hand. Insert the head of the atomizer of one of the syringes into one nostril snugly (Picture 1).
  3. Quickly press in the plunger to deliver the full syringe into the nostril.
  4. Insert the atomizer head of the second syringe into the other nostril.
  5. Quickly press in the plunger to deliver the full syringe into the nostril.

Medicine storage

  • Store all medicine out of the reach of children.
  • Always keep medicine in the original container from the pharmacy.
  • Do not keep this medicine in the refrigerator. Store at room temperature.
  • Keep this medicine away from heat or direct sunlight.
  • Do not use this medicine after the expiration date printed on the container.

WARNING

If your child is allergic to midazolam, he or she should not take this medicine.

Possible side effects

  • Sleepiness
  • Nausea
  • Nasal irritation
  • Dizziness
  • Stuffy nose
  • Headache
  • Agitation
  • Breathing changes

When to call the doctor

Call your child's doctor if he or she is having any side effects that continue or are very bothersome.

If you have any questions, be sure to ask your child's doctor, nurse or pharmacist.

When to call for emergency help

Stay and watch your child after giving this medicine.

Call for emergency help if:

  • Seizures are more severe or happen more than before.
  • Your child’s color is gray or blue and his breathing is shallow.
  • There is another problem that concerns you.
  • As directed by your child’s provider.

Miscellaneous

  • Ask your child’s provider or pharmacist for an extra dose of medicine if the child’s daycare provider or school will be giving this medicine.
  • Some pharmacies may not have this medicine or the atomizer. Please ask your child’s nurse to call the pharmacy before you leave the hospital to see if they have this medicine or need to order it for him or her. You may also have the prescription filled at one of our Nationwide Children's Hospital Outpatient Pharmacies.

Other advice about the medicine

  • Tell your child's doctor and pharmacist if your child has a strange or allergic reaction to any medicine.
  • If you carry medicine in your purse, keep it in its childproof vial and keep your purse out of the reach of children.
  • Bring all your child's medicines with you in the original containers whenever the child sees a doctor, goes to an emergency room or is admitted to the hospital. This helps providers who may not know your child.
  • Do not change the amount given without first talking with your child's provider or pharmacist. This dose is specific for your child.
  • The provider has prescribed this medicine for your child only. Do not give it to anyone else.
  • If your child takes too much of this medicine, or if someone else takes this medicine, first call the Central Ohio Poison Center at 1-800-222-1222 (TTY 866-688-0088). They will tell you what to do.

Intranasal Midazolam (Versed®) – Prefilled Syringe (PDF)

HH-V-239 2/93 Revised 6/16 Copyright 1993, Nationwide Children’s Hospital

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