Intranasal Midazolam (Nayzilam®) Spray

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Midazolam (mih-day-zoh-lam) is the generic name for Nayzilam®. This medicine is a fine mist that is given through the nose and is absorbed quickly. It works in the brain to stop cluster and prolonged seizures. Cluster seizures happen close together. Prolonged seizures last more than 5 minutes. The seizures should stop within 5 minutes after giving the medicine.

Warning

If your child is allergic to midazolam, don’t give them this medicine. See the signs of an allergic reaction on page 3 in “When to Call 911.”

The midazolam medicine device

Giving This Medicine

  • Don’t remove the medicine from the packaging
    until it’s needed.
  • Midazolam is given in the nose (intranasally).
  • The nasal spray device of midazolam has a nozzle, finger grips, and a plunger (Picture 1).
  • The nasal spray device can only be used one time. Do not test or prime it before use. You will lose the dose.
  • Read the label carefully. Make sure you’re giving the right dose of the right medicine.
  • Stay with your child until the seizure stops.
  • Midazolam does not replace your child’s other medicines. Do not stopgiving their other medicines without talking to their doctor or health care provider.

How to Give

  1. When ready to use, hold the package in the palm of your hand. On the foil backing, find the ‘Peel Here’ tab and pull down (Figure 1).
  2. Remove the nasal spray device carefully.
  3. If your child has a runny nose, clean it before giving the medicine.
  4. Hold the nasal spray device with your thumb on the plunger and your middle and index fingers on each side of the nozzle (Figure 2). Do NOT press down.
  5. Hold your child’s head steady with your free hand. Place the tip of the nozzle into 1 nostril until your fingers on either side of the nozzle touch the bottom of the nose (Figure 3).
  6. Press the plunger firmly to give the dose of nasal spray (Figure 4).
  7. The person does NOT need to breathe deeply when you give them the medicine.
  8. If the directions are to place one spray in each nostril, follow the instructions above using a new nasal spray unit in the other nostril.

Possible Side Effects.

  • Sleepiness
  • Headache
  • Easily upset (agitation)
  • Nausea
  • Stuffy nose
  • Dizziness
  • Nasal irriation
  • Breathing Changes

When to Call the Doctor

Call your child’s doctor or health care provider if any side effects continue or cause problems. If you have any questions, be sure to ask the doctor, nurse, or pharmacist.

When to Call 911

Stay and watch your child after giving them this medicine.

Call 911 if:

  • Your child has any of these signs of an allergic reaction:
  • Trouble breathing
  • Swelling of the tongue, hands, feet, or ankles
  • Your child has a seizure that lasts more than 5 minutes after giving midazolam.
  • Your child has seizures that are more severe or happen more than before.
  • Your child’s color is gray or blue, and their breathing is shallow.
  • There is another problem that bothers you.
  • Your child’s doctor or health care provider tells you to.

Storage and Disposal

  • Always keep medicine in the original container from the pharmacy.
  • Do not keep this medicine in the refrigerator. Store it at room temperature.
  • If you carry medicine in a purse or bag, keep it out of the reach of children and pets.
  • Do not use this medicine after the expiration date printed on the packaging.
  • Throw away (dispose of) the nasal spray unit and package after it has been used.
  • Throw away expired medicine or medicine that’s no longer needed at a medicine return bin. You can find these at rxdrugdropbox.org.

Nasal Midazolam (Nayzilam®) Spray (PDF), Intranasal Midazolam (Nayzilam®) Spray (Nepali) (PDF), Intranasal Midazolam (Nayzilam®) Spray (Somali) (PDF), Intranasal Midazolam (Nayzilam®) Spray (Spanish) (PDF)

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