Intranasal Midazolam (Versed®) - Vial

Helping Hand Logo

Midazolam (MID-aye-zoe-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.

HHV227_Photo_1

How to give 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 vial of the medicine, a syringe, a needle or needleless access device and a Mucosal Atomization Device (MAD) (Picture 1).
  • The MAD creates a fine spray to deliver the correct amount of medicine into your child’s nose.

How to prepare the medicine

  1. Take the plastic wrap off the needleless access device, the syringe HHV227_Photo_2
    and the MAD.
  2. Put the open end of the needleless access device onto the tip of the syringe. Twist it to the right to lock it in place.
  3. Take off the cap from the vial of medicine and from the needleless access device.
  4. Pull back the plunger in the syringe to the number of milliliters (mL) needed for the dose of the medicine.
  5. Put the needleless access device into the rubber stopper of the
    medicine vial and turn it upside down.
  6. Push the plunger and pull it back to draw out the right amount of liquid.
  7. If there are air bubbles in the liquid in the syringe, tap
    the side of the syringe to bring the bubbles to the top. Push the plunger just enough to push the bubbles back into the vial. Pull the plunger back again to draw the right amount of the liquid drug into the syringe.
  8. Pull the needleless access device out of the vial of medicine. Put the cap back on it. Twist the top to the left to take off the needleless access device.
  9. Put the MAD on the syringe. Twist the large open end of the MAD onto the tip of the syringe.
  10. To give the medicine, hold your child’s head with one hand. Put the tip of the MADHHV227_Photo_3
    into your child’s right nostril (Picture 2).
  11. Quickly press the syringe to give HALF of the drug.
  12. Put the tip of the MAD into the left nostril.
  13. Quickly press the syringe to give the rest of the medicine in the left nostril.

Medicine storage

  • Store all medicine out of the reach of children.
  • Always keep medicine in the original vial 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.
  • Do not remove medicine from vial until needed.

How to dispose of used needles and syringes

  • Do not bend or break off the needleless access device.
  • Put the used syringe and needleless access device into a puncture-resistant container with a cover, such as a used bleach vial or a coffee can (or a "sharps" container).
  • Do not let the “sharps” container get too full. When the container is two-thirds full, tape down the cover or lid, put it into a bag and return it to your local hospital for disposal.

CAUTION: Syringes and needleless access devices should be used only once. Keep syringes and supplies out of the reach of children and others who might misuse them.

WARNINGS

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

Possible side effects

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

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

When to call for emergency help

Call for emergency help if:

  • Seizures last more than 5 minutes after giving midazolam.
  • 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.

Miscellaneous

  • Ask your pharmacist for 2 labeled vials if your daycare provider or school will be giving this medicine.
  • Some pharmacies may not have this medicine. 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 your child. 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 your child sees a doctor, goes to an emergency room or is admitted to the hospital. This helps doctors who may not know your child.
  • Do not change the amount given without first talking with your child's doctor or pharmacist. This dose is specific for your child.
  • The doctor 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.

When to call the doctor

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

Intranasal Midazolam (Versed®) - Vial (PDF)

HH-V-277 Reviewed 6/18 Copyright 1979, Nationwide Children’s Hospital