Has your epilepsy doctor suggested that you use a seizure nasal spray? Nasal sprays for seizures are an emergency medicine for people who have cluster seizures, which is when you have several seizures in a row.
Cluster seizures can be very disruptive, and they may develop into status epilepticus if not stopped fast. Emergency seizure medications are intended to stop cluster seizures in their tracks.
Until just a couple years ago, the main medication available for stopping cluster seizures were rectal suppositories (putting a medication in the backside of the person having a seizure) or oral suppositories (putting medication inside the person’s mouth). But in the last couple of years two new kinds of nasal spray for seizures have been approved by the Food and Drug Administration (FDA). They have been shown to be just as effective as traditional emergency seizure medications, and they can also be easier to give to people.
Here's what you need to know about nasal sprays for seizures.
What nasal sprays for seizures are available today?
There are two kinds of seizure nasal spray that have been approved by the FDA.
Nayzilam®
This is a nasal spray created using a drug called midazolam.
- It is approved for people aged 12 years and older.
- Doses are usually 5 mg and are given as a single spray in one nostril
- If the person continues having cluster seizures, you can give a second dose of Nayzilam® after 10 minutes (if your doctor has approved)
Valtoco®
This is the brand name of a diazepam nasal spray for seizures.
- This diazepam nasal spray for seizures is designed for people aged six years and older.
- The dose depends on the individual’s age and weight. For 5 mg or 10 mg doses, it is given as a single spray in one nostril. For 15 mg or 20 mg doses, the package contains two nasal sprays, one for each nostril.
- Depending on your doctor's instructions, you may be able to give a second dose of Valtoco® at a minimum of four hours after the first dose
When should you use nasal sprays for seizures?
Seizure nasal sprays are only approved for use as an emergency medicine for people having cluster seizures. You should not use them instead of your usual seizure medication, or for anything other than cluster seizures.
Related: What is rescue medication for seizures?
How do you use nasal sprays for seizures?
Always refer to the manufacturer’s instructions, which are provided in a leaflet when you collect the sprays from the pharmacy. You can also find official instructions for using Nayzilam® and Valtoco® on each company’s website.
It is best to get training from your healthcare provider before you try using a nasal spray for seizures. Most often, the person who administers (gives) the emergency seizure medication nasal spray will be the caregiver of the person with epilepsy. Sometimes people with epilepsy may be able to administer it to themselves between seizures.
If you do not have access to the leaflet for your seizure nasal spray, the following steps may help.
- Open the blister pack
- Hold the medication so that your thumb is on the bottom of the plunger, whilst your first and middle fingers sit on either side of the nozzle
- Put the tip of the nasal spray inside the person's nostril, until your fingers touch the bottom of their nose
- Press the plunger firmly with your thumb in one smooth motion
- Take the nozzle out of the person’s nose and throw it away
- There is only ever one dose per spray
Suggested: Introduction to seizure first aid
Seizure nasal sprays as part of your seizure action plan
Epilepsy doctors normally prescribe nasal sprays for seizures as part of a seizure action plan, if you are at risk of having seizure clusters. If you have any doubts about how to use your seizure nasal spray, contact your treatment team.
