How Quickly Does Nayzilam Stop Seizure Clusters?
Nayzilam (midazolam) nasal spray acts fast to stop active seizure clusters in patients aged 12 and older. Most patients (66%) achieve seizure cessation within 10 minutes of a 5 mg dose, with median time to stopping seizures at 1.3 minutes based on clinical trial data.[1][2]
What Do Clinical Studies Show on Timing?
In the ARTEMIS1 trial, a pivotal phase 3 study, Nayzilam terminated seizures in 53.8% of episodes within 10 minutes after one dose, rising to 66.2% with an optional second dose 10 minutes later. No seizures stopped beyond 30 minutes post-dose. The trial involved 152 patients with epilepsy and up to 261 seizure clusters.[1][3]
When Does It Start Working?
Nayzilam reaches peak plasma levels in about 18 minutes, but seizure-stopping effects begin much sooner due to rapid nasal absorption. Patients often report relief within 1-3 minutes.[2][4]
What If the First Dose Doesn't Work?
Administer a second 5 mg dose (total 10 mg) 10 minutes after the first if seizures continue. About 12% of clusters needed this second dose to stop within the next 10 minutes. Do not exceed two doses in 24 hours.[1][2]
How Does It Compare to Rescue Medications Like Diastat?
Nayzilam works faster than rectal diazepam (Diastat), which takes 15-30 minutes for peak effect. Nayzilam avoids rectal administration, making it easier for caregivers to use during clusters.[3][5]
Risks and What Happens If Seizures Persist?
Seizures stopping beyond 30 minutes are rare, but call 911 if they continue after two doses or last over 5 minutes post-second dose. Common side effects include sleepiness (23%), runny nose (10%), and nasal discomfort (5%). Respiratory depression occurs in under 5%.[2][4]
Sources:
[1] Nayzilam Prescribing Information (UCB)
[2] Epilepsy.com Nayzilam Overview
[3] ARTEMIS1 Trial Results (NEJM)
[4] FDA Label for Nayzilam
[5] Diastat vs. Nayzilam Comparison (Epilepsy Foundation)