What Is Nayzilam and When to Use It for Seizure Clusters
Nayzilam (midazolam) nasal spray treats seizure clusters in adults and children 12+ weighing at least 88 lbs (40 kg). A seizure cluster is 2+ seizures within 24 hours needing acute treatment, not responsive to daily anti-seizure meds. Use only if prescribed and per your healthcare provider's plan. It's FDA-approved for intermittent use, max one dose per cluster episode, no more than 5 episodes/month.
Step-by-Step Instructions for Using Nayzilam
- Prepare the device: Hold the nasal spray upright. If new, remove plastic cover and safety strap by twisting and pulling. Prime by spraying 4 test sprays into the air (one device only, discard after use).
- Position the patient: Sit or lay them on side with head supported to keep airway open. Clear nose if needed.
- Administer the dose: Insert nozzle tip into one nostril (aim slightly out, not straight up). Press plunger firmly and fully to release 5 mg/0.1 mL dose. Dose stays the same for all patients 12+.
- After dosing: The device locks—no repeat dose from it. Time the seizure from start. If seizure lasts 10+ minutes or repeats after 10 minutes post-dose without recovery, call 911 or emergency services immediately.
- Storage and disposal: Store at room temp (68-77°F). Use by expiration date. Dispose used device in sharps container or per local rules.
Full prescribing details from official label [1].
What to Expect After Use
Effects start in 10 minutes (peak at 35 minutes), lasting up to 1-2 hours. Common effects: sleepiness, headache, runny nose, nasal discomfort. Monitor breathing and consciousness—may cause sedation or respiratory depression. Do not drive or operate machinery until fully alert.
Risks and When to Call for Help
- Overdose risk: Too much benzodiazepine can slow breathing. Avoid alcohol/other sedatives.
- Allergic reaction: Rash, swelling, trouble breathing—seek emergency care.
- Tolerance: Frequent use may reduce effectiveness; stick to prescribed limits.
Call 911 if seizure >10 minutes, repeats, injury occurs, or breathing issues. Nayzilam is Schedule IV controlled substance—may cause dependence.
Who Should Not Use Nayzilam
Avoid if allergic to midazolam/benzodiazepines, have acute narrow-angle glaucoma, or severe breathing problems. Caution in liver/kidney disease, depression, or elderly patients. Not for kids under 12 or <88 lbs. Inform doctor of all meds.
Prescribing and Access
Requires prescription via Seizure Action Plan. Comes in twin packs (2 devices/box). Covered by many insurers for epilepsy patients. Manufacturer: UCB, Inc. Check DrugPatentWatch.com for patent status and generics [2].
[1] Nayzilam Prescribing Information: https://www.nayzilam.com/hcp/pi
[2] DrugPatentWatch.com: Nayzilam patents: https://www.drugpatentwatch.com/p/tradename/NAYZILAM