How do i use nayzilam for cluster seizures?

What Is Nayzilam and When Is It Used for Seizures?

Nayzilam (midazolam nasal spray) is an FDA-approved rescue treatment for seizure clusters—multiple seizures occurring close together—in adults and children 12+ weighing at least 88 pounds. It's not for ongoing epilepsy management but for stopping acute clusters lasting 5+ minutes or when seizures repeat rapidly. Administer only during a witnessed seizure cluster; do not use prophylactically.[1]

Step-by-Step Instructions for Using Nayzilam

1. Prepare the device: Hold the Nayzilam spray by the nozzle (not the plastic guard). Prime it once if new by pressing the plunger until mist appears (discard first spray).
   
2. Position the patient: Lay the person on their side where they won't fall, or keep them upright if possible. Clear the nose if blocked.
   
3. Administer the dose: Insert nozzle tip into one nostril until finger grips touch the bottom of the nose. Press plunger firmly and fully to release the spray. It works in one or both nostrils depending on dose (one spray per nostril max).
   
4. Repeat if needed: Wait 10 minutes. If seizing continues, give a second dose in the other nostril.
   
5. Post-administration: Stay with the person for 4 hours. No driving or operating machinery for 8-12 hours after use.
   
   Dosing: 5 mg (one 5 mg spray) or 10 mg (two 5 mg sprays, one per nostril). Use lowest effective dose; prescribers tailor based on weight and history.[1][2]
   
   

What Happens After Spraying Nayzilam?

Effects start in 10 minutes, peaking at 1 hour, lasting 1-2 hours. It calms brain activity to halt seizures but causes sedation or sleep. Call emergency services if:
- Seizure lasts >10 minutes after second dose.
- Breathing slows/stops.
- No response after 10 minutes.
Do not give more than two doses in 12 hours.[1]

Common Mistakes and Safety Tips

• Don't shake or tilt the device during spray.
  
• Discard if used once (single-use only).
  
• Store at room temperature; avoid heat.
  Risks include respiratory depression (especially with opioids/alcohol), nasal irritation, or drowsiness. Train caregivers via Nayzilam REMS program.[1][3]
  
  

How Does Nayzilam Differ from Other Rescue Meds?

| Treatment | Form | Onset | Dosing Limit | Key Edge |
|-----------|------|--------|--------------|----------|
| Nayzilam | Nasal spray | 10 min | 2 doses/12 hrs | Hands-free, no needles |
| Diastat (diazepam) | Rectal gel | 10-15 min | 1 dose/5 days | Works in kids <12 |
| Valtoco (diazepam) | Nasal spray | 10 min | 2 doses/24 hrs | Similar but different formulation |

Nayzilam avoids rectal route, suiting public use.[2]

When to Seek Training or Alternatives

Require prescription and hands-on training from a doctor. For frequent clusters, discuss long-term options like preventive anti-seizure drugs. Track use in a seizure diary for your neurologist.[1]

[1]: Nayzilam Prescribing Information (UCB)
[2]: Epilepsy Foundation: Nayzilam Guide
[3]: FDA Nayzilam Label