Valtoco vs. Nayzilam for Epilepsy: Important Differences and Potential Risks.

Key takeaways

Valtoco (diazepam) and Nayzilam (midazolam) are both benzodiazepines used to treat seizure attacks in people with epilepsy, but they have some key differences. Valtoco is approved for use in children as young as 6 years old, while Nayzilam is only for those 12 and older. Valtoco comes in multiple doses (5 mg, 10 mg, 15 mg, and 20 mg), whereas Nayzilam is available in a single 5 mg dose. Valtoco can be used up to twice in a 24-hour period, and Nayzilam allows for a second dose if the seizure isn't controlled after 10 minutes. Both medications are nasal sprays and work quickly, but Valtoco typically works within 4 minutes, while Nayzilam can take up to 10 minutes. Additionally, Valtoco and Nayzilam are only available as a brand-name medication. Common side effects for both include drowsiness, headache, and nasal discomfort.

Valtoco

(diazepam)

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Nayzilam

(midazolam)

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Summary for Valtoco

Prescription only

Valtoco (diazepam) is a fast-acting prescription medication used for short-term treatment of frequent seizure activity in adults and children 2 years and older. It comes as a ready-to-use nasal spray device, and your dose depends on your age and weight. Your prescriber will give you instructions on how to use the spray. Since it's a benzodiazepine, it's classified as a controlled substance. Side effects include feeling sleepy, headache, and nasal discomfort.

Indications for Valtoco

Short-term treatment of frequent seizures activity in people with epilepsy who are 2 years and older

Pros and Cons for Valtoco

Pros

Approved for people 2 years of age and older
Fast-acting and works within a few minutes
Easy for someone to give the medication as a nasal spray

Cons

Can cause sleepiness, headache, and nasal discomfort
Has a limit on how often you can use it
Might not be the safest option during pregnancy or breastfeeding

Common Side Effects for Valtoco

Nasal discomfort (5%)
Changes in taste (2%)
Nosebleed (2%)
Runny nose (1%)

Warnings for Valtoco

Extreme drowsiness and difficulty breathing
Risk of misuse and addiction
Dependence and withdrawal
Difficulty with concentration and focus
Suicidal thoughts or behaviors
Increased eye pressure in people with glaucoma
Harm to unborn babies

Summary for Nayzilam

Prescription only

Nayzilam (midazolam) is a nasal spray that quickly treats seizure attacks in people with a seizure condition called epilepsy. It comes in a ready-to-use spray device, but the person giving the medication must know when and how to give it properly. Nayzilam (midazolam) commonly causes drowsiness, throat irritation, and nasal discomfort. Nayzilam (midazolam) is only available as a brand-name medication.

Indications for Nayzilam

Seizure attacks in people with epilepsy who are 12 years of age and older

Pros and Cons for Nayzilam

Pros

Works within 10 minutes to treat seizure attacks
Might help prevent another seizure attack from happening within 24 hours
Good option for someone who can't take anything by mouth, such as in the middle of a seizure attack

Cons

Only for treating seizure attacks, not for long-term seizure control
Caregivers need special training to know when and how to give the medication properly.
Can't use in children younger than 12 years of age
Only available as a brand-name medication