Nayzilam
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.
What is Nayzilam (midazolam)?
What is Nayzilam (midazolam) used for?
- Seizure attacks in people with epilepsy who are 12 years of age and older
How Nayzilam (midazolam) works
Nayzilam (midazolam) is a benzodiazepine. It's thought to slow down activity in your brain to help stop seizures.
Drug facts
Risks and warnings for Nayzilam (midazolam)
Nayzilam (midazolam) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Extreme sleepiness and difficulty breathing
- Risk factors: Taking Nayzilam (midazolam) with opioids, alcohol, or other medications that cause drowsiness or affect breathing | Taking medications that interact with Nayzilam (midazolam) | Older adults | Lung or breathing problems
Nayzilam (midazolam) can cause serious drowsiness, tiredness, trouble breathing, and low blood pressure. If you also drink alcohol or are taking opioid medications or other sedatives, these effects are more likely to happen, be more severe, and can even result in death. Talk to your provider to make sure it's safe for you to take Nayzilam (midazolam) with your other medications. They might see if other medication options are available. If you develop difficulty breathing or have trouble waking up easily, get medical help right away.
Misuse and addiction
- Risk factors: History of substance of alcohol use disorder | Taking higher than recommended doses of Nayzilam (midazolam)
Nayzilam (midazolam) has risks of misuse and addiction, which can potentially lead to overdose (taking too much medication) and death. Misuse often involves using higher than recommended doses of Nayzilam (midazolam). Your provider will ask you questions before you start Nayzilam (midazolam) to assess your risk of misuse and addiction. To lower your risk, take Nayzilam (midazolam) exactly as prescribed to you.
Dependence and withdrawal
- Risk factors: Taking Nayzilam (midazolam) for a long time | Taking Nayzilam (midazolam) at higher than recommended doses | Taking Nayzilam (midazolam) more often than recommended | Stopping Nayzilam (midazolam) suddenly
If you're taking Nayzilam (midazolam) for a long period of time, using it at higher doses, or using it more often than recommended, you might become physically dependent on the medication. This can raise your risk for withdrawal symptoms if you stop the medication or lower your dose suddenly. These withdrawal symptoms can include unusual involuntary movements, muscle pain, anxiety, panic attacks, shaky hands, and fast heart beat. More severe symptoms, like more seizures, can be life-threatening.
To lower your risk of dependence and withdrawal symptoms, take Nayzilam (midazolam) only as prescribed. It should be taken only as needed for seizure attacks. If you've been using this medication more frequently than recommended and want to stop, ask your provider how you can do so safely.
Suicidal thoughts or behaviors
Anti-seizure medications like Nayzilam (midazolam) can raise your risk of suicide or thoughts of suicide. Watch for any new or worsening depression and any unusual changes in mood. Report any concerning behavior to your provider. If you have thoughts of hurting yourself, call 911 or get medical attention right away.
Difficulty with concentration, focus, and memory
Taking Nayzilam (midazolam) affect your concentration and focus. It can also affect your ability to remember things for several hours after a dose. Avoid activities that require you to be alert, like riding a bike or operating machinery, until these effects go away. If you've had a seizure attack, remember that it might be against the law in some states to drive for a few months afterwards, even if you feel back to normal after getting a dose of Nayzilam (midazolam).
Rise in eye pressure in people with glaucoma
- Risk factors: Glaucoma
Benzodiazepines, such as Nayzilam (midazolam), can raise eye pressure in people who have glaucoma. If you have open-angle glaucoma (the most common type of glaucoma), make sure that you're taking appropriate medications for it before you use Nayzilam (midazolam). If you've been diagnosed with narrow-angle glaucoma, you shouldn't use Nayzilam (midazolam) since the effects can be dangerous to your eyesight.
Side effects of Nayzilam (midazolam)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Drowsiness (10%)
- Nasal discomfort (9%)
- Headache (4%)
- Throat irritation (3%)
- Runny nose (3%)
Less Common Side Effects
- Slurred speech
- Weird taste in the mouth
- Tearing up or watery eyes
Nayzilam (midazolam) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Withdrawal: unusual involuntary movements, muscle pain and stiffness, shaky hands, stomach upset, anxiety, panic attacks, changes in mood or behavior, fast heart beat, more seizures
- Accidentally taking too much (overdose): trouble breathing, extreme sleepiness, difficulty thinking straight, confusion, weakness, bluish fingernails and lips, hard time walking or moving normally, coma
- Thoughts of hurting yourself or suicide
The following Nayzilam (midazolam) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- CNS depression—slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, trouble staying awake
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dizziness
- Drowsiness
- Headache
- Irritation inside the nose or throat
- Runny or stuffy nose
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Pros and cons of Nayzilam (midazolam)
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
Pharmacist tips for Nayzilam (midazolam)
- Nayzilam (midazolam) should only be used for stopping seizure attacks, or when a bunch of seizures happen in a row that are different than typical seizure activity. Don't use Nayzilam (midazolam) as your regular seizure prevention medication.
- Seizure attacks can happen at any time, so it's best to have Nayzilam (midazolam) with you or your child at all times.
- It's important for caregivers to feel confident about when and how to give this medication properly. It's also important to know what to watch for afterwards and when to get medical help. You might need to teach this information to other people in case you or your child has a seizure attack.
- Nayzilam (midazolam) comes with an instruction manual with helpful images. Read and review the instructions with other caregivers. Ask a provider if you have any questions about how to use Nayzilam (midazolam).
- The Nayzilam (midazolam) nasal spray is ready to use as soon as you take it out of the blister pack. Each nasal spray device contains only one dose. Don't test, "prime", or play around with the plunger before you place the nozzle inside the nostril for the dose. Otherwise, you might lose the dose.
- After the Nayzilam (midazolam) dose is given, keep the person on their side. This position makes it easier to breathe while recovering from a seizure. Stay with the person, and watch for continued seizure activity or changes in breathing or skin color. Write down the date and time of the seizure attack, the type and number of seizures that you observe, and the time(s) that you gave Nayzilam (midazolam). All of this information is important to share with the provider later on.
- Your provider might recommend a second dose if needed. The second dose should be given at least 10 minutes after the first dose. Don't give a second dose if the person having the seizures is having trouble breathing or is more sleepy than usual. Call 911 if this happens.
- After you use each Nayzilam (midazolam) nasal spray device, throw it away in a safe place away from children or pets.
- Check the expiration date of your Nayzilam (midazolam) device regularly and replace it if it's about to expire. This makes sure your medication works as it should when you need to use it. It's important that you get the full effect from Nayzilam (midazolam) when you have a seizure attack.
- Keep Nayzilam (midazolam) in the blister pack until it's about to be used. Keep this medication at room temperature.
Common questions about Nayzilam (midazolam)
Nayzilam (midazolam) is used to treat a seizure attack, or when you have a bunch of seizures in a row that are different than typical seizure activity. Seizures can be a little confusing. So, if you're unsure, ask your provider about what kinds of scenarios you should use Nayzilam (midazolam). Don't use Nayzilam (midazolam) daily or for long-term control of seizures since it can cause dependence.
Nayzilam (midazolam) comes with an instruction manual with helpful images that you and all your caregivers should carefully read and review. This manual can help you become familiar with when and how to give this medication properly. Follow the directions on the packaging to remove the nasal spray device from the blister pack. Hold the nasal spray with your thumb on the plunger and your middle and index fingers on either side of the nozzle. Before you press the plunger, make sure to place the tip of the nozzle into one nostril. Insert the tip into the nostril until your fingers holding the nozzle touch the bottom of your nose. Then, firmly press the plunger once to give the dose. There's no need to breathe deeply when giving the dose. Ask a provider or pharmacist if you have questions about using and giving a dose of Nayzilam (midazolam).
Nayzilam (midazolam) contains the active ingredient midazolam. This particular medication is a nasal spray that's used to treat seizure attacks. There are other medications that contain the same active ingredient, but they come as different formulations and are used for different purposes. Midazolam is also available as an oral syrup and injectable form, which are typically used in hospitals to help people sleep before procedures or anesthesia. Some injection forms of midazolam can be used to treat certain types of seizures that are considered medical emergencies (status epilepticus).
Nayzilam (midazolam) and Valtoco (diazepam) are both nasal sprays that are used to treat seizure attacks right away on an as-needed basis. They're both good options for people who can't take anything by mouth (i.e., during an active seizure attack). Nayzilam (midazolam) can be used for children 12 years and older, whereas Valtoco is approved for use in children as young as 6 years of age. The two medications have similar side effects of drowsiness, headache, and nasal discomfort. They're both available as brand-name medications only. Talk with your provider about which option is best for you.
Studies show that Nayzilam (midazolam) can stop a seizure attack within 10 minutes. If the seizure isn't controlled after 10 minutes of giving Nayzilam (midazolam), spray a second dose into the other nostril.
If you're pregnant or planning to become pregnant, talk to your provider about the risks and benefits of using Nayzilam (midazolam). Benzodiazepines, like Nayzilam (midazolam), might be harmful to your baby. There have been reports of extreme sleepiness and withdrawal (e.g., irritability, restlessness, poor feeding) in newborn babies of mothers who've used benzodiazepines in late pregnancy. But, seizure attacks during pregnancy can also be dangerous for both you and your unborn baby. If you're currently pregnant and taking Nayzilam (midazolam), you're encouraged to enroll in the North American Antiepileptic Drug (NAAED) Pregnancy Registry. This pregnancy registry studies the safety of anti-seizure medications during pregnancy and helps researchers learn more about the risks.
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Nayzilam (midazolam) dosage
Nasal spray| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg | 2 nasal sprays | $644.68 | $322.34 |
Typical dosage for Nayzilam (midazolam)
Adults and children 12 years of age and older: Spray 1 dose (5 mg) into one nostril. After 10 minutes, if the seizure isn't controlled, spray a second dose into the other nostril. Don't use more than 2 doses of Nayzilam (midazolam) to treat a seizure attack.
It isn't recommended to use Nayzilam (midazolam) more than once every 3 days or more than 5 times in a month. Talk to your provider if you or your child has a seizure attack more often than this because it means that your seizures aren't well controlled. Your provider will need to adjust your daily seizure medications so that the attacks happen less often.
How much does Nayzilam (midazolam) cost?
$644.68
Nayzilam (midazolam) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Nayzilam (midazolam) will not be safe for you to take.
- Narrow-angle glaucoma
