Nayzilam (midazolam) is a prescription drug that’s used to treat certain types of seizures. The drug comes as nasal spray. It’s used as an immediate treatment of seizure clusters.

Nayzilam is used in adults and certain children for immediate treatment of repetitive seizures or seizure clusters (2 or more seizures in 24 hours) caused by epilepsy.

The active ingredient in Nayzilam is midazolam. (An active ingredient is what makes a drug work.) Nayzilam belongs to a group of drugs called benzodiazepines.

This article describes the dosages of Nayzilam, as well as its strength and how to use it. To learn more about Nayzilam, see this in-depth article.

This section describes the usual dosages of Nayzilam. Keep reading to learn more.

What is Nayzilam’s form?

Nayzilam is available as a nasal spray in single-dose units. (One kit contains two single-dose units.)

What strength does Nayzilam come in?

Nayzilam comes in one strength of 5 milligrams (mg) per 0.1 milliliter (mL) of solution per single-dose unit.

What are the usual dosages of Nayzilam?

Your doctor will prescribe the recommended dosage of Nayzilam that provides the desired effect. If you’re new to Nayzilam treatment, you may receive a dose of Nayzilam in the presence of a healthcare professional to see how you react to the medication. If you have serious breathing problems, your doctor may discuss safer treatment options with you.

The information below describes dosages that are commonly used or recommended. But be sure to use the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs.

Dosage for seizures

Nayzilam is used in adults to treat immediate episodes of repetitive seizures or seizure clusters (2 or more seizures in 24 hours) caused by epilepsy.

First dose: The first dose of Nayzilam is one spray into one nostril.

Second dose: If Nayzilam doesn’t treat your seizure cluster episode within 10 minutes, use a new Nayzilam nasal spray unit to give one spray into the opposite nostril. Use a second dose only if your doctor has recommended this for you. Don’t use a second dose of Nayzilam if you have breathing problems or excessive sleepiness from the first dose of the medication.

It is not recommended to use more than two doses of Nayzilam for a single seizure episode. Nayzilam should be used for a maximum of one seizure episode every 3 days and five seizure episodes each month.

Talk with your doctor if you have questions about your dosage of Nayzilam and how often you can use the medication.

What’s the dosage of Nayzilam for children?

Nayzilam is used to help treat immediate episodes of seizure clusters from epilepsy in children ages 12 years and older.

The dosage used in children is the same as the dosage for adults. To learn more, see the “Dosage for seizures” section above.

For more information about Nayzilam’s dosage for children, talk with your child’s doctor or a pharmacist.

Is Nayzilam used long term?

No. Nayzilam is used as needed to treat seizure clusters or episodes. It is not meant to be used daily or as a long-term treatment.

Be sure to use Nayzilam exactly as your doctor prescribes it.

Dosage adjustments

If you have moderate to severe kidney problems, it may take longer for Nayzilam to leave your body. This can cause Nayzilam to buildup in your body and increase your risk for side effects. Your doctor may monitor you more closely.

Tell your doctor if you have congestive heart failure. It may take longer for Nayzilam to clear from your body if you have this condition. This may increase your risk for serious side effects from the medication.

Talk with your doctor if you have questions about dosage adjustments you may need with Nayzilam treatment.

The dosage of Nayzilam you’re prescribed may depend on several factors. These include:

  • the severity of the condition you’re using the drug to treat
  • other medications you may be taking
  • other conditions you may have (see the “Dosage adjustments” section above)

Nayzilam is available as a nasal spray in single-dose units. Your doctor will show you and a caregiver how to give a dose of Nayzilam. (When you’re having a seizure cluster episode, you may not be able to give yourself a dose of Nayzilam.)

Directions for how to give a dose of Nayzilam are provided in the product package. You can also see step-by-step instructions on the manufacturer’s website.

For information on the expiration, storage, and disposal of Nayzilam, talk with your doctor or pharmacist.

Accessible drug containers and labels

Some pharmacies provide medication labels that:

  • have large print
  • use braille
  • feature a code you can scan with a smartphone to change the text to audio

Your doctor or pharmacist may be able to recommend pharmacies that offer these accessibility features if your current pharmacy doesn’t.

Be sure to store Nayzilam in a secure location to prevent misuse of the medication.

Nayzilam has a boxed warning about the risk of misuse and addiction. (A boxed warning is the most serious warning from the Food and Drug Administration [FDA].) It’s a Schedule IV controlled substance. This means Nayzilam has an approved medical use, but it has a small risk of misuse during treatment.

“Misuse” refers to using a drug in a way other than how a doctor prescribes it. Examples of misuse include using the drug more often or at higher doses than recommended by your doctor. Addiction involves using a drug even if it’s causing harmful outcomes.

You should use Nayzilam only as your doctor has prescribed it. Misuse increases the risk of overdose, which can lead to trouble breathing, coma, and even death in rare cases.

Do not use more Nayzilam than your doctor prescribes, as this can lead to harmful effects.

Symptoms of overdose

Symptoms caused by an overdose can include:

In some cases, death has occurred as a result of respiratory depression caused by an overdose of this drug.

What to do in case you use too much Nayzilam

Call your doctor right away if you think you’ve used too much Nayzilam. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Nayzilam is a benzodiazepine. It has a boxed warning for the risk of dependence and withdrawal. (A boxed warning is the most serious warning from the FDA.)

The drug is used to treat immediate episodes of seizure clusters from epilepsy. However, using Nayzilam more often, in higher doses, or over a longer period of time than recommended can increase your risk for physical dependence. This condition occurs when your body relies on a drug to function as usual.

If you suddenly stop using Nayzilam, you may experience withdrawal symptoms. These are side effects that can occur when you stop taking a drug that your body has become dependent on. Examples of withdrawal symptoms include:

It is important to use Nayzilam exactly as prescribed by your doctor. If you need to stop using Nayzilam, your doctor will have you stop Nayzilam gradually to reduce your risk of withdrawal symptoms.

Below are answers to some commonly asked questions about Nayzilam’s dosage.

How long does it take for Nayzilam to start working?

Nayzilam starts to work after your first dose. In most cases, the medication works to stop an episode of seizure clusters within 10 minutes. But if your seizure episode doesn’t stop within 10 minutes, your doctor may recommend using a second dose of Nayzilam. (See the “What is Nayzilam’s dosage?” section above for details.)

If you have other questions about what to expect from your Nayzilam treatment, talk with your doctor.

Is Nayzilam’s dosage similar to the dosages of Valtoco?

The forms and uses of each drug are similar, but there are some differences. Nayzilam and Valtoco are both nasal sprays used to treat immediate episodes of seizure clusters from epilepsy.

Nayzilam and Valtoco belong to the same group of medications, called benzodiazepines, and work similarly to treat seizure clusters. But they do have different active ingredients. (An active ingredient is what makes a drug work.) Nayzilam contains the active ingredient midazolam, while Valtoco contains the active ingredient diazepam.

Valtoco comes in different strengths than Nayzilam, and its dosage to treat a seizure cluster episode is based on body weight.

To learn more about how these drugs compare, talk with your doctor. They will prescribe the drug and the dosage that’s right for you.

The sections above describe the usual dosages provided by Nayzilam’s manufacturer. If your doctor recommends this drug, they’ll prescribe the dosage that’s right for you.

Remember, you should not change your dosage of Nayzilam without your doctor’s recommendation. Only use Nayzilam exactly as prescribed. Talk with your doctor if you have questions or concerns about your current dosage.

Here are some examples of questions you may want to ask your doctor:

  • Would my risk for side effects increase if I need to use two doses of Nayzilam?
  • How does the dosage of Nayzilam compare with Diastat?
  • Will I need a dosage adjustment if I’m taking other medications to treat my condition?

To learn more about Nayzilam, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.