Seizure Rescue Medication - Intranasal Midazolam

Article Translations: (Spanish) (Somali)

How does this medicine work? 

Intranasal (through the nose) Midazolam (Nyazilam) is a medicine that is used short-term to stop seizures that will not stop on their own. The medicine starts working to stop the seizure within 10 minutes of giving it. 

How should I give it? 

Intranasal Midazolam (Nyazilam) comes in a nasal spray form. Give the medicine per your provider’s order.  

To give intranasal midazolam: 

1. Peel the packaging back by pulling on the foil at the “Peel Here” tab. Remove the device that contains the medicine. 
2. Hold the device with your thumb on the plunger and your middle and index fingers on each side of the nozzle. DO NOT PRESS the plunger yet. 
3. Place the tip of the nozzle into one nostril until your fingers are against the bottom of the patient’s nose.  
4. Press the plunger firmly to administer the medication, 
5. Dispose by throwing the device and packaging into the trash. 

• Do not test or prime the medication before use. There will no longer be medication left to administer if you do this.   
• If a second dose is required (as prescribed by your doctor), give the second dose in the other nostril. 
• Do not give more than two doses. Call your doctor or go to the emergency room if more than 2 doses are required.  
• If seizure does not stop after Intranasal Midazolam (Nayzilam) is used, get emergency help right away. 

Are there any precautions to take with food or other medicines? 

• Do not eat grapefruit or drink grapefruit juice. 
• Intranasal midazolam is a benzodiazepine medicine. Benzodiazepine medicines slow down activity in the brain and nervous system, known as depressants. Taking benzodiazepines with opioid medicine, alcohol or other central nervous system medication depressants can cause severe drowsiness and breathing problems. Talk with your provider about recommendations for use. 

What should I do if a dose is missed? 

This drug is used on a needed basis. Do not use more often than told by a provider.  

What are the side effects? 

• Feeling Sleepy 
• Nose and throat irritation 
• Runny Nose 
• Headache 
• Memory problems or loss 
• Burning sensation with administration 

Questions?  

This information is not specific to your child but provides general information. If you have any questions, please call your clinic.  

Reviewed 8/2025

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