midazolam (nasal) (Nayzilam)

Brand Names: Nayzilam

Generic Name: midazolam (nasal)

What is midazolam nasal (Nayzilam)?

Midazolam is a benzodiazepine (ben-zoe-dye-AZE-eh-peen).

Midazolam is used short term to treat seizure clusters (also called "acute repetitive seizures") in adults and children at least 12 years old.

Midazolam may also be used for purposes not listed in this medication guide.

What are the possible side effects of midazolam nasal (Nayzilam)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Midazolam nasal can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, if you are hard to wake up, or if you stop breathing.

Call your doctor right away or seek emergency medical help if you have:

  • extreme drowsiness;
  • a weak pulse;
  • mood or behavior changes, depression;
  • agitation, anxiety, panic, trouble sleeping, feeling irritable; or
  • thoughts about suicide or hurting yourself.

Common side effects may include:

  • drowsiness;
  • headache;
  • runny nose, discomfort in your nose; or
  • throat irritation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the most important information I should know about midazolam nasal (Nayzilam)?

You should not use this medicine if you have narrow-angle glaucoma.

Midazolam nasal can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, if you are hard to wake up, or if you stop breathing.

Fatal side effects can occur if you use opioid medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Some people have thoughts about suicide while using midazolam. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor.

What should I discuss with my healthcare provider before using midazolam nasal (Nayzilam)?

You should not use this medicine if you are allergic to midazolam, or if you have:

Tell your doctor if you have ever had:

Tell your doctor if you become pregnant. Using midazolam nasal during late pregnancy may cause breathing problems, feeding problems, or dangerously low body temperature in the baby.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of midazolam on the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

How should I use midazolam nasal (Nayzilam)?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Midazolam may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Do not take by mouth. This medicine is for use only in the nose.

Before using midazolam nasal, be sure you know how to recognize what is and is not a seizure cluster and when it is best to use this medicine. Ask your doctor or pharmacist if you have questions.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Midazolam is usually given as a single spray into one nostril. If you still have seizures 10 minutes after using 1 spray, use a second spray in the opposite nostril.

Get emergency medical help if you have still have seizures after using this medicine.

You should not use a second spray if you have very slow breathing after using the first spray.

Do not use more than 2 sprays of midazolam nasal to treat a seizure cluster. Do not use this medicine to treat more than 1 seizure cluster every 3 days, or more than 5 seizure clusters in one month (30 days).

Store at room temperature away from moisture and heat. Keep the spray bottle in the blister pack until you are ready to use the medicine.


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What happens if I miss a dose (Nayzilam)?

Since midazolam nasal is used when needed, it does not have a daily dosing schedule. Call your doctor if your symptoms do not improve after using this medicine.

What happens if I overdose (Nayzilam)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of midazolam can be fatal.

Overdose symptoms may include severe drowsiness, confusion, muscle weakness, loss of coordination, or coma.

What should I avoid while using midazolam nasal (Nayzilam)?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or doing anything that requires you to be awake and alert until the effects of this medicine have worn off completely. Midazolam nasal can cause amnesia or forgetfulness that may last for several hours after you have used the medicine.

What other drugs will affect midazolam nasal (Nayzilam)?

Using midazolam with other drugs that slow your breathing can cause dangerous side effects or death. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many drugs can affect midazolam. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Where can I get more information (Nayzilam)?

Your pharmacist can provide more information about midazolam.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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Reviewed on 11/15/2021

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