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What is the correct way to use Nayzilam Nasal Spray?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 9, 2023.

Official answer


To administer Nayzilam:

  • For the first dose, use one 5 mg spray in one nostril.
  • If the seizure cluster continues for at least 10 minutes after the first dose, a second 5 mg dose may be given if your healthcare provider has instructed you to give a second dose. Give the second dose in the other nostril.
  • If the seizures do not stop after Nayzilam is used, get emergency medical help right away (call 911). DO NOT give more than 2 doses to treat a seizure cluster.

Use Nayzliam exactly as your healthcare provider prescribed it. If you have questions about how to use Nayzilam, ask your doctor or pharmacist.

It is not known if Nayzilam is safe and effective in children under 12 years of age. Do not use Nayzilam if you are allergic to midazolam, or if you have an eye problem called acute narrow-angle glaucoma.

Learn more: Nayzilam: Instructions for Use (in more detail)

What is Nayzilam?

Nayzilam (midazolam) nasal spray is a prescription benzodiazepine medicine used short term to treat frequent seizure activity (such as seizure clusters, acute repetitive seizures) in adults and children at least 12 years old.

Nayzilam was approved by the FDA in May 2019. It is supplied in a box that contains two single-use nasal spray devices. It is only used in the nose. You can store it at room temperature between 68°F to 77°F (20°C to 25°C). It does NOT have to be refrigerated.

Nayzilam is classified as a C-IV controlled substance because it contains midazolam, a benzodiazepine that can be abused or lead to drug dependence. Keep this medicine in a safe place to prevent misuse, abuse and theft.

The most common side effects with Nayzilam include:

  • Sleepiness (drowsiness, somnolence)
  • Headache
  • Runny nose (rhinorrhea)
  • Nasal discomfort
  • Throat irritation

Read more: Nayzilam Serious Side Effects and Warnings (in detail)

Related questions

How often can I use Nayzilam?

You or your caregiver should not use Nayzilam for more than one seizure cluster episode every 3 days. Also, do not use Nayzilam for more than 5 seizure cluster episodes per month. It is not intended to be used daily to prevent seizure activity.

Before you use Nayzilam, you and / or your caregiver should read and follow the Instructions for Use that comes with your Medication Guide. If you do not have a Medication Guide, you can ask your pharmacist or other healthcare provider for one.

  • For the first dose, use one 5 mg spray in one nostril. If the seizure cluster is continuing 10 minutes after the first dose of Nayzilam, a second dose of Nayzilam may be used if you have been told to do so by your healthcare provider.
  • If a second dose of Nayzilam is used, you should give the second dose in the other nostril. You should not give more than 2 doses of Nayzilam to treat a seizure cluster.
  • A second dose should not be given if the patient has trouble breathing
    or they appear more drowsy than they usually are during a seizure cluster episode.

Contact emergency medical services right away (call 911 in the U.S.) if the seizures do not stop after Nayzilam is used.

If someone uses benzodiazepines daily, they may experience withdrawal symptoms if the medicine is stopped. Suddenly stopping benzodiazepines can cause:

  • Seizures that do not stop (called status epilepticus)
  • Hearing or seeing things that are not there (hallucinations)
  • Shaking
  • Nervousness
  • Stomach cramps
  • Muscle cramps

If you use too much Niazkilam, call your healthcare provider, go to the nearest emergency room right away, or call 911 right away.

This is not all the information you need to know about Nayzilam for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.


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