Midazolam

Midazolam is used for sedation during medical procedures and, in specific formulations, for seizure rescue. Nayzilam nasal spray treats prescribed seizure clusters. It is not a routine daily anxiety or sleep treatment.

It strengthens the effect of GABA, a calming brain messenger. This can stop seizure activity or produce sedation, while also affecting memory, coordination, and breathing.

Rescue treatment is intended to work during a seizure cluster. Follow the emergency plan if seizures continue. After procedural sedation, effects on judgment and coordination may outlast the obvious sleepiness.

• Caregivers should learn the device and written seizure plan before an emergency. Do not test or prime a Nayzilam device.
• Nayzilam: use one prescribed spray in one nostril. A second spray in the other nostril may be given after 10 minutes only if the plan permits.
• Do not give a second dose if breathing is impaired or sedation is unusually excessive. Call emergency services.
• Do not use more than two doses for one episode. Label limits are one episode every three days and five episodes monthly; report more frequent clusters.

• Sleepiness, slowed reactions, or fatigue
• Dizziness, poor balance, or falls
• Memory problems or difficulty concentrating

Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.

Watch for daytime sedation, falls, memory changes, and breathing problems. Older adults and people taking other sedatives may be more sensitive.

Physical dependence can develop with regular use. Sudden stopping or a rapid reduction can cause severe withdrawal, including seizures. Dependence is different from addiction, but misuse and addiction are also possible.

For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.

Discuss sleep apnea, lung disease, liver or kidney disease, glaucoma, falls, and any history of substance use problems. Tell your provider about all opioids and other sedatives.

Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.

Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.

Combining a benzodiazepine with an opioid can cause profound sedation, slowed breathing, coma, or death. Use such combinations only under a specifically reviewed treatment plan.

Avoid alcohol. Sleeping pills, sedating antihistamines, muscle relaxants, and other sedatives can increase impairment and breathing risks.

Keep rescue medicine accessible to trained caregivers, within its expiry date.

Tell procedural teams about opioids, alcohol, and medicines that inhibit CYP3A, including certain antibiotics and antifungals.

Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.