Nayzilam (midazolam) is a brand-name prescription medication. It’s FDA-approved as a short-term treatment for seizure clusters due to epilepsy. The drug is for use in adults as well as children ages 12 years and older.

Epilepsy is a type of brain disorder that can cause seizures. A seizure cluster is a period of increased seizure activity, which is two or more seizures within 24 hours.

Drug details

Nayzilam contains the active drug midazolam. Nayzilam is in a drug class known as benzodiazepines. (A drug class is a group of medications that work in a similar way.)

Nayzilam comes as a nasal spray that’s available in one strength: 5 milligrams (mg) of midazolam per 0.1 milliliter (mL) of liquid solution. The drug is used as an immediate (“rescue”) treatment. For information on how and when to use Nayzilam, see the “Nayzilam dosage” section below.

FDA approval

Nayzilam was approved by the Food and Drug Administration (FDA) in 2019.

Midazolam, the active drug in Nayzilam, was first FDA-approved in 1985 under the brand name Versed. (Versed is a type of drug called a sedative, which makes you feel calm or sleepy. It comes in injection form and isn’t used for seizures.)

Is Nayzilam a controlled substance?

Yes, Nayzilam is a controlled substance. It contains the drug midazolam, which is classified as a schedule IV drug by the FDA. This means that midazolam has acceptable medical uses but carries risks for dependence and misuse.

The government has created special rules for how controlled substances can be prescribed by a doctor and dispensed by a pharmacist. Your doctor or pharmacist can tell you more.

Effectiveness

For information about the effectiveness of Nayzilam, see the “Nayzilam uses” section below.

Nayzilam is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Nayzilam contains the active drug midazolam in the form of a nasal spray. Other forms of midazolam are available as generics, including an injection and oral syrup. These other forms of midazolam aren’t used to treat seizures.

As with all medications, the cost of Nayzilam can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Nayzilam. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor or your insurance company.

Before approving coverage for Nayzilam, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Nayzilam, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Nayzilam, or if you need help understanding your insurance coverage, help may be available.

UCB Inc., the manufacturer of Nayzilam, offers a savings card that may help lower the cost of its drug. For more information, visit the drug’s website or call 888-786-5879.

The manufacturer also offers a financial assistance program for its drug. For more information and to find out if you’re eligible for support, call 877-785-8906 or visit the program website.

Mail-order pharmacies

Nayzilam may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Nayzilam, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor and your insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Nayzilam is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

The Nayzilam dosage your doctor prescribes will depend on how your body responds to the drug.

The following information describes the dosage that is commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Nayzilam comes as a nasal spray in a unit, which is a device that’s used once and then thrown away.

Nayzilam is available in one strength: 5 milligrams (mg) of midazolam per 0.1 milliliter (mL) of liquid solution. Midazolam is the active drug in Nayzilam.

Dosage for seizures

Nayzilam is used as a short-term treatment for seizure clusters due to epilepsy. A seizure cluster is a period of increased seizure activity, which is two or more seizures within 24 hours.

Each Nayzilam nasal spray unit contains one dose of the drug. Your doctor may recommend that you use either one or two doses of Nayzilam depending on:

  • how effectively the drug treats your seizure clusters
  • whether you have any side effects and how severe they are

First dose

The first dose of Nayzilam is one spray (5 mg) into one nostril. You don’t have to inhale when taking the dose.

Second dose

If the drug doesn’t help ease your seizure cluster within 10 minutes, you may use a new unit of Nayzilam to spray a second dose in your other nostril. You don’t have to inhale when taking the dose. Keep in mind that you should take a second dose of Nayzilam only if your doctor has advised you to do so.

If you’re giving Nayzilam to someone else, don’t administer a second dose if they’re having trouble breathing or are excessively sleepy. You shouldn’t use more than two doses of Nayzilam to treat a single seizure cluster episode.

Usage guidelines

Nayzilam isn’t meant to be used often. Frequent use of this drug may increase your risk for physical dependence and misuse.* It’s recommended that you don’t use Nayzilam for more than one episode every 3 days, and no more than five episodes per month.

If your seizure clusters are becoming more frequent, talk with your doctor. They may want to perform testing or make changes to your treatment plan.

* Nayzilam has boxed warnings for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect details” in the “Nayzilam side effects” section below.

Children’s dosage

Nayzilam is used as a short-term treatment for seizure clusters in children ages 12 years and older who have epilepsy.

The dosage for children is the same as for adults. See “Dosage for seizures” above for details.

Will I need to use this drug long term?

No. Nayzilam isn’t meant to be used as a daily or long-term treatment. The drug is a rescue treatment used for occasional seizure cluster episodes.

Other drugs are available that can treat seizures. Some may be a better fit for you than others. If you’re interested in finding an alternative to Nayzilam, talk with your doctor. They can tell you about other medications that may work well for you.

All the drugs currently used to treat seizure clusters are in the same drug class: benzodiazepines. A drug class is a group of medications that work in a similar way. Nayzilam is a type of benzodiazepine that comes as a nasal spray. Benzodiazepines also come in oral forms (pills that you swallow) and sublingual forms, which are pills that dissolve under your tongue.

If you remain conscious and are able to take an oral or sublingual benzodiazepine during a seizure, those forms may be an option for you. But they take longer to work than a nasal spray. To stop seizure clusters quickly, regardless of your state of consciousness, oral and sublingual benzodiazepines aren’t usually ideal rescue treatments.

It’s important that rescue medications for seizures can be given to a person even if they aren’t able to take them themself. Like Nayzilam, the drugs listed below can be administered without the person actively inhaling or swallowing.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the Food and Drug Administration (FDA).

Examples of other drugs that may be used as a rescue treatment for seizure clusters include:

  • diazepam nasal spray (Valtoco)
  • diazepam rectal gel (Diastat)
  • lorazepam injection (Ativan)
  • midazolam injection (Versed)

You should take Nayzilam according to your doctor’s or healthcare provider’s instructions.

Your healthcare provider will show you and your caregiver how to administer Nayzilam. Depending on your condition during a seizure cluster episode, you may not be able to give yourself Nayzilam. It’s important for your family members and coworkers to be aware of your condition so they can administer Nayzilam to you if needed.

Step-by-step instructions for using Nayzilam are included in the product packaging. The manufacturer’s website also features instructions for use and a helpful video demonstration.

The Food and Drug Administration (FDA) approves prescription drugs such as Nayzilam to treat certain conditions. Nayzilam may also be used off-label for other conditions. Off-label drug use means using a drug for a purpose other than what it’s been approved for by the FDA.

Nayzilam for seizures

Nayzilam is FDA-approved as a short-term treatment for seizure clusters due to epilepsy. The drug is for use in adults as well as children ages 12 and older.

Epilepsy explained

Epilepsy is a type of brain disorder that can be caused by many different underlying conditions that affect a person’s brain. Epilepsy can cause seizures that are the result of disturbances in the brain’s electrical activity. Epilepsy is usually diagnosed after a person has had at least two seizures.

There are several different types of seizures. Seizure symptoms can vary greatly between types and also between individuals with the same type. Some examples of seizure symptoms include:

  • continuous jerking movements or rhythmic twitching of the body
  • muscles may become weak, limp, tense, or rigid
  • staring spells with no movements
  • brief twitches of a one body part, such as the eyelids
  • person may or may not be conscious during the seizure or remember it afterward

For most people with epilepsy, long-term daily use of antiepileptic drugs (AEDs) help prevent seizures. But sometimes additional treatment with rescue medication, such as Nayzilam, is needed for seizure clusters.

Seizure clusters

A seizure cluster is a period of increased seizure activity, which is two or more seizures within 24 hours. Seizure clusters are intermittent (occasional) episodes that are distinct from a person’s typical seizure pattern. Seizure clusters are also known as acute repetitive seizures.

Rescue treatments are taken as needed for seizure clusters. They aren’t used in place of daily AEDs. The goal of rescue treatment is to stop seizure clusters quickly to help prevent status epilepticus (SE). SE is a severe seizure that won’t stop and can be life threatening.

Effectiveness for seizures

Nayzilam has been found to be more effective than a placebo in treating seizure clusters. (A placebo is a treatment that contains no active drug.) For information on how the drug performed in clinical studies, see Nayzilam’s prescribing information.

Nayzilam and children

Nayzilam is used as a short-term treatment for seizure clusters in children ages 12 years and older who have epilepsy.

Nayzilam can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Nayzilam. These lists do not include all possible side effects.

For more information about the possible side effects of Nayzilam, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Nayzilam, you can do so through MedWatch.

Mild side effects

Mild side effects* of Nayzilam can include:

  • sleepiness
  • headache
  • nasal discomfort
  • throat irritation
  • runny nose
  • slurred speech
  • change in sense of taste
  • watery eyes

Most of these side effects may go away within a few hours or a couple of days. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Nayzilam. To learn about other mild side effects, talk with your doctor or pharmacist, or view Nayzilam’s medication guide.

Serious side effects

Serious side effects from Nayzilam aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

  • Respiratory depression (slowed, shallow breathing). Symptoms can include:
    • confusion
    • dizziness
    • nausea
  • Suicidal thoughts and behaviors, which were very rare in clinical studies of Nayzilam. Symptoms can include:
    • changes in mood or behavior
    • depression symptoms, such as prolonged feelings of sadness and loss of interest in activities previously enjoyed, as well as changes in sleep patterns or weight
  • Slowed thinking and reduced motor skills.* Symptoms can include:
    • short-term memory loss
    • reduced mental alertness
    • slowed reaction time
    • increased risk of falling
  • Risk of use with opioids.†‡
  • Risk of misuse and addiction.†‡
  • Risk of dependence and withdrawal.‡ (See the Nayzilam dependence and withdrawal section below.)
  • Breathing problems.†‡
  • Allergic reaction.†

* For more information about this side effect, see “Is it OK to drive after I’ve taken a dose of Nayzilam?” in the “Common questions about Nayzilam” section below.
† For more information about this side effect, see “Side effect details” below.
Nayzilam has boxed warning for this side effect. This is the most serious warning from the FDA.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

Side effect details

Here’s some detail on certain side effects this drug may cause.

Risk of problems if used with opioids

Nayzilam has a boxed warning about problems if it’s used with opioid drugs. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous.

Nayzilam contains the active drug midazolam, which is a type of medication called a benzodiazepine. Commonly called “benzos,” these drugs have many valid medical purposes. But most of these uses relate to making a person sedated (calm or sleepy).

Opioids are a type of prescription medication sometimes prescribed to treat severe pain. Examples of opioids include:

  • hydrocodone (an active ingredient in Norco)
  • oxycodone (Roxicodone; an active ingredient in Percocet, others)
  • tramadol (Ultram)

It’s common for opioids to cause sedation (excessive sleepiness). If you take an opioid and Nayzilam, you’ll have a higher risk for serious side effects than usual.

Symptoms of taking Nayzilam with opioids

If you take Nayzilam with an opioid, their combined effects could lead to:

For more information about risks of taking opioids and Nayzilam, see the drug’s prescribing information.

What your doctor will do

If your doctor prescribes Nayzilam with an opioid, they’ll monitor you closely. Before prescribing Nayzilam, your doctor may give you a test dose at their office. This way, they can see what effect the drug has on your body and provide emergency care if needed. You don’t have to be having a seizure cluster for your doctor to test your response.

For more information on the risks of taking Nayzilam with opioids, see the “Nayzilam interactions” section below. You can also talk with your doctor or pharmacist.

Risk of misuse and addiction

Nayzilam has a boxed warning about the risk of misuse and addiction. A boxed warning is the most serious warning from the FDA. The warning alerts doctors and patients about drug effects that may be dangerous.

Nayzilam is a type of medication called a benzodiazepine. And benzodiazepines are classified as controlled substances. This is because taking these drugs regularly may lead you to misuse them or become addicted to them. These actions may increase your risk for overdose and, in rare cases, death.

Symptoms of abusing, misusing, or becoming addicted to Nayzilam can include:

  • physical symptoms such as weakness, blurred vision, or drowsiness
  • mood changes
  • risky behavior choices, such as driving after misusing Nayzilam*
  • not being able to stop yourself from misusing Nayzilam

If you use Nayzilam only occasionally for episodes of seizure clusters, your risks for misuse and addiction are low.† Nayzilam isn’t meant to be taken often. Frequent use of this drug can increase your risk for physical dependence‡ and misuse. It’s recommended that you don’t take Nayzilam for more than one episode every 3 days, and no more than five episodes per month.

If your seizure clusters are becoming more frequent, talk with your doctor. They may want to perform testing or make changes to your treatment plan.

* To learn more about driving and Nayzilam, see the “Common questions about Nayzilam” section below.
† To find out how often this occurred in clinical studies, refer to the drug’s prescribing information.
‡ For more information on dependence, see the “Nayzilam dependence and withdrawal” section below.

Breathing problems

Respiratory depression (slowed, shallow breathing) and shallow breathing alone occurred in people who received Nayzilam during clinical trials. In one study, breathing problems weren’t common. Respiratory depression developed in two individuals who received Nayzilam. But other health conditions, such as sleep apnea, may have contributed to their breathing problems.

If you’re giving Nayzilam to someone else, don’t administer a second dose if they’re having trouble breathing or are excessively sleepy. You shouldn’t use more than two doses of Nayzilam to treat a single seizure cluster episode.

Your risk for breathing problems increases if you use Nayzilam with opioid drugs or alcohol. For more information, see the “Nayzilam and alcohol” and “Nayzilam interactions” sections below.

If you’re concerned about breathing problems while taking Nayzilam, talk with your doctor. They can help determine the right treatment plan for you.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Nayzilam. It’s not known how often allergic reactions may have occurred in clinical trials.

Symptoms of a mild allergic reaction can include:

  • rash
  • itchiness
  • flushing (warmth or redness/deepening of skin color for a brief time)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Nayzilam, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Using Nayzilam and drinking alcohol can increase your risk for dangerous side effects. These include excessive sleepiness, respiratory depression (slowed, shallow breathing), coma, and in rare cases, death.

Also, drugs called benzodiazepines, including Nayzilam, carry risks of misuse and physical dependence.* Taking benzodiazepines with alcohol increases these risks.

In addition, alcohol can worsen some common side effects of Nayzilam. These include:

  • sleepiness
  • dizziness
  • headache
  • slowed thinking
  • reduced motor skills

If you’re prescribed Nayzilam, don’t drink alcohol without first consulting with your doctor. They can advise you on whether it’s safe to consume alcohol during your treatment.

* Nayzilam has boxed warnings for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect details” in the “Nayzilam side effects” section above.

Nayzilam can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase the number of side effects or make them more severe.

Nayzilam and other medications

Below is a list of medications that can interact with Nayzilam. This list does not contain all drugs that may interact with Nayzilam.

Before taking Nayzilam, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Types of drugs that can interact with Nayzilam include the following.

Certain calcium-channel blockers. Calcium-channel blockers (CCBs) are medications prescribed for high blood pressure or heart conditions. Certain CCBs can interact with Nayzilam. With this interaction, CCBs can slow down how long it takes for your body to remove Nayzilam. So, it could take longer than usual for the effects of Nayzilam to wear off. These may include sleepiness and slowed thinking and functioning. CCBs that could interact with Nayzilam include:

  • diltiazem (Cardizem)
  • verapamil (Calan, Verelan)

Certain antifungal medications. Some antifungal medications can interact with Nayzilam and slow down how long it takes the drug to be removed from your system. If you’re using one of these antifungals, side effects from Nayzilam may take longer than usual to wear off. The side effects can include sleepiness and slowed thinking and brain functioning. Examples of these antifungal drugs include:

  • itraconazole (Sporanox)
  • ketoconazole (Nizoral)

Certain macrolide antibiotics. A macrolide antibiotic is a type of antibiotic commonly used to treat respiratory and skin infections. Some macrolide antibiotics can interact with Nayzilam. If you take a macrolide antibiotic that interacts with Nayzilam, it may take longer for Nayzilam to be removed from your system. So, it may take longer for certain side effects, such as sleepiness, to wear off. An example of this type of macrolide antibiotic is erythromycin.

Central nervous system depressants. Nayzilam may cause a serious side effect known as respiratory depression (slowed, shallow breathing). Drugs called central nervous system (CNS) depressants may cause sleepiness. Taking Nayzilam with CNS depressants may increase your risk for respiratory depression. Examples of CNS depressants can include:

  • Opioid medications.* If you take opioid medications, it may not be safe for you to take Nayzilam. But, if used occasionally and appropriately, you may need to take Nayzilam to stop seizure clusters, even if you take opioids. You and your doctor should discuss the risks and benefits, and make the decision that’s best for you. Examples of opioids can include:
    • codeine (an active ingredient in Robitussin-AC, others)
    • hydrocodone (an active ingredient in Norco, others)
    • oxycodone (Roxicodone; an active ingredient in Percocet, others)
  • Barbiturates. These drugs are sometimes prescribed to treat epilepsy or migraine. Examples of barbiturates can include:
    • butalbital (an active ingredient in Esgic, Fioricet, others)
    • phenobarbital (Luminal)
    • primidone (Mysoline)
  • Sedative-hypnotics, which are commonly known as sleep disorder drugs. They’re prescribed to treat insomnia (difficulty falling asleep or staying asleep). Examples of sedative-hypnotics can include:
    • eszopiclone (Lunesta)
    • suvorexant (Belsomra)
    • zaleplon (Sonata)
    • zolpidem (Ambien)
  • Antispasmodics. These medications are often referred to as muscle relaxants, and they ease muscle spasms by working in the CNS. Examples of antispasmodics can include:
    • carisoprodol (Soma)
    • chlorzoxazone (Lorzone, Parafon Forte)
    • cyclobenzaprine (Amrix, Flexeril)
    • metaxalone (Skelaxin)
    • methocarbamol (Robaxin)
    • tizanidine (Zanaflex)

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

* Nayzilam has boxed warning for a risk of problems if used with opioids. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect details” in the “Nayzilam side effects” section above.

Nayzilam and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Nayzilam. However, you should still check with your doctor or pharmacist before using any of these products while taking Nayzilam.

Nayzilam and foods

It’s recommended that you don’t eat grapefruit or drink grapefruit juice while taking Nayzilam. The fruit and its juice may interact with Nayzilam and raise your risk for side effects from the drug.

If you have any questions about consuming grapefruit with Nayzilam, talk with your doctor or pharmacist.

Nayzilam is approved as a short-term treatment for seizure clusters due to epilepsy. A seizure cluster is a period of increased seizure activity, which is two or more seizures within 24 hours. (For more about seizure clusters and epilepsy, see the “Nayzilam uses” section above.)

Nayzilam contains the active drug midazolam, which belongs to a class of medications known as benzodiazepines. A medication class is a group of drugs that work in a similar way.

Benzodiazepines are thought to stop seizure clusters by making brain cells less sensitive to stimulation.

How long does it take to work?

For some people, one dose (5 milligrams) of Nayzilam is enough to stop a seizure cluster episode within 10 minutes. For others, a second dose is needed, if their doctor advises it.

In clinical trials, the seizure cluster eased within 10 minutes of the initial dose for the majority of people treated with Nayzilam. Most of the people in this group were able to return to functional activities within 90 minutes. Also, most people who used Nayzilam didn’t have a seizure cluster between 10 minutes and 6 hours after the initial dose of the drug.

Nayzilam hasn’t been studied during pregnancy. But based on past evidence of benzodiazepine use during pregnancy, harmful effects can occur. (Nayzilam is a type of drug called a benzodiazepine.)

In clinical trials, various side effects, physical dependence, and withdrawal occurred in children whose mothers took benzodiazepines during pregnancy. For more detailed information on the effects of benzodiazepines during pregnancy, see Nayzilam’s prescribing information.

Be sure to let your doctor know if you’re pregnant or planning to become pregnant before taking Nayzilam. They can discuss the risks and benefits of this treatment with you.

Nayzilam hasn’t been studied during pregnancy. But based on past evidence of benzodiazepine use during pregnancy, harmful effects can occur. (Nayzilam is a type of drug called a benzodiazepine.) If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Nayzilam.

For more information about taking Nayzilam during pregnancy, see the “Nayzilam and pregnancy” section above.

Nayzilam hasn’t been studied in people who are breastfeeding. But based on studies, midazolam (the active drug in Nayzilam) is known to pass into breast milk and may cause harmful effects in children who are breastfed.

If you’re breastfeeding or planning to breastfeed, talk with your doctor about the safest way to feed your child after using Nayzilam. For example, they may recommend temporarily pumping and discarding your breast milk after occasional rescue treatment with the drug.

Here are answers to some frequently asked questions about Nayzilam.

Is Nayzilam a benzodiazepine?

Yes. Nayzilam is a type of drug called a benzodiazepine. Nayzilam and all benzodiazepines are controlled substances because of their risks for misuse and physical dependence.* It’s important not to use Nayzilam more often than prescribed, which is on an as-needed basis for occasional seizure cluster episodes.

For more information on controlled substances, see the “What is Nayzilam?” section above. To learn more about Benzodiazepines, talk with your doctor or pharmacist.

* Nayzilam has boxed warnings for these side effects. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see “Side effect details” in the “Nayzilam side effects” section above.

Is it OK to drive after I’ve taken a dose of Nayzilam?

No, it’s not safe. Nayzilam takes several hours to be removed from your system. During this time, you may experience impaired thinking and slowed physical responses. These side effects could make driving very dangerous. In fact, the side effects may begin within 10 minutes of receiving a Nayzilam dose.

You should wait for at least 6 hours after your last dose of Nayzilam before driving, as long as you aren’t feeling sleepy or dizzy. You should also avoid operating heavy machinery or doing activities requiring mental alertness during this time.

If you have any questions about how Nayzilam may affect you, talk with your doctor.

Can I take Nayzilam if I use other nasal spray medications?

Yes, you can take Nayzilam if you use other nasal sprays. There’s no evidence that Nayzilam is less effective or causes harm with other nasal spray medications.

If you have questions about using Nayzilam with other nasal sprays, talk with your doctor or pharmacist.

This drug comes with several precautions.

FDA warnings

This drug has boxed warnings. Boxed warnings are the most serious type of warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

  • Risk of problems if used with opioids. Nayzilam is a type of drug called a benzodiazepine. If you take a benzodiazepine with an opioid drug, it could cause dangerous side effects. These can include respiratory depression (slowed, shallow breathing), severe drowsiness, coma, and in rare cases, death. If your doctor prescribes Nayzilam with an opioid, they’ll monitor you closely. (For more information, see “Side effect specifics” in the “Nayzilam side effects” section above.)
  • Risk of misuse and addiction. Taking a benzodiazepine, such as Nayzilam, may lead to misuse and addiction. This may increase your risk for overdose and, in rare cases, death. (For details, see “Side effect specifics” in the “Nayzilam side effects” section above.)
  • Risk of dependence and withdrawal. If you use Nayzilam more frequently than recommended, you may develop physical dependence on the drug. This can lead to life threatening withdrawal effects if you suddenly stop taking Nayzilam. To help prevent this, your doctor will likely decrease your dosage slowly. (To learn more about the risk of physical dependence and withdrawal, see the “Nayzilam dependence and withdrawal” section below.)

Other precautions

Before taking Nayzilam, talk with your doctor about your health history. Nayzilam may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Acute narrow-angle glaucoma. If you have glaucoma, Nayzilam can increase pressure inside your eye. If you’ve been diagnosed with narrow-angle glaucoma, you shouldn’t use Nayzilam. Talk with your doctor about other treatment options that would be safe for you.
  • Open-angle glaucoma. If you have glaucoma, Nayzilam can increase eye pressure. If you’ve been diagnosed with open-angle glaucoma and your condition is currently managed with medication, it may be safe for you to use Nayzilam. But you’ll need to have regular eye exams to monitor your condition. Let your eye doctor know if you’ve been prescribed Nayzilam. They may want to examine your eyes more often than usual. Also, it’s important to continue using your glaucoma treatment as prescribed.
  • History of severe depression or suicidal behavior. In clinical studies, people who took Nayzilam rarely reported having suicidal thoughts or behaviors. If you have a history of depression or suicidal behavior, there’s a small chance that Nayzilam could worsen your condition. Before taking Nayzilam, be sure to talk with your doctor about your depression or past suicidal behavior. They may want to monitor you more carefully than usual during your treatment. It’s also important that you continue with your depression treatment plan as prescribed.
  • Impaired thinking and brain function. If you have a brain condition that slows your ability to think and function, such as ataxia, Nayzilam could worsen it for a time. For several hours following the use of Nayzilam, certain brain functions may become slower than usual. This can result in short-term memory loss, reduced mental alertness, and slowed reaction time. Before you take Nayzilam, be sure your doctor knows about any brain conditions you have.
  • Congestive heart failure. If you have congestive heart failure (CHF), it may take longer than usual for Nayzilam to be removed from your system. This means it may take more time for certain side effects, such as slowed thinking, to wear off. If you have CHF, it’s especially important to talk with your doctor. They can advise you on how long to wait after your Nayzilam dose before you can drive or engage in other activities.
  • Allergic reaction. If you’ve had an allergic reaction to Nayzilam or any of its ingredients, you shouldn’t take Nayzilam. Ask your doctor what other medications are better options for you.
  • Pregnancy. Nayzilam hasn’t been studied during pregnancy. But based on past evidence of benzodiazepine use during pregnancy, harmful effects can occur. (Nayzilam is a type of drug called a benzodiazepine.) For more information, see the “Nayzilam and pregnancy” section above.
  • Breastfeeding. Nayzilam contains the drug midazolam, which passes into human breast milk. This drug may have harmful effects on a child who is breastfed. For more information, see the “Nayzilam and breastfeeding” section above.

Note: For more information about the potential negative effects of Nayzilam, see the “Nayzilam side effects” section above.

Using more than the recommended dosage of Nayzilam can lead to serious side effects. Do not use more Nayzilam than your doctor recommends.

Overdose symptoms

Symptoms of an overdose can include:

  • slowed or shallow breathing
  • dizziness, which could be a sign of hypotension (low blood pressure)
  • sleepiness, which could be a sign of a slowed heart rate

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Nayzilam has a boxed warning about the risk of dependence and withdrawal. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). The warning alerts doctors and patients about drug effects that may be dangerous.

Nayzilam contains the active drug midazolam, which is a type of medication called a benzodiazepine. If you take a benzodiazepine regularly, especially long term in high doses, your body can become used to the drug. This is known as physical dependence.

When you’re physically dependent on a drug, your body relies on having it. If you suddenly stop taking the drug, your body can go into withdrawal. Some withdrawal symptoms of Nayzilam may include:

If untreated, severe withdrawal symptoms can occur and may be life threatening. These may include:

Nayzilam isn’t intended for daily use. If you use it more often than prescribed, the risk of physical dependence and withdrawal reactions increases.

Some people who suddenly stop taking benzodiazepines develop withdrawal symptoms that can last for months.

If you’re using Nayzilam more often than prescribed, talk with your doctor. They can guide you on a supportive treatment plan that will safely and gradually end your physical dependence on the drug.

When you get Nayzilam from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

Until you’re ready to use Nayzilam nasal spray, you should store it in its sealed packaging at room temperature (68°F to 77°F/20°C to 25°C). If needed, you may keep the medication at 59°F to 86°F (15°C to 30°C) for short periods of time. Avoid storing this medication in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Nayzilam and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today 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 other 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.