Nayzilam (midazolam) is a brand-name drug that’s prescribed for seizure clusters due to epilepsy in adults and some children. Nayzilam comes as a nasal spray that you’ll typically use as needed. The dosage can vary depending on seizure frequency or severity.

Nayzilam belongs to a drug class called benzodiazepines. Nayzilam isn’t available in a generic version.

Keep reading for specific information about the dosage of Nayzilam, including its strength and how to use the medication. For a comprehensive look at Nayzilam, including details about its uses, see this article.

Note: This article describes typical dosages for Nayzilam provided by the drug’s manufacturer. When taking Nayzilam, always follow the dosage prescribed by your doctor.

The information below describes Nayzilam’s typical dosages and other details about the drug.

Nayzilam form

Nayzilam comes as a single-dose nasal spray unit. You’ll discard the unit after each use.

Nayzilam strength

Nayzilam comes in one strength: 5 milligrams (mg) per 0.1 milliliter (mL) liquid solution.

Typical dosages

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

Dosage for seizures

The typical adult dosage of Nayzilam nasal spray for a seizure cluster* is one 5-mg spray (one dose) into one nostril. If the seizure cluster doesn’t ease within 10 minutes, you can spray a second dose into the other nostril. You’ll open a new nasal spray unit to deliver the second dose.

It’s important to remember that you’ll only give a second dose of Nayzilam if your doctor has told you to do so. When your doctor prescribes the drug, they’ll advise you on specific situations in which to give a second dose.

Note: You should not spray a second dose if you or the person you’re caring for has trouble breathing or excessive sleepiness after the first dose. Your doctor can recommend what to do if these side effects† occur after one dose of Nayzilam. However, if the symptoms seem severe or life threatening, call 911 or your local emergency number right away.

The following dosing chart provides additional details about Nayzilam dosages:

First doseSecond dose (if needed)Maximum dosageTreatment frequency
5 mg into one nostril (one single-dose nasal spray unit)5 mg into the other nostril (one single-dose nasal spray unit)10 mg (two single-dose nasal spray units)One seizure cluster treatment per 3-day period and no more than five treatments per month

* A seizure cluster is an episode of increased seizure activity due to epilepsy.
† For information about side effects with Nayzilam, see this article.

Children’s (pediatric) dosage

Nayzilam is prescribed to treat seizure clusters in children ages 12 years and older with epilepsy. Nayzilam’s dosage is the same as the adult dosage. See “Dosage for seizures” just above for details.

Long-term treatment

Nayzilam isn’t meant to be used as a long-term treatment. It’s a rescue treatment for seizure clusters. Rescue treatments are medications that work quickly to stop a seizure. You use them as needed for seizure clusters.

Talk with your doctor if you have questions about your Nayzilam treatment.

Nayzilam comes as a single-dose nasal spray unit. To deliver a dose, you’ll open one unit. Then, insert the tip of the unit into your nostril and press the plunger. Throw the unit away after using it.

When your doctor prescribes Nayzilam, they’ll tell you whether to give a second dose of the drug. If your doctor has advised you to give a second dose, you’ll open a new nasal spray unit. Then you’ll repeat the same steps above with the other nostril.

It’s important to note that you may not be able to deliver your own dose of Nayzilam. So be sure that someone who lives or works with you knows how to administer your Nayzilam dose.

For more information about Nayzilam nasal spray, you can refer to the drug manufacturer’s instructions. You can also order a training kit. The training kit doesn’t contain any active medication. It aims to help you learn how to give a dose of Nayzilam.


Some pharmacies offer labels with large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist might be able to recommend a pharmacy that does.

Nayzilam has a boxed warning* about the risk of drug misuse and addiction. With misuse, a drug is taken in a way other than how it’s prescribed. With addiction, a drug is used even though it’s causing harm. In fact, like other benzodiazepines, Nayzilam is a controlled substance† due to the risk of misuse.

Symptoms of misuse or addiction can include:

  • using more Nayzilam than your doctor prescribed
  • muscle weakness
  • drowsiness
  • blurred vision
  • changes in your mood or behavior
  • making riskier choices than you typically do

The risk of addiction is low if you use Nayzilam as your doctor prescribes. However, misuse and addiction can lead to overdose or, rarely, death. Nayzilam use with other drugs or alcohol increases the risk of severe outcomes.

Due to the risk of misuse and addiction, your doctor may not prescribe Nayzilam if you’ve ever experienced substance use disorder.

If you have questions or concerns about Nayzilam misuse or addiction, talk with your doctor.

* A boxed warning is a serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
† A controlled substance is a drug the government regulates due to the risk of dependence or misuse. (With dependence, your body needs the drug to function as usual.)

You may develop serious side effects if you use more Nayzilam than your doctor prescribes. To learn about the side effects of Nayzilam, see this article.

It’s important that you do not use more Nayzilam than your doctor advises.

Symptoms of an overdose

Nayzilam overdose symptoms can include:

If you use more than the recommended amount of Nayzilam

Call your doctor right away if you believe you’ve used too much Nayzilam. Another option is to call America’s Poison Centers at 800-222-1222 or use its online tool. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Nayzilam has a boxed warning* about the risk of physical dependence and withdrawal. Withdrawal symptoms are side effects that can occur when you stop taking a drug that your body has become dependent on.

Using Nayzilam more frequently or at higher doses than prescribed increases the risk of dependence and withdrawal. The risk of dependence and withdrawal is low if you use Nayzilam as your doctor prescribes. However, people who’ve taken benzodiazepines long term and suddenly stopped taking them have experienced life threatening withdrawal symptoms. (Nayzilam is a benzodiazepine.)

Benzodiazepine withdrawal symptoms can include:

If you’ve been using Nayzilam for a long time, your doctor will recommend safe ways to stop treatment. For more information, talk with your doctor.

Note: If you experience thoughts of suicide or harming yourself, tell your doctor right away or call 911 or your local emergency number. You can also refer to this article for ways to seek support.

* A boxed warning is a serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

The dosages in this article are typical dosages provided by the drug’s manufacturer. If your doctor recommends Nayzilam for you, they’ll prescribe the dosage that’s right for you. Always follow the dosage that your doctor prescribes.

As with any drug, never change your dosage of Nayzilam without your doctor’s recommendation. If you have questions about the dosage of Nayzilam that’s best for you, talk with your doctor.

Besides learning about dosage, you may want other information about Nayzilam. These additional articles might be helpful:

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 another 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.