What is Nayzilam?

Nayzilam Dosage, forms & strengths

Medically reviewed by Jamie Winn, PharmD

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Nayzilam (midazolam) is a C-IV antiepileptic drug (AED) that is manufactured by UCB, Inc. It is indicated by the U.S. Food and Drug Administration (FDA) to treat episodes of frequent seizure activity such as seizure clusters and acute repetitive seizures that are different from a patient’s usual seizure pattern. It is used in patients with epilepsy that are 12 years of age and older.

What is Nayzilam’s mechanism of action?

The exact way Nayzilam works to treat seizure clusters is not known. It is a benzodiazepine that binds to the GABA-A receptor to increase GABA activity in your brain. GABA-A is an inhibitory neurotransmitter that decreases your brain cells’ sensitivity to stimulation.

Nayzilam dosage forms and strengths

5mg/0.1ml solution in a single-dose nasal spray unit

Nayzilam dosage

Nayzilam should only be given by nasal route and is dosed as follows for adults and pediatric patients ages 12 years of age and older:

Initial Dose: Administer 1 spray (5mg) into a nostril.
Second Dose (only as needed): One additional spray (5 mg) into the other nostril can be given if the patient is still having seizure activity 10 minutes after the initial dose. A second dose should not be given if the patient has breathing problems or if there is excessive sedation.
Maximum Dosage and Frequency: You should not use more than 2 doses of Nayzilam to treat a single seizure cluster episode. Do not take Nayzilam for more than 1 episode every 3 days and more than 5 episodes per month.

Nayzilam dosage restrictions

No recommended dose adjustments are available for patients with liver or kidney impairment. However, patients with moderate and severe kidney impairment or congestive heart failure may eliminate midazolam slowly, which can result in prolonged exposure to this medication.

How to take Nayzilam

Patients and caregivers should read the Full Prescribing Information with Boxed Warning, Instructions for Use, and Medication Guide that comes with this medication.
Use Nayzilam exactly as your healthcare provider tells you to. It is typically given as 1 spray into a nostril to treat a seizure cluster. If you still have seizure activity after 10 minutes, you can give an additional spray of Nayzilam in your other nostril. You should not use more than 2 doses of Nayzilam to treat a seizure cluster. If you are still having seizures after taking 2 doses of Nayzilam, seek medical attention right away.
You should not use this medication for more than 1 episode every 3 days and for more than 5 episodes per month.
If you think you have used too much Nayzilam, go to the nearest emergency room immediately.
Store Nayzilam nasal spray in the blister pack at room temperature between 59° – 86°F (15° – 30°C), away from light and moisture until you are ready to use it.

Nayzilam dosage FAQs

What are some side effects of Nayzilam?

Some common side effects of Nayzilam seen in clinical trials include:

Sleepiness
Headache
Nasal discomfort
Throat irritation
Rhinorrhea (runny nose)
Slurred speech
Excessive tear production
Abnormal taste

Nayzilam can sometimes cause more serious side effects, including:

Serious, life-threatening allergic reactions (hives, swelling of the face or throat, and breathing problems)
Increased risk of suicidal thoughts or behavior
Respiratory depression
Worsening narrow-angle glaucoma

Contact your healthcare professional for medical advice about any adverse reactions you experience while taking Nayzilam. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What are some drug interactions with Nayzilam?

The concomitant use of Nayzilam with other drugs can affect how they work or increase the frequency and severity of side effects. You should ask your doctor if any of the prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take may interact with this medication, including:

CYP3A4 inhibitors such as clarithromycin, ketoconazole, erythromycin, or verapamil
Opioids such as fentanyl and hydrocodone
Other CNS depressants

What are some contraindications of Nayzilam?

You should not use Nayzilam if you have a hypersensitivity to midazolam or any inactive ingredients in this product. Nayzilam is also contraindicated in patients with narrow-angle glaucoma. It can be used if you have open-angle glaucoma but only if you are receiving appropriate treatment.

Is it safe to use Nayzilam while pregnant or breastfeeding?

Based on animal studies, Nayzilam may cause harm to your unborn baby. If you become pregnant while taking this medication, you should register with the North American Antiepileptic Drug (NAAED) Pregnancy Registry by calling 1-888-233-2334. For more information about the NAAED registry, go to http://www.aedpregnancyregistry.org.

Nayzilam is found in breast milk during lactation and breastfed infants may suffer adverse effects. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.

Does Nayzilam make you tired?

Nayzilam can make you feel drowsy and slow your thinking and motor skills. Do not drive, operate heavy machinery, or do other dangerous activities until you know how Nayzilam affects you.

How do you administer Nayzilam?

You should keep the Nayzilam nasal spray in the blister packaging until you are ready to use it. Hold Nayzilam with your thumb on the plunger and your middle and index fingers on each side of its nozzle. Press the plunger firmly to deliver the Nayzilam dose using 1 motion. You don’t have to breathe in deeply when you administer this medication.

How long does it take for Nayzilam to start working?

For most patients, one dose of Nayzilam 5mg is enough to stop a seizure cluster episode within 10 minutes. If the seizure continues 10 minutes after giving the first dose of Nayzilam medication, another dose may be given.

How many doses are there in Nayzilam?

There are 2 single doses of Nayzilam in each box of Nayzilam.

When should you use Nayzilam?

You can give Nayzilam during or immediately after your first seizure of a cluster occurs. It can be given by a caregiver even if you are unconscious.

Is Nayzilam a controlled substance?

Nayzilam contains midazolam, which is a controlled substance (CIV) as it can be abused or lead to physical dependence. Using this medication more than recommended and then stopping it abruptly can lead to withdrawal symptoms and an increased risk of seizures that won’t stop (status epilepticus).

What is the average price of Nayzilam?

The average cost of #2 Nayzilam 5mg/inhalation is almost $700.

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The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.