A special form of midazolam administration is use of the midazolam nasal spray. The nasal spray is only used for patients experiencing (serious) epileptic seizures. During a seizure, bystanders can administer the nasal spray, which causes the patient to recover from a seizure faster.
When to use the midazolam nasal spray
The midazolam nasal spray is only used when an epileptic seizure lasts more than ten minutes. Seizures lasting this long can cause the patient to be unable to recover from it. This is known as status epilepticus, which is potentially life threatening. When patients do not have enough time between seizures to recover from the effects of the seizure, midazolam nasal sprays are also used, to stop the seizures as soon as possible.
Diazepam versus midazolam
Before the development of the midazolam nasal spray, diazepam was widely used to recover from seizures. Diazepam, also known for its brand names Stesolid and Valium, is still widely used, but requires a rectal administration. This can be quite hard and is socially undesirable for the patient. As the midazolam nasal spray is easier to administer and socially more desirable, it is used more and more. Midazolam is also just as effective as diazepam for this purpose.
The midazolam nasal spray is very easy to use, even for someone that has never used it before. For new sprays a few pumps are required to clear the spray of air. During epileptic seizures, generally one spray per nostril is sufficient for the patient to recover from it. As each spray contains 2,5 mg midazolam, this sums up to a total dosage of 5 mg. For some patients 10 mg of midazolam is used.