Midazolam Nasal Spray

What is this medication?

MIDAZOLAM (MID ay zoe lam) treats seizures. Call emergency services right away if seizures do not stop. You may need additional treatment. It works by calming overactive nerves in your body. It belongs to a group of medications called benzodiazepines.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Nayzilam

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Glaucoma
• Heart disease
• History of substance use disorder
• Kidney disease
• Liver disease
• Lung or breathing disease, such as asthma
• Mental health condition
• Suicidal thoughts, plans, or attempt by you or a family member
• An unusual or allergic reaction to midazolam, other benzodiazepines, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is for use in the nose. Take it as directed on the prescription label at the same time every day. Do not use it more often than directed. Make sure that you are using your nasal spray correctly. Ask your care team if you have any questions.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 12 years for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

This does not apply.

What may interact with this medication?

Do not take this medication with any of the following:

• Boceprevir
• Certain antiviral medications for HIV or AIDS
• Certain medications for fungal infections like ketoconazole and itraconazole
• Grapefruit juice
• Idelalisib
• Opioid medications for cough
• Sodium oxybate
• Telaprevir

This medication may also interact with the following:

• Alcohol
• Antihistamines for allergy, cough and cold
• Calcium channel blockers like diltiazem and verapamil
• Certain antibiotics like clarithromycin, erythromycin, rifampin
• Certain antiviral medications for HIV or AIDS
• Certain medications for anxiety or sleep
• Certain medications for depression, like amitriptyline, fluoxetine, sertraline
• Certain medications for seizures like carbamazepine, phenobarbital, primidone
• General anesthetics like halothane, isoflurane, methoxyflurane, propofol
• Local anesthetics like lidocaine, pramoxine, tetracaine
• Medications that relax muscles for surgery
• Opioid medications for pain
• Phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Call emergency services right away if seizures do not stop.

Visit your care team for regular checks on your progress.

Do not stop taking this medication except on your care team's advice. You may develop a severe reaction. Your care team will tell you how much medication to take. Long term use of this medication may cause your brain and body to depend on it. This can happen even when used as directed by your care team. You and your care team will work together to determine how long you will need to take this medication.

This medication may affect your coordination, reaction time, or judgment. Do not drive or operate machinery until you know how this medication affects you. Sit up or stand slowly to reduce the risk of dizzy or fainting spells. Drinking alcohol with this medication can increase the risk of these side effects.

If you are taking another medication that also causes drowsiness, you may have more side effects. Give your care team a list of all medications you use. Your care team will tell you how much medication to take. Do not take more medication than directed. Get emergency help right away if you have problems breathing or unusual sleepiness.

Wear a medical ID bracelet or chain. Carry a card that describes your condition. List the medications and doses you take on the card.

If you or your family notice any changes in your behavior, such as new or worsening depression, thoughts of harming yourself, anxiety, other unusual or disturbing thoughts, or memory loss, call your care team right away.

Talk to your care team if you wish to become pregnant or think you might be pregnant. This medication can cause serious birth defects. Talk to your care team before breastfeeding. Changes to your treatment plan may be needed.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• CNS depression—slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, trouble staying awake
• Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
• Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
• Thoughts of suicide or self-harm, worsening mood, feelings of depression

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Drowsiness
• Headache
• Irritation inside the nose or throat
• Runny or stuffy nose

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets. This medication can be abused. Keep your medication in a safe place to protect it from theft. Do not share this medication with anyone. Selling or giving away this medication is dangerous and against the law.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) in the blister package until ready to use. Throw away any unused medication after the expiration date.

This medication may cause harm and death if it is taken by other adults, children, or pets. Return medication that has not been used to an official disposal site. Contact the DEA at 1-800-882-9539 or your city/county government to find a site. If you cannot return the medication, mix any unused medication with a substance like cat litter or coffee grounds. Then throw the medication away in a sealed container like a sealed bag or coffee can with a lid. Do not use the medication after the expiration date.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.