Midazolam (Nasal spray)

Parent or patient Information Leaflet

Dr. C. P. Ravi Kumar

Consultant Paediatric Neurologist
MRCPCH, CCT in Paediatrics (U.K.)
Fellow in Paediatric Epilepsy &
Neurology (London)

Brand names : Medistat, Midacap (both Nasal Spray)

MIDAZOLAM (Nasal spray)

Midazolam is used to abort seizures; it is an emergency use medicine. It is generally used in Emergency room. But now, spray has been introduced which can be used by parents / carers anywhere in case of seizures.

Midazolam is used to stop all forms of seizures. Majority of seizures last less than 5 minutes, meaning they stop by themselves without any intervention.

Midazolam is used to abort Seizures if it is longer than 5 minutes, however this rule is adapted to each child based on their medical background. Your doctor will advise when you should be using the spray.

“Generic Vs Branded Drugs”

How many sprays in EACH nostril?

Your doctor will advise based on child’s weight. Spray to be used in both nostrils as advised by your doctor.

What to do when my child has seizure? How to use spray?

Help him stay calm.

Make your child as comfortable as possible

Don’t put anything in your child’s mouth

Don’t try to restrain your child

These are the steps to use MIDACIP Nasal Spray

Gently Shake the bottle of nasal spray and then remove the protective dust cap over it.

Hold the bottle with your forefinger and middle finger on either side of the nozzle and your thumb underneath the bottle.

If using for the first time, spray it three times in the air, with the nozzle pointing away from the patient.

If the patient is in a supine position, the head should be slightly lifted upwards. Make sure you place the device near the patient’s nose.

Now, insert the nozzle into the nostril. Press the pump with a firm and even stroke. The patient need not inhale. Do not tilt the patient’s head backward while spraying – this will help in avoiding swallowing of the solution. Administer number of spray(s) at a time into each nostril as per the prescribed dose.

Please see Video which would be easy to understand

Could this medication have any side effects on my child? Side effects

Generally, it is safe medicine, post seizure individual can go to deep sleep, using Midazolam may make them sleepier, it is difficult to differentiate if child is sleepy because of seizure or medicine.

CHILD CAN HAVE SLOW BREATHING, SOMETIMES LIPS MAY TURN BLUE WHICH MEANS CHILD NEEDS OXYGEN; HENCE IT IS ADVISED TO TAKE CHILD TO NEARBY HOSPITAL FOR ASSESSMENT IMMEDIATLEY.

If your child starts developing skin Rash, Stop Medications right there and SEEK IMMEDIATE MEDICAL ADVICE from your DOCTOR

Where should I keep the medication?

Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.

Make sure the medicine is out of your child’s reach.

Store the medication in the same box it was packed in.

For more information please refer the manufacturer’s information leaflet.

References :

1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home
2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi
3. British National Formulary for Children (BNFC), https://www.nice.org.uk/bnfc
4. Food and Drug Administration, USA https://www.fda.gov