Midazolam, Intranasal
“This page provides important general information for pet owners whose animals have been prescribed Midazolam, Intranasal during a consultation by Dr Noor in Perth.”
Key Information
- Midazolam can be put into the nose to help stop a seizure. It may be sprayed in, or allowed to drip in.
- Use this medicine only in the exact situations your veterinarian told you to use it. Also follow the limit your veterinarian set for how many times it may be used in one day.
- Before an emergency happens, make sure you know how to get the dose ready and how to give it.
- If you use needles, put the used needles into a sharps container right away.
- Possible effects after giving it include sneezing, sleepiness, or moving in an unsteady way.
- If your animal’s seizure gets worse, or if the seizure does not stop within a few minutes after you give this medicine, contact your veterinarian.
- This medicine is a controlled substance. It must be used only for the animal it was prescribed for. Giving it to someone else or selling it is against the law.
Note: This handout is meant to answer common questions. It does not include every detail about this medicine. It also does not replace medical guidance from your veterinary care team.
Description
- This medicine belongs to a group of medicines called benzodiazepines, which are used to stop seizures.
- It comes as a liquid that is normally sold as an injectable product, but for this use it is placed into the nose (intranasal), either by dripping or spraying.
Other common names
- Versed
Uses
Your veterinarian may choose to use it in animals (extra-label), including for:
- Stopping seizures in dogs
This medicine is used to stop a seizure that is happening right now. It does not take the place of any daily seizure-control medicines your animal may already be taking.
Before this medication is given
No medicine is completely safe for every patient. Talk with your veterinarian about:
- Any other medicines or supplements your animal is using
- Any health problems your animal has now, or has had before
- Any bad reactions your animal has had to medicines in the past
- The risks of using this medicine if your animal is pregnant or nursing
Warnings for animals
Do not use this medicine in animals:
- That have an allergy to this medicine or to other benzodiazepines
- That have narrow-angle glaucoma
Use extra care in:
- Older animals, or animals that are weak or in poor condition
- Animals that have kidney, liver, or heart disease
Some animal competitions do not allow certain medicines. If your animal competes, check the rules while your animal is taking a medicine.
Warnings for humans
- Wash your hands after you handle any medicine.
- Be careful to avoid needle sticks. Needle sticks can cause pain and infection. If you get stuck by a needle, contact your doctor.
- Follow your veterinarian’s directions closely so you do not get bitten by accident while your animal is having a seizure.
- This medicine is a controlled substance. It must only be used for the animal it was prescribed for. It is illegal to give it to anyone else or sell it.
How do I give this medication?
This medicine is supplied as a liquid made for injection, but you must not inject it into your animal. The only way to give it is into the nose, by dripping or spraying.
Follow your veterinarian’s directions about exactly when to use it and the maximum number of times it can be used in one day.
Keep everything you need together in one place as a kit, so it is ready when you need it.
Supplies needed include:
- Midazolam vial
- Syringes
- Needles OR a dispensing pin
- Alcohol swab
- Sharps container (if using needles)
Before you ever need to use it in an emergency, make sure you are comfortable with how to give it. It may help to practice assembling the parts ahead of time.
To reduce medicine running back out of the nose, if the dose is more than 1 mL, divide it between the two nostrils.
To give the dose:
If the vial is new, take off the plastic cap.
Pull up the prescribed amount into the syringe. You can do this using either a needle or a dispensing pin placed into the vial.
If you are using a needle:
- Clean the rubber top of the vial with an alcohol swab. Let it dry on its own.
- Put the needle onto the syringe and remove the needle cap.
- Pull the plunger back to the amount your animal needs, so the syringe fills with air.
- Put the needle into the vial and push the air into the vial.
- Turn the vial upside down and pull back the plunger to draw up the prescribed amount.
- Turn the vial upright again and take the needle out of the vial.
- Put the needle cap back on carefully by setting the cap on a flat surface and sliding the needle into the cap without holding the cap. After the needle tip is covered, press the cap on fully. Then remove the needle from the syringe and throw the needle away right away in a sharps container.
If you are using a dispensing pin:
- Clean the rubber top of the vial with an alcohol swab. Let it dry on its own. Then push the dispensing pin spike firmly into the rubber top.
- Unscrew the pin cap. Wipe the opening with an alcohol swab and let it dry on its own.
- Connect the syringe to the dispensing pin. Turn the vial upside down and draw up the prescribed amount.
- Before you remove the syringe, turn the vial back upright.
- Put the cap back on the pin and leave the pin in the vial. The pin stays in place until the vial is empty.
If you were provided a nasal syringe tip that turns the liquid into a fine mist (an atomizer), attach it to the syringe and spray the medicine into your animal’s nostril(s).
If you were not provided an atomizer tip, use the syringe to let the liquid drip into your animal’s nostril(s).
Throw the empty syringe into the trash.
Use a fresh syringe each time you give a dose.
If your animal’s seizure becomes worse or does not stop within a few minutes after giving the medicine, contact your veterinarian right away.
Give this medicine exactly as your veterinarian prescribed.
Side effects of Midazolam, Intranasal
Possible side effects include:
- Sneezing
- Sleepiness or low energy
- Unsteady movement
- Confusion
- Unusual excitement or restlessness
Contact your veterinarian immediately if your animal:
- Keeps having seizures
- Becomes too sleepy or too unsteady
- Has itching, swelling, pale or blue gums, heavy drooling, or trouble breathing
How will I know it's working?
The seizure should stop within a few minutes.
If the seizure gets worse or does not get better, contact your veterinary clinic.
How long will the medication effects last?
This medicine should wear off within a few hours after the last dose.
It may last longer if your animal’s kidneys or liver do not work as well.
How long do I give it for?
Follow your veterinarian’s directions about when additional doses may be needed.
Overdose
If you see an overdose happen, or you think one may have happened, call your veterinarian or an animal poison control service (a consultation fee applies):
If possible, have the product or the label with you.
Missed dose
This medicine is not used on a set daily schedule. It is used as a “rescue” medicine during a seizure or after a seizure.
If you are not sure when to give doses, call your veterinary clinic. Do not give more than your veterinarian prescribed.
Storage
- Keep it in the original container at room temperature.
- Keep it away from light.
- Store it where children and animals cannot reach it.
- Because it is a controlled substance, keep it in a secure place and out of view.
Disposal
Midazolam disposal: Because this is a controlled substance, get rid of any unused medicine as soon as you can. Do not flush it in a toilet and do not pour it into a sink. Ways to dispose of unused or expired medicine include:
- Drug take-back sites: This is the best option when available. To locate a nearby site, contact your local law enforcement or your waste management office.
- Home disposal: Pull any remaining liquid out of the vial, combine it with coffee grounds or kitty litter, place it in a sealed plastic bag, and put it in the trash.
Do not keep leftover medicine and do not give it to other people to use.
Disposal of used needles:
- Put used needles into a sharps container. Your veterinarian or pharmacist can help you get a sharps container.
- When the sharps container is about three-quarters full, dispose of it. Ask your local trash service or health department what disposal options are available where you live.
Questions? Talk to your veterinarian.
“Disclaimer: The information on this page is provided as general educational material only. Every animal’s health situation is unique, and treatment decisions must be based on a full veterinary assessment. Always follow the specific instructions given during your consultation, and contact the prescribing veterinarian if you have any concerns.”