Intranasal Lorazepam for Prolonged Seizures

If prolonged tonic-clonic seizures or clusters of shorter seizures are not treated, they can sometimes lead to status epilepticus. Status epilepticus is a prolonged seizure that lasts for 30 minutes or longer. Quick treatment within 3-5 minutes can stop a prolonged seizure or status epilepticus. You might be able to avoid going to an emergency room with early treatment.

Lorazepam for Seizures

A caregiver will use an atomizer to put the medicine in your nose as a spray or mist. This way, it goes straight into your bloodstream and there is no need to swallow.

Using Lorazepam Instead of Valium

Research suggests giving lorazepam in the nose instead of rectal Valium for patients who do not have an IV. We have found that it:

• Is safe.

• Works quickly.

• Sends medicine right to the blood and spinal fluid.

• Is less likely to build up when given more than once.

• Works as well as IV medicines to stop seizures.
  

Side Effects

• Fatigue

• Irritation in the lining of your nose
  

If Seizure Doesn’t Stop

Follow the directions your doctor gave you.

Repeat Seizures

Follow the directions your doctor gave you. For some people, your doctor may instruct you to repeat the lorazepam for repeat seizures.

Supplies

Carpuject

Atomizer

Prefilled lorazepam vial

Giving Lorazepam Nasal Spray

1. Twist the tube to break the seal and separate the parts of the package to remove the vial.

2. Open the Carpuject by spinning the top part of the handle (darker color) ½ turn away from the bottom part of the handle (clear). Then pull the white plunger out.

   

3. Place the prefilled lorazepam vial into the Carpuject.

   

4. Close the Carpuject by spinning the top part of the handle ½ turn towards the bottom part of the handle. Then, tighten the white plunger by spinning it clockwise a few turns until it reaches the syringe.

   

5. Pull the cap off the lorazepam vial. Then attach the atomizer by gripping the clear wing and inserting into the tip of the vial. Then, turn the atomizer in a clockwise motion to secure it on the vial.

   

6. Insert the white cone of the atomizer into the nostril until you feel resistance. Push down on the plunger to give the medicine.

   

7. Follow the directions from your doctor for how much medicine to give. Then, remove the atomizer from the nose.

8. Remove the atomizer by twisting it off in a counter-clockwise motion away from the empty vial. You can reuse the atomizer within 24 hours. If it has been more than 24 hours get rid of the atomizer.

9. Remove the used lorazepam vial from the Carpuject device by pulling the plunger back and unscrewing the Carpuject. The used vial can then be removed and disposed of. Do not throw away the Carpuject device. You can use again in the future when needed.

   

Storing Lorazepam

Store lorazepam in the fridge. If you will be away from a fridge, carry it in a cooler with an ice pack.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.