Midazolam for stopping seizures

This leaflet is about the use of midazolam to stop seizures. (Seizures may also be called convulsions or fits.)

Never give your child more than one dose of midazolam during one seizure.

This leaflet has been written specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again. It is vital that anybody who looks after your child knows exactly what to do if your child has a seizure.

Name of drug

Midazolam buccal liquid

Common brands: Hypnovel^®, Epistatus^®

Why is it important for my child to take this medicine?

Midazolam is used to stop a seizure.

What is midazolam available as?

Hypnovel® is a liquid that is also used for injections. It comes in a small glass tube.
Epistatus® is a syrup. This comes in a bottle with four syringes.

When should I give midazolam?

You should give midazolam if your child’s seizure lasts more than 5 minutes. Follow these steps.

Do not give your child another dose of midazolam.
Do not give your child rectal diazepam or any other drug.

How much should I give?

The amount of midazolam that you give your child (the dose) depends on their weight. It also depends on whether they have Hypnovel® or Epistatus®. Your doctor will tell you how much to give.

If you are not sure how much midazolam to give, you must ask your doctor before you give any. It is important that you do not give too much.

Do not give your child more than one dose of midazolam during one seizure, as this can be dangerous.

How should I give midazolam?

Midazolam needs to go into the space between the inside of the cheek and the teeth, which is called the buccal cavity. Your doctor or nurse will show you what to do.
If you can, give about half the amount slowly into one side of the mouth, then give the other half slowly into the other side.
The drug quickly gets from the buccal cavity into the blood to stop the seizure. If you put the midazolam into the middle of the mouth it will not work as well because it cannot get into the blood so quickly.
Your child does not need to swallow the medicine.

(It is not harmful if they do swallow it, but it will not work as well.)

What if my child is sick (vomits)?

Do not give your child another dose of midazolam.

What if I don’t give it?

If you do not give the midazolam, or do not give the right dose, your child’s seizure may not stop. This could be dangerous, and your child will need to go to hospital.

What if I give too much?

If there is any possibility that you may have given too much midazolam, or your child’s breathing slows down or stops, telephone for an ambulance straight away.

Are there any possible side effects?

Your child may be sleepy after having midazolam. They should have a sleep if they want to.
Your child may be confused. They probably won’t remember having the seizure.

Can other common medicines be given at the same time as midazolam?

You must not give your child any other medicine to stop the seizure, unless your doctor has said that you can do this.

Is there anything else I need to know about this medicine?

Make sure that your child always has their midazolam with them.
Make sure that anyone who looks after your child knows what to do and how to give midazolam if your child has a seizure.
It is best that your child always has the same brand of midazolam (Hypnovel® or Epistatus®). Write down which brand you use, and how much you give. Keep this information with you.
Only give midazolam to your child. Never give it to anyone else, even if they seem to be having a seizure, as this could do harm.
If anyone else takes the medicine by accident, take them to a doctor straight away.
Make sure that the midazolam you have at home is not older than the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

Keep the medicine in a cupboard, away from heat and direct sunlight. It does not need to be kept in the fridge.
Make sure that children cannot see or reach the medicine.
Keep the medicine in the container it came in.