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Paraldehyde for seizures
Paraldehyde for seizures
This leaflet is about the use of rectal paralydehyde to stop seizures. (Seizures may also be called convulsions or fits).
This leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.
Do not give paraldehyde if the liquid is brownish in colour or if it has a vinegar-like smell.
Name of drug
Why is it important for my child to take this medicine?
Paraldehyde is used to stop a seizure.
What is paraldehyde available as?
Liquid to be given via the rectum (back passage): the mixture usually contains equal amounts of paraldehyde and olive oil.
Make sure the mixture you have is paraldehyde mixed with oil. You must never use neat paraldehyde. If you are not sure, ask your pharmacist.
When should I give paraldehyde?
You should give rectal paraldehyde if your child’s seizure lasts more than 5 minutes. Follow these steps.
(If you have been given paraldehyde to use in case buccal midazolam doesn’t help, follow your doctor’s advice for when to give it.)
Do not give your child another dose of paraldehyde, unless you have been told to do so by your doctor.
How much should I give?
Your doctor will work out the amount of paraldehyde (the dose) that is right for your child. This amount will be shown on the medicine label.
You must check what volume of the mixture to use, especially if you have a new prescription, because different mixtures may contain different amounts of paraldehyde.
It is important that you follow your doctor’s instructions about how much to give.
How should I give paraldehyde?
Paraldehyde is given rectally (into the back passage).
Your epilepsy nurse or doctor should have given you all the things you need. They should be kept together, somewhere close to hand. You will need:
- the paraldehyde solution
- plastic syringe and plastic tubing (quill)
- lubricating gel
- disposable plastic gloves.
Although it can be upsetting to see your child having a seizure, it is important that you stay calm and follow the instructions.
Prepare the paraldehyde
- Put on gloves if available, or wash your hands with soap and hot water.
- Attach a quill to the end of the plastic syringe.
- Draw up the right amount of paraldehyde liquid into the syringe.
- You must not leave mixture in the plastic syringe for any longer than 15 minutes, because the paraldehyde will start to eat into the plastic.
Give the paraldehyde
- Smear some lubricating gel onto the end of the tube.
- Put your child into the recovery position (as you would normally during a seizure), lying on their left side (this will help the paraldehyde to be absorbed). With a small child it may be easier to lie the child on their front or across your knees.
- Hold one buttock gently to one side so that you can see the back passage.
- Gently push the quill into the back passage, then slowly push the plunger of the syringe until it is empty.
- Gently remove the quill and hold your child’s buttocks together for a few minutes to make sure the solution does not leak out.
- Throw away the syringe, quill and gloves.
- Wash your hands thoroughly with soap and hot water.
What if my child is sick (vomits)?
You do not need to give your child another dose of paraldehyde, as it will still work.
What if I don’t give the paraldehyde?
If you do not give the paraldehyde, or you 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 you think you may have given your child too much paraldehyde, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales) or take your child to hospital.
Take the medicine container or packet with you, even if it is empty. This will be useful to the doctor. Have the packet with you if you telephone for advice.
Are there any possible side-effects?
We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).
Paraldehyde does not usually cause any side-effects.
- Your child may have a rash around their back passage, or the skin may feel sore for a short time.
- Your child’s breath will smell of paraldehyde for some hours after it has been given. This is because of the way paraldehyde is broken down in the body and is nothing to worry about.
Is there anything else I need to know about this medicine?
- Make sure that your child always has their paraldehyde and the things needed to give it with them at all times.
- Make sure that anyone who looks after your child knows what to do if your child has a seizure and how to give rectal paraldehyde.
You must keep the paraldehyde solution in the container it came in. Do not store it in rubber or plastic containers (i.e. syringes).
Once you have drawn the liquid up into the syringe, it must be used within 15 minutes. If the mixture has been in the syringe for longer than this, throw away the syringe and solution and start again with a fresh syringe.
Paraldehyde solutions are specially made when you get a new prescription. Check how much you should use (a volume in mL), as this may be different from the previous supply.
- Ensure that you have paraldehyde that is mixed with oil and is not neat paraldehyde. If you are not sure, check with your pharmacist.
- Only give paraldehyde to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.
If you get any paraldehyde in your eyes or on your skin, wash the area with cold water immediately. If irritation continues, go to your local Emergency department.
If you think someone else may have taken the medicine by accident, contact your doctor straight away.
- Make sure that the medicine you have at home has not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.
- Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before it has reached the ‘best before’ or ‘use by’ date on the packaging.
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.
- You must keep the medicine in the container it came in.
Who to contact for more information
Your child’s doctor, pharmacist or epilepsy nurse will be able to give you more information about paraldehyde and about other medicines used to treat seizures.
You can also get useful information from:
- England - NHS 111
- Scotland - NHS 24
- Wales/Galw lechyd Cymru - NHS Direct
0845 46 47
- Northern Ireland - NI Direct
- Epilepsy Action Helpline
0808 800 5050
- Epilepsy Society Helpline
01494 601 400
- National Centre for Young People with Epilepsy (NCYPE) Confidential enquiry line
01342 831 342
Version 2, June 2014. © NPPG, RCPCH and WellChild 2011, all rights reserved. Reviewed by: June 2017.
The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk
We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.