Rescue seizure medications are prescription medications used to stop a seizure while it is occurring. Common emergency situations that may require rescue medications includeseizures that last longer or occur more oftenthan usual and seizures of unknown origin.These medications are fast-acting, and their effects often wear off within a few hours.

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Intravenous medications in emergency setting

Rescue Seizure Medications

In addition to stopping seizures, rescue seizure medications also cause tiredness, dizziness, and slowed thinking. They may also slow down breathing, potentially requiring medical respiratory support. The antiseizure effects and the side effects of rescue seizure medications generally stop after a few hours.

Ativan (lorazepam)

Ativan is a benzodiazepine. The oral form of this medication is used for treatment of anxiety disorders. For treatment of status epilepticus, the intravenous (IV, in a vein) form of Ativan is recommended at a dose of 4 milligrams (mg) at a rate of 2 mg/min for patients 18 years and older.

If the seizures stop, no further administration of Ativan is recommended. If the seizures continue or recur after 10 to 15 minutes, an additional 4 mg dose is administered at the same rate as the first dose.

Diastat (diazepam)

This benzodiazepine is a rectal gel that is administered in a weight-based recommended dose of 0.2-0.5 mg/kilograms (kg) of body weight, depending on age.

Valtoco (diazepam)

This benzodiazepine is administered as a nasal spray. It is indicated for acute treatment of seizure clusters in patients with epilepsy 6 years of age and older. Dosing is weight and age based. The recommended dose is a single intranasal spray of 5 mg or 10 mg into one nostril or 15 mg or 20 mg doses, which requires two nasal spray devices, one spray into each nostril.

If necessary, a second dose can be used at least 4 hours after the initial dose. No more than two doses should be used to treat a single episode and Valtoco should not be used more than every five days and it shouldn’t be used to treat more than five episodes per month.

Valium (diazepam)

Klonopin (clonazepam)

Klonopin is a benzodiazepine that is used in the treatment ofanxiety disorders. It is also used to treat acute persistent, repetitive seizures that occur as part ofLennox-Gastaut syndromeandmyoclonic epilepsy.

Nayzilam (midazolam)

This benzodiazepine nasal spray is indicated for acute treatment of seizure clusters in patients with epilepsy 12 years of age and older. The recommended dose is one 5 mg spray into one nostril. An additional 5 mg spray can be used into the opposite nostril after 10 minutes if necessary.

No more than two doses should be used for a single seizure cluster episode, and Nayzilan should not be used more than every three days and should not be used to treat more than five episodes per month.

Phenytoin

The oral form of this nonbenzodiazepine medication is used as a maintenance therapy, and the IV formulation is used to stop ongoing seizures in the medical setting.Dosing is typically weight-based.

Phenobarbital

Thisbarbiturate medicationinteracts with GABA to control seizures. An oral formulation is used as maintenance therapy, and the IV form is used for emergency seizure control in a medical setting.

Keppra (levetiracetam)

This anticonvulsant is approved for treatment of seizures in adults and children ages four and older. It is indicated for certain types of epilepsy that are typically difficult to treat, including myoclonic epilepsy. It is available as a tablet and an oral solution.

Rescue Medications vs. Maintenance Therapies

Rescue medications are different from maintenance therapies, which areanti-epilepsy drugs (AEDs)that are taken on a regular ongoing basis to prevent seizures.

Indications

Rescue medications are often used in an emergency setting, such as in the hospital. In these situations, you can be monitored closely for side effects, such as slowed breathing, and you would have medical support as needed.

In some cases, such as when a person has frequent seizures despite the use of maintenance AEDs, the healthcare provider might prescribe a rescue medication to take at home or at an assisted care facility. Usually, caregivers will be given detailed instructions about dosing and timing.

Rarely, a person who has seizures would be given instructions about how to self-administer a rescue medication during thepre-ictal stage of a seizureto prevent the seizure from progressing to theictal phase.

Specific settings when rescue seizure medications may be needed include:

First Aid for Epilepsy Seizures

A Word From Verywell

Rescue medications can be a necessary part of managing seizures.In some situations, your healthcare provider may recommend that you have a rescue medication with you in case a breakthrough seizure occurs—and would provide you with detailed instructions about when and how to use your rescue medication.

Rescue seizure medications are often used in the medical care setting when a seizure is occurring or to treat a prolonged seizure that won’t stop on its own.

9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Scheuermeyer FX, Miles I, Lane DJ, Grunau B, Grafstein E, Sljivic I, Duley S, Yan A, Chiu I, Kestler A, Barbic D, Moe J, Slaunwhite A, Nolan S, Ti L, Innes G.Lorazepam versus diazepam in the management of emergency department patients with alcohol withdrawal.Ann Emerg Med.2020 Dec;76(6):774-781. doi:10.1016/j.annemergmed.2020.05.029Food and Drug Administration.Ativan label.Food and Drug Administration.Diastat label.Food and Drug Administration.Valtoco label.Food and Drug Administration.Nayzilam label.Crawshaw AA, Cock HR.Medical management of status epilepticus: Emergency room to intensive care unit.Seizure. 2020 Feb;75:145-152. doi:10.1016/j.seizure.2019.10.006.Erratum in: Seizure.Sharpe C, Reiner GE, Davis SL, Nespeca M, Gold JJ, Rasmussen M, Kuperman R, Harbert MJ, Michelson D, et al. NEOLEV2 INVESTIGATORS.Levetiracetam versus phenobarbital for neonatal seizures: A randomized controlled Trial.Pediatrics. 2020 Jun;145(6):e20193182. doi:10.1542/peds.2019-3182. Erratum in:Pediatrics.Jafarpour S, Hirsch LJ, Gaínza-Lein M, Kellinghaus C, Detyniecki K.Seizure cluster: definition, prevalence, consequences, and management.Seizure. 2019 May;68:9-15. doi:10.1016/j.seizure.2018.05.013Silbergleit R, Lowenstein D, Durkalski V, Conwit R; NETT Investigators.Lessons from the RAMPART study–and which is the best route of administration of benzodiazepines in status epilepticus.Epilepsia. 2013 Sep;54 Suppl 6(0 6):74-7. doi:10.1111/epi.12284

9 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Scheuermeyer FX, Miles I, Lane DJ, Grunau B, Grafstein E, Sljivic I, Duley S, Yan A, Chiu I, Kestler A, Barbic D, Moe J, Slaunwhite A, Nolan S, Ti L, Innes G.Lorazepam versus diazepam in the management of emergency department patients with alcohol withdrawal.Ann Emerg Med.2020 Dec;76(6):774-781. doi:10.1016/j.annemergmed.2020.05.029Food and Drug Administration.Ativan label.Food and Drug Administration.Diastat label.Food and Drug Administration.Valtoco label.Food and Drug Administration.Nayzilam label.Crawshaw AA, Cock HR.Medical management of status epilepticus: Emergency room to intensive care unit.Seizure. 2020 Feb;75:145-152. doi:10.1016/j.seizure.2019.10.006.Erratum in: Seizure.Sharpe C, Reiner GE, Davis SL, Nespeca M, Gold JJ, Rasmussen M, Kuperman R, Harbert MJ, Michelson D, et al. NEOLEV2 INVESTIGATORS.Levetiracetam versus phenobarbital for neonatal seizures: A randomized controlled Trial.Pediatrics. 2020 Jun;145(6):e20193182. doi:10.1542/peds.2019-3182. Erratum in:Pediatrics.Jafarpour S, Hirsch LJ, Gaínza-Lein M, Kellinghaus C, Detyniecki K.Seizure cluster: definition, prevalence, consequences, and management.Seizure. 2019 May;68:9-15. doi:10.1016/j.seizure.2018.05.013Silbergleit R, Lowenstein D, Durkalski V, Conwit R; NETT Investigators.Lessons from the RAMPART study–and which is the best route of administration of benzodiazepines in status epilepticus.Epilepsia. 2013 Sep;54 Suppl 6(0 6):74-7. doi:10.1111/epi.12284

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Scheuermeyer FX, Miles I, Lane DJ, Grunau B, Grafstein E, Sljivic I, Duley S, Yan A, Chiu I, Kestler A, Barbic D, Moe J, Slaunwhite A, Nolan S, Ti L, Innes G.Lorazepam versus diazepam in the management of emergency department patients with alcohol withdrawal.Ann Emerg Med.2020 Dec;76(6):774-781. doi:10.1016/j.annemergmed.2020.05.029Food and Drug Administration.Ativan label.Food and Drug Administration.Diastat label.Food and Drug Administration.Valtoco label.Food and Drug Administration.Nayzilam label.Crawshaw AA, Cock HR.Medical management of status epilepticus: Emergency room to intensive care unit.Seizure. 2020 Feb;75:145-152. doi:10.1016/j.seizure.2019.10.006.Erratum in: Seizure.Sharpe C, Reiner GE, Davis SL, Nespeca M, Gold JJ, Rasmussen M, Kuperman R, Harbert MJ, Michelson D, et al. NEOLEV2 INVESTIGATORS.Levetiracetam versus phenobarbital for neonatal seizures: A randomized controlled Trial.Pediatrics. 2020 Jun;145(6):e20193182. doi:10.1542/peds.2019-3182. Erratum in:Pediatrics.Jafarpour S, Hirsch LJ, Gaínza-Lein M, Kellinghaus C, Detyniecki K.Seizure cluster: definition, prevalence, consequences, and management.Seizure. 2019 May;68:9-15. doi:10.1016/j.seizure.2018.05.013Silbergleit R, Lowenstein D, Durkalski V, Conwit R; NETT Investigators.Lessons from the RAMPART study–and which is the best route of administration of benzodiazepines in status epilepticus.Epilepsia. 2013 Sep;54 Suppl 6(0 6):74-7. doi:10.1111/epi.12284

Scheuermeyer FX, Miles I, Lane DJ, Grunau B, Grafstein E, Sljivic I, Duley S, Yan A, Chiu I, Kestler A, Barbic D, Moe J, Slaunwhite A, Nolan S, Ti L, Innes G.Lorazepam versus diazepam in the management of emergency department patients with alcohol withdrawal.Ann Emerg Med.2020 Dec;76(6):774-781. doi:10.1016/j.annemergmed.2020.05.029

Food and Drug Administration.Ativan label.

Food and Drug Administration.Diastat label.

Food and Drug Administration.Valtoco label.

Food and Drug Administration.Nayzilam label.

Crawshaw AA, Cock HR.Medical management of status epilepticus: Emergency room to intensive care unit.Seizure. 2020 Feb;75:145-152. doi:10.1016/j.seizure.2019.10.006.Erratum in: Seizure.

Sharpe C, Reiner GE, Davis SL, Nespeca M, Gold JJ, Rasmussen M, Kuperman R, Harbert MJ, Michelson D, et al. NEOLEV2 INVESTIGATORS.Levetiracetam versus phenobarbital for neonatal seizures: A randomized controlled Trial.Pediatrics. 2020 Jun;145(6):e20193182. doi:10.1542/peds.2019-3182. Erratum in:Pediatrics.

Jafarpour S, Hirsch LJ, Gaínza-Lein M, Kellinghaus C, Detyniecki K.Seizure cluster: definition, prevalence, consequences, and management.Seizure. 2019 May;68:9-15. doi:10.1016/j.seizure.2018.05.013

Silbergleit R, Lowenstein D, Durkalski V, Conwit R; NETT Investigators.Lessons from the RAMPART study–and which is the best route of administration of benzodiazepines in status epilepticus.Epilepsia. 2013 Sep;54 Suppl 6(0 6):74-7. doi:10.1111/epi.12284

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