Hackensack Meridian Children’s Health Research Shows Nasal Spray Seizure Rescue Medication Safe to Use with Oral Medication

Diazepam Nasal Spray Shown Safe with Oral Benzodiazepines for Emergency Seizure Cluster Treatment in Patients with Epilepsy

Eric Segal, M.D., co-director of epilepsy at Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center has published research showing that diazepam nasal spray, which uses benzodiazepine, is safe and effective for emergency seizure cluster treatment in patients who are already taking oral benzodiazepines.

The research, published in Epilepsia, evaluated the safety profile of diazepam nasal spray in patients with and without concomitant use of benzodiazepines. The long-term phase-3, open-label safety study enrolled 175 patients with epilepsy who had seizures despite a stable anti-seizure medication regimen. Patients were split into two groups: those who used oral benzodiazepines, and those who did not.

In addition to finding that there were no significant differences in tolerance or adverse effects between patient groups, the research also showed that there was a low need for a second dose of diazepam, regardless of whether patients use daily benzodiazepines. Use of a single dose of diazepam nasal spray and high study retention rates suggest the effectiveness of diazepam nasal spray in patients irrespective of chronic daily benzodiazepine use. Results were similar in the clobazam sub-analysis.

Other FDA-approved benzodiazepine rescue medications for seizure clusters must be administered rectally and often need to be given at higher doses to patients who are taking oral benzodiazepines. This new research significantly shows that the nasal spray—a more socially acceptable method of rescue medication delivery—works at the same prescribed dose for those who are taking oral benzodiazepines and those who are not, with no additional risk of adverse events.

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