A plain-English explanation of how Nayzilam works to stop seizure clusters. Learn about its mechanism of action, why it's given as a nasal spray, and how it compares to other rescue medications.
Nayzilam (Midazolam nasal spray) is a rescue medication that stops seizure clusters by calming overactive electrical signals in the brain. It does this by boosting the effects of a natural brain chemical called GABA, which acts like a "brake" on brain activity. When a seizure cluster is happening, the brain's electrical activity is out of control — Nayzilam helps slam on the brakes.
If you want a general overview of the medication first, start with What Is Nayzilam?
To understand how Nayzilam works, it helps to understand what happens during a seizure. Your brain communicates through electrical signals. Normally, these signals are carefully balanced — some signals excite brain cells (tell them to fire), and others inhibit them (tell them to calm down).
During a seizure, the excitatory signals overwhelm the inhibitory ones. Too many brain cells fire at once, creating a surge of uncontrolled electrical activity. This is what causes the physical symptoms of a seizure — muscle jerking, loss of consciousness, confusion, and other effects depending on the type of seizure.
In a seizure cluster, this happens multiple times in a short period, which is why a fast-acting rescue medication is so important.
Your brain has a chemical messenger called GABA (gamma-aminobutyric acid). GABA is the main inhibitory neurotransmitter — it's the brain's natural way of calming things down. When GABA attaches to a receptor on a brain cell (specifically the GABA-A receptor), it opens a channel that lets chloride ions flow in, making the cell less likely to fire.
Think of each brain cell as having a volume knob. GABA turns the volume down.
Nayzilam contains Midazolam, a benzodiazepine. Benzodiazepines don't replace GABA — instead, they make GABA work better. When Midazolam binds to the GABA-A receptor, it changes the receptor's shape so that GABA can attach more effectively and keep the chloride channel open longer.
The result: stronger inhibitory signals throughout the brain, which helps override the uncontrolled excitatory activity of the seizure and bring it to a stop.
It's like having a brake pedal that normally works fine, but during a seizure emergency, Nayzilam gives you power brakes — the same push stops the car much more effectively.
Midazolam has been used in hospitals for decades as an injectable medication. So why make it a nasal spray? The answer comes down to practicality:
The nasal spray delivers 5 mg of Midazolam per device, and the medication begins working within minutes of administration.
Because the nasal lining absorbs Midazolam rapidly, effects typically begin within minutes. This is why the dosing instructions say to wait 10 minutes before considering a second dose — the first dose needs time to take full effect. If the seizure cluster hasn't stopped after 10 minutes, a second dose can be given in the opposite nostril.
Several rescue medications are available for seizure clusters. They all work through the same basic mechanism — enhancing GABA activity — but they differ in how they're delivered:
For a detailed comparison of your options, read our guide on alternatives to Nayzilam.
Knowing how Nayzilam works can help you understand:
If you need help finding Nayzilam at a pharmacy, use MedFinder to check stock near you. For savings options, see our guide on how to save money on Nayzilam.
You focus on staying healthy. We'll handle the rest.
Try Medfinder Concierge FreeMedfinder's mission is to ensure every patient gets access to the medications they need. We believe this begins with trustworthy information. Our core values guide everything we do, including the standards that shape the accuracy, transparency, and quality of our content. We’re committed to delivering information that’s evidence-based, regularly updated, and easy to understand. For more details on our editorial process, see here.
%2C%20Color%3DOriginal.png)
