How to Help Your Patients Find Valtoco in Stock: A Provider's Guide

When you prescribe Valtoco (diazepam nasal spray, CIV) to a patient, their journey to filling that prescription is often more difficult than it should be. As a prescribing clinician, you can take specific, proactive steps to make that process smoother. This guide outlines actionable strategies for neurologists, epileptologists, pediatricians, and other providers who prescribe Valtoco.

Why Patients Struggle to Fill Valtoco Prescriptions

The core challenge is straightforward: Valtoco is a brand-name-only specialty medication made by a single manufacturer (Neurelis, Inc.), and most retail pharmacies don't stock it as standard inventory. Patients who receive a Valtoco prescription and walk to their nearest pharmacy often find it's not available. This can be alarming—particularly because Valtoco is a rescue medication that needs to be available before a seizure cluster occurs, not during one.

Step 1: E-Prescribe Directly to a Specialty Pharmacy

The single most impactful thing you can do is e-prescribe Valtoco directly to a specialty pharmacy that reliably stocks it, rather than letting the patient handle pharmacy selection. Recommended options:

PharmaCord Pharmacy (NABP 1836191): Preferred by the myNEURELIS program. Required for PAP patients. E-scribed prescriptions are processed efficiently.

Local specialty pharmacies: Verify in advance that they stock Valtoco in your patient's specific dose kit (5 mg, 10 mg, 15 mg, or 20 mg).

CVS Specialty, Walgreens Specialty, Optum Specialty: Major specialty pharmacy chains that carry a broader range of products than retail branches.

Step 2: Enroll Patients in myNEURELIS at the Time of Prescribing

The myNEURELIS program, run by Neurelis, provides end-to-end support for Valtoco patients. Enrolling your patients at the time of prescribing eliminates much of the friction downstream. The program provides:

Insurance verification and benefit investigation

Prior authorization support and appeals assistance

Copay assistance card enrollment (commercially insured patients may pay as little as $20)

Patient Assistance Program for uninsured patients with limited income (medication at no cost if eligible)

Nurse educator calls to review administration and seizure action plan

Pharmacy access support and specialty pharmacy referrals

Enroll via the myNEURELIS referral form or call 1-866-myNEURELIS (1-866-696-3873), Monday–Friday, 8 AM–8 PM ET.

Step 3: Submit Prior Authorization Proactively

Most commercial payers require prior authorization for Valtoco. Submit the PA at the time of prescribing rather than waiting for a pharmacy rejection. Include in your PA submission:

ICD-10 diagnosis code for epilepsy and seizure clusters

Documentation that seizure clusters are distinct from the patient's usual seizure pattern

Patient weight and age for dose selection justification

Clinical rationale for nasal spray delivery (patient preference, age-appropriateness, self-administration feasibility)

For step therapy requirements: trial history with alternative rescue medications, or clinical reasoning for why alternatives are not appropriate

Step 4: Recommend medfinder to Your Patients

For patients who are managing pharmacy searching on their own, medfinder provides a service where patients enter their medication, dose, and location—medfinder then calls local pharmacies and texts the patient results showing which pharmacies have their prescription in stock. This is particularly valuable for specialty medications like Valtoco that aren't stocked everywhere.

Step 5: Provide a Seizure Action Plan That Includes Pharmacy Information

The Epilepsy Foundation recommends that every patient with seizure clusters have a Seizure Action Plan (SAP). Consider including pharmacy information as part of that plan—specifically, the name and phone number of the specialty pharmacy that stocks their Valtoco. This ensures caregivers, school nurses, and emergency contacts know where to find the medication if a refill is needed urgently.

Step 6: Have a Bridge Rescue Plan Ready

In cases where Valtoco cannot be filled quickly, ensure your patient is not left without a rescue plan. Options include a standing prescription for Nayzilam (midazolam nasal spray, for ages 12+) or generic diazepam rectal gel as a bridge while Valtoco is being located or the PA is being processed.

See also: Valtoco Shortage: What Providers and Prescribers Need to Know in 2026.