Epilepsy Rescue Medication – What is it and How Does it Work?

26th May 2022

For most people with epilepsy, seizures will last for less than 5 minutes or even seconds and will stop by themselves with no need for intervention. However, in some cases, seizures can continue for much longer without ceasing or a person can experience one seizure after another with no time to recover in between. These prolonged seizures are known as status epilepticus and can be very dangerous. For this reason, should status epilepticus occur, epilepsy rescue medication will often be required. 

What is Epilepsy Rescue Medication? 

Outside of a hospital, epilepsy rescue medications are used to halt seizures that could potentially be life threatening. 

There are two types of epilepsy rescue medication:

Buccal Midazolam

Buccal midazolam is a benzodizepine liquid sedative that’s released into the buccal cavity of the mouth (the side of the mouth between the cheek and the gum). The medication is then absorbed through the lining of the cheek. Buccal midazolam comes as a pre-filled syringe that can be administered by a parent or carer if required, although some training is required to do so. 

Rectal Diazepam

Rectal diazepam is a benzodiazepine that comes in gel form and needs to be administered into the rectum. It works similarly to buccal midazolam in that it will halt seizure activity. It also comes in a pre-filled rectal tube (enema) to ensure it can be administered quickly and efficiently.

Both of these medications must be prescribed and are not designed for regular use and specialist training is required before someone should attempt to administer either. As these are sedatives, there is a chance that the medication can cause breathing difficulties, which means the person should be closely monitored after administration to ensure they don’t need further medical help.

Which Medication is Right For You?

Choosing a rescue medication is something to be discussed between you and your healthcare provider. Although both options can be effective, there are a variety of factors that need to be taken into consideration before a prescription for either medication can be given, including: 

  • Ease of use
  • How fast it needs to work
  • Potential side effects
  • Method of administration

A buccal midazolam or rectal diazepam plan needs to be in place before the medications can be safely administered. This needs to be written and agreed by a healthcare professional. 

How Can I Learn How to Administer Rescue Medications?

As previously mentioned, specialist training is required before you are able to administer either of these medications. In some cases, an epilepsy nurse may provide this to parents and carers. However, often there are other people who may need to learn this skill, such as teachers, friends, coworkers and others. 

National Epilepsy Training is able to provide expert training on the administration of buccal midazolam or rectal diazepam (or both). Our trainers have a wealth of experience in the administration of these medications and are qualified to provide training to others. 

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