Epilepsy Rescue Drugs

Reviewed by: HU Medical Review Board | Last reviewed: October 2023 | Last updated: October 2023

Many people can manage their seizures with anti-seizure medications (ASMs) alone. These are drugs taken every day to prevent seizures ahead of time. But even with ASMs, seizures can still happen – for example, if you have an infection, are overly tired, or stressed. In these cases, an epilepsy rescue drug is used to quickly stop the seizure. These rescue drugs are also called as-needed drugs (written as “PRN” on the prescription from your doctor).1

How do rescue drugs work?

Rescue drugs are designed to:1

  • Be easy to use
  • Be safe
  • Work quickly

The goal of rescue drugs is to stop seizures and prevent emergencies. They are usually taken after a seizure has lasted a certain amount of time, which your doctor will specify. But they do not take the place of medical care. In a medical emergency, you still need to get emergency care.1

Benzodiazepines are the most commonly prescribed rescue drugs for seizures. They get into the bloodstream and to the brain very quickly. They work by attaching to certain receptors in the brain. This activates the receptors and triggers events that calm overactive brain activity and suppress seizures.1,2

Examples of rescue drugs

Some rescue drugs can only be used at a hospital. These include benzodiazepines that are injected into the bloodstream or muscle. Some rescue drugs are a pill that you swallow or dissolve in your mouth (placed under the tongue or between the cheek and gum). The best drug for you will depend on your seizures. For example, if you stay awake during your seizures, you may be able to take a pill. For those who clamp their mouth shut during seizures or lose consciousness, pills may not be an option. You might instead use a dissolvable oral drug, a nasal spray, or a rectal gel, or you might have to seek emergency care for an intravenous drug.2,3

Rescue drugs that are approved in the United States for at-home use include:1,2

  • Diastat® (diazepam) rectal gel – This is commonly only prescribed for children. It can be hard to give to adults or administer in public.
  • Valtoco® (diazepam) nasal spray – This is sprayed in the nose.
  • Nayzilam® (midazolam) nasal spray – This is sprayed in the nose.

If you have a rescue drug, make sure someone around you knows how to give it. This person can be:4-5

  • Someone you live with
  • A close colleague
  • A school nurse

What are the side effects of rescue drugs?

Side effects can vary depending on the specific drug you are taking. Side effects of rescue drugs include:1-5

  • Dizziness
  • Headache
  • Sleepiness
  • Blurred vision
  • Mood changes
  • Nausea
  • Upset stomach

Nasal sprays may also cause a runny nose or nose and throat irritation. Rescue drugs can also cause serious side effects. Tell your doctor every time you use a rescue drug since this information can guide your overall treatment plan.1-5

These are not all the possible side effects of rescue drugs. Talk to your doctor about when you should take rescue drugs and what to expect when taking rescue drugs. Ask your doctor if you or a close family member or caregiver can be trained on how to use rescue drugs so you are prepared during an emergency. Call your doctor if you have any changes that concern you when taking rescue drugs.

Things to know about rescue drugs

Rescue drugs are not a replacement for daily seizure drugs. Rescue drugs and ASMs both have their own jobs in a seizure action plan.1,3-5

Not everyone who has seizures will need rescue drugs. They may only be recommended for certain cases. These include:1-5

  • Status epilepticus (a seizure emergency that lasts longer than 5 minutes)
  • Seizure clusters that are more frequent or longer than usual
  • Seizures that are longer than usual
  • Children with seizures that are hard to control

Rescue drugs may be recommended for people who live very far from an emergency room. They may also be helpful for people who struggle to remember to take their daily seizure drugs.1,3-5

Before beginning treatment for epilepsy, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

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