Treatment of Prolonged Seizures and Prevention of
With Intranasal Lorazepam
Why do we treat seizures with
Prolonged tonic-clonic seizures or clusters
of shorter seizures left untreated can
sometimes lead to status epilepticus. Status
epilepticus is a prolonged seizure that
continues for 30 minutes or longer. Prompt
treatment within 3-5 minutes can stop a
seizure from becoming prolonged or status
epilepticus. Visits to an emergency room
might be avoided if seizures are treated
How is Lorazepam given for seizures?
A family member or caregiver will use an
atomizer to put the medicine in your nose as
a spray or mist. When we give it this way, it
goes straight into your bloodstream and
there is no need to swallow.
Why do we give lorazepam instead of
Research suggests lorazepam instead of
rectal Valium for patients who do not have
an IV. We have found that lorazepam given
in the nose:
ξ Is Safe
ξ Is Fast
ξ Sends medicine right to the blood
and spinal fluid.
ξ Is less likely to build up when given
more than once.
ξ Works as well as IV medicines to
Are there any side effects?
ξ You may feel sleepy after getting
ξ It may irritate the lining of your
What if the seizure continues?
Follow the directions given to you by your
doctor for what to do if a seizure continues
even after giving the medication.
What if another seizure occurs in the
Follow the directions given to you by your
doctor for what to do if another seizure
occurs in the same day. For some people, if
a long seizure or clusters of seizures happen
again the same day, lorazepam can be
repeated if instructed by your doctor.
Intranasal Instructions for:
Lorazepam Prefilled Vial with Carpuject and Atomizer
What supplies will I need to give lorazepam as a nasal spray?
ξ Prefilled Lorazepam Vial
Prefilled Lorazepam Vial
How do I give lorazepam as a nasal spray?
ξ Remove the lorazepam for the packaging by twisting the tube to break the seal and
separate the parts of the packaging to remove the vial.
ξ Open the Carpuject by spinning the top part of the handle (darker color) ½ turn away
from the bottom part of the handle (clear). Then pull the white plunger out.
ξ Place the prefilled lorazepam vial into the Carpuject.
ξ Close the Carpuject by spinning the top part of the handle ½ turn towards the bottom part
of the handle. Then tighten the white plunger by spinning it clockwise a few turns until it
reaches the syringe.
ξ Pull the cap off of the lorazepam vial. Then attach the atomizer by gripping the clear
wing and inserting into the tip of the vial. Once inserted turn the atomizer in a clockwise
motion to secure it on the vial.
ξ With the atomizer attached, insert the white cone of the atomizer into the nostril until
resistance is felt. Once inserted push down on the plunger to give the medication. Follow
the specific directions from your doctor as to how much medication should be given.
Once all the medication has been given, remove the atomizer from the nose.
ξ After giving the medication remove the atomizer by twisting it off in a counter clockwise
motion away from the empty lorazepam vial. The atomizer can be reused again within 24
hours, if it has been greater than 24 hours dispose of the atomizer.
ξ Remove the used lorazepam vial from the Carpuject device by pulling the plunger back
and unscrewing the Carpuject. The used vial can then be removed and disposed of.
ξ Do NOT throw away the Carpuject device; you can use again in the future when needed
How do I store lorazepam?
ξ Lorazepam should be stored in the refrigerator.
ξ If you will be away from a refrigerator, lorazepam should be carried in a cooled container
with an ice pack.
Images Drawn by Media Solutions 10/2017
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor.
This is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because
each person’s health needs are different, you should talk with your doctor or others on your health care team
when using this information. If you have an emergency, please call 911. Copyright © 10/2017University of
Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#8011