Some fast-acting medicines, such as diazepam or lorazepam, can be used 'as needed' to stop seizures. When used outside of a hospital setting, they are usually given by mouth. Some forms of injections and nasal sprays are being developed and tested. The following information will help people understand important facts about giving and using rescue medicines that are meant to be taken orally or sublingually (which means under the tongue). People who are prescribed these medicines or who are asked to give them to someone else (such as their child) should receive one on one teaching from a doctor or nurse.

How can oral or sublingual medicines be given?

Some people don’t like the idea of using a medicine rectally, or their doctor may feel that an oral medicine is better for them. You may be asked to take or give a medicine in one of three ways.

  • Oral or by mouth: This usually means swallowing the pill with water. This should be done only if the person is awake and alert and is not at risk for choking on the pill or water.
  • Sublingual: This means that the pill is placed under the tongue where it will dissolve and be absorbed into the bloodstream. The person should not drink or eat anything until the medicine is gone.
  • Buccal: This means that the medicine can be placed in the mouth between the cheeks and the nearby gum where it will dissolve and be absorbed into the bloodstream. Usually, medicines that can be taken sublingually can also be taken buccally. The person should not drink or eat anything until the medicine is gone.

Taking the pills orally is usually easier for most people. However, it may be hard to give medicines this way to an infant or young child, a person who is too sleepy or not able to cooperate, a person who can not keep the medicine in their mouth (for example someone who drools or has vomited), or a person who is having too many seizures. In these situations, talk to your doctor about rectal forms of the medicine such as Diastat.

Specific orders needed from your doctor:

  • Name of the drug.
  • The dose of each pill and how much to take at each dose.
  • When it should be given - for example after a certain number of seizures or after clusters of seizures that last a certain period of time.
  • How often it can be taken and how much in one day.
  • Times when it should NOT be taken.
  • How to take it – swallow, sublingual or buccal.

Remember: 

  • Talk to your health care provider about the best way to use rescue seizure medicine.
  • Make sure you have a specific plan on when to use it and when not to.
  • Include information on how to give these medicines on your Seizure Plan so others will know how best to help you.
Authored by: Steven C. Schachter, MD | Patricia O. Shafer, RN, MN | Joseph I. Sirven, MD on 11/2013
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