What types of medicines can be used as a rescue treatment? 

The most common type of rescue medicines are from a group of medicines called benzodiazepines. These are generally fast-acting, which means they will start to work quickly once they get into the bloodstream.

  • Some benzodiazepines can be swallowed in pill form, some can be placed under the tongue or placed between the cheek and the gum, and some can be given rectally or by a nasal spray. They are only given by an injection directly into the blood stream vein in hospital settings.
  • The names of benzodiazepines that are most commonly used as rescue medications include: diazepam (Valium®), lorazepam (Ativan®), and midazolam (Versed®).
    • The availability of these medicines in different forms and how they are used may vary from country to country.
    • In the United States, only rectal diazepam gel, commonly known by the brand name Diastat®, has been approved by the Food and Drug Administration (FDA) for out-of-hospital use for the treatment of acute repetitive seizures or clusters.
    • The other ones have been used in out-of-hospital treatment but have not yet been approved by the FDA.
  • The main points to consider in using these medicines is how fast they will act, what forms may be available, who can give it, and how easy it may be to use. Other factors such as cost, possible side effects, and everyone’s comfort level in using the medicines must be talked about with your doctor.
    • People who may need a fast-acting medicine at specific times for breakthrough seizures and who are alert and able to swallow may use one of the pill forms of lorazepam or diazepam.
    • People who are not able to swallow for some reason may be given a form that can be given under the tongue (sublingual), between the cheek and gum (buccally), or sprayed into a nostril (nasal spray).
    • People who are not able to take an oral form can use the rectal form of diazepam. This is most often prescribed for children.

How can I learn more about these?

Glad you asked! Everyone who is given a prescription for a rescue treatment should receive training on what to do, when and how often. Usually your first teaching should come from the health care professional who gave the prescription. However, you can learn more about the treatments and how to give them right here. Once you feel you have this conquered, make sure to teach your family, friends or whoever else may help you during a seizure. They'll want to know what to do too!

A key point to consider: It often helps to try the first dose of a rescue medicine when you are at home or in the doctor's or nurse's office. This gives you a chance to practice how to use it and see how the medicine affects you. If you plan on doing it in your doctor's or nurse's office, you'll need to bring a dose of medicine with you. 

Some people worry that this will 'waste' a dose of medicine. However, learning your response to a medicine is not a waste. It's an important part of knowing what to expect. And of course, practice makes perfect! You want to know ahead of time how to give the medicine quickly when you really need it. 

Authored By: 
Patty Obsorne Shafer RN, MN
Authored Date: