Jacqueline French, MD: Safety of Intranasal Diazepam As Rescue Medication


The professor of neurology at NYU Langone Medical Center discussed the importance of these safety data for intranasal diazepam, and why future comparative data would be essential.

“In the past, [there have been agents] that have burned the inside of the nose, so you lost your sense of smell. To know that it doesn’t happen with this therapy is essential.”

At the 73rd annual meeting of the American Epilepsy Society (AES), December 6-10, 2019, in Baltimore, Maryland, Jacqueline A. French, MD, professor of neurology, NYU Langone Medical Center, and colleagues presented a number of safety findings for intranasal diazepam (Valtoco; Neurelis) in the treatment of epileptic seizures.

All told, the use of the spray as seizure rescue medication was deemed safe with multiple uses over the long-term. The analysis included data from 132 patients and 2485 seizure episodes across a 1-year follow-up period. Patients received either 5, 10, 15, or 20 mg of intranasal diazepam, with a second dose administered 4 to 12 hours later if needed.

These findings, French told NeurologyLive, are reassuring at the very most and essential at the very least, as in years past, the use of intranasal delivery systems was not always successful. In addition to noting the importance of these data, French also shared her insight into why comparative data with other rescue medications—which is not yet available—will be helpful in determining who may benefit.

For more coverage of AES 2019, click here.


Miller I, Wheless JW, Hogan RE, et al. Safety and tolerability of NRL-1, an intranasal formulation of diazepam, in relationship to usage frequency in subjects with epilepsy: interim results from a phase 3, open-label, repeat dose study. Presented at: 2019 American Epilepsy Society Annual Meeting. December 6-10, 2019; Baltimore, Maryland. Abstract 1.22.

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