Midazolam nasal spray for anxiety in palliative care
Wairehu Midazolam ā-ihu
Being short of breath or breathless can be common and upsetting for people receiving palliative care. It can cause panic and anxiety. Midazolam can help to reduce that feeling of panic and anxiety. Your doctor or nurse can also sometimes advise you to use it for other reasons.
You spray midazolam into your nostrils and the medication is quickly absorbed into the lining of your nose. The medication achieves its full effect within 10 minutes.
How to use the spray
- Hold the bottle with your thumb at the base and the nozzle between your first and second fingers.
- If you are using the spray bottle for the first time, prime it by squeezing the pump until you see mist spraying from the nozzle.
- Keep your head upright and insert the nozzle into your nostril.
- Keep the spray bottle upright.
- Squeeze the pump with a firm even stroke. Do not sniff. If you do, the medication will be lost in your lungs.
- Do not tilt your head back while spraying. Having your head upright will help stop the liquid going down your throat.
- Give yourself one spray at a time into alternate nostrils, depending on how many sprays you have been prescribed.
- If the spray irritates your nose, you can spray it inside your cheeks instead.
- Keep the spray bottles in a cool dry place, but not in the fridge. Keep them out of the reach of children.
- The contents of the spray bottle expire a month after they are prepared by your pharmacy. Return any unused or part used bottles to your pharmacy.
- The spray bottles may cost up to around $10.
Possible side effects
Midazolam can make you feel drowsy.
Do not drive a car or operate heavy machinery if you are sleepy.
Sometimes people do not like the taste at the back of their throat or the sensation in their nose, but this does not last long.
Midazolam can cause nasal and eye irritation.
Midazolam is addictive.
Keep a record of use
Keep a record of when you use your midazolam spray so your doctor can check if it is working well for you. You should record:
- the date and time you used the spray
- whether it helped
- how long it took to work
- any side effects.
If you have any concerns about using the midazolam spray, see your general practice team.
Based on Using midazolam nasal spray, a patient/carer guide, Hutt Valley DHB. Adapted by HealthInfo clinical advisers. Last reviewed October 2024.
Sources
The information in this section comes from the following sources, some of which may be clinically complex or not available to the general public
Canterbury Community HealthPathways – Cough in palliative care, retrieved December 2016.
Canterbury Community HealthPathways – Dyspnoea in palliative care, retrieved December 2016.
Canterbury Community HealthPathways – Pruritus (itch) in palliative care, retrieved December 2016.
Canterbury Community HealthPathways – Weakness and fatigue in palliative care, retrieved December 2016.
Canterbury DHB – Palliative care guidelines (http://cdhb.palliativecare.org.nz/4207.htm), retrieved August 2016.
Nurse Maude – Symptom management, retrieved December 2016.
Palliative Care Australia – Facts about morphine and other opioid medicines in palliative care, retrieved February 2017.
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South Island Alliance – Health of older people useful resources (https://www.sialliance.health.nz/programmes/health-of-older-people/useful-resources/), retrieved September 2022.
UpToDate – Managing pain when you have cancer, retrieved February 2017.
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Page reference: 300573
Review key: HIPAL-17434
