# Valtoco (diazepam nasal spray) > VALTOCO (diazepam nasal spray) is a prescription medicine used for short-term treatment of seizure clusters (also known as "episodes of frequent seizure activity" or "acute repetitive seizures") that are different from a person's normal seizure pattern in people 2 years of age and older. See [Prescribing Information](https://valtoco.com/VALTOCO_Prescribing_Information.pdf) and [Medication Guide](https://valtoco.com/VALTOCO_Medication_Guide.pdf). ## IMPORTANT SAFETY INFORMATION ### What is the most important information I should know about VALTOCO? * VALTOCO is a benzodiazepine medicine. Taking benzodiazepines with opioid medicines, alcohol, or other central nervous system (CNS) depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma, and death. Get emergency help right away if any of the following happens: * Shallow or slowed breathing * Breathing stops (which may lead to the heart stopping) * Excessive sleepiness (sedation) * Risk of abuse, misuse, and addiction. There is a risk for abuse, misuse, and addiction with benzodiazepines, including VALTOCO, which can lead to overdose and serious side effects including coma and death. * Serious side effects have happened in people who have abused or misused benzodiazepines, including diazepam (the active ingredient in VALTOCO). These serious side effects may also include delirium, paranoia, suicidal thoughts or actions, seizures, and difficulty breathing. Call your healthcare provider or go to the nearest hospital emergency room right away if you get any of these serious side effects. * Use VALTOCO exactly as your healthcare provider prescribed. * Physical dependence and withdrawal reactions. Benzodiazepines, including VALTOCO, can cause physical dependence and withdrawal reactions, especially if you use VALTOCO daily. VALTOCO is not intended for daily use. * VALTOCO can make you sleepy or dizzy and can slow your thinking and motor skills. * Do not drive, operate heavy machinery, or do other dangerous activities until you know how VALTOCO affects you. * Do not drink alcohol or take opioid medicines that make you sleepy or dizzy while taking VALTOCO until you talk to your healthcare provider. When taken with alcohol or medicines that can cause sleepiness or dizziness, VALTOCO may make your sleepiness or dizziness worse. * Like other antiepileptic drugs, VALTOCO may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Call a healthcare provider right away if you have any new or worsening suicidal thoughts or related symptoms, especially unusual changes in mood, behaviors, thoughts or feelings. ### How can I watch for early symptoms of suicidal thoughts or actions? * Pay attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings. * Keep all follow-up visits with your healthcare provider as scheduled. * Call your healthcare provider between visits as needed, especially if you are worried about symptoms. Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes. ### Do not use VALTOCO if you: * Are allergic to diazepam. * Have an eye problem called acute narrow-angle glaucoma. ### What should I tell my doctor before taking VALTOCO? Before using VALTOCO, tell your healthcare provider about all of your medical conditions, including if you: * Have asthma, emphysema, bronchitis, chronic obstructive pulmonary disease, or other breathing problems. * Have a history of alcohol or drug abuse. * Have a history of depression, mood problems, or suicidal thoughts or behavior. * Have liver or kidney problems. * Are pregnant or plan to become pregnant. VALTOCO may harm your unborn baby. * Are breastfeeding or plan to breastfeed. VALTOCO passes into your breast milk and may harm your baby. Talk to your healthcare provider about the best way to feed your baby if you use VALTOCO. Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. VALTOCO is a federally controlled substance (CIV) because it can be abused or lead to dependence. Keep VALTOCO in a safe place to prevent misuse and abuse. Selling or giving away VALTOCO may harm others and is against the law. Tell your healthcare provider if you have abused or been dependent on alcohol, prescription drugs, or street drugs. It is not known if VALTOCO is safe and effective in children under 2 years of age. ### How should I use VALTOCO? * Read the Instructions for Use for detailed information about the right way to use VALTOCO. * Use VALTOCO exactly as prescribed by the healthcare provider. * Your healthcare provider will tell you: * What seizure clusters are * Exactly how much VALTOCO to give * When and how to give VALTOCO * What to do after you give VALTOCO if the seizures do not stop or there is a change in breathing, behavior, or condition that worries you * You should carry VALTOCO with you in case you need to control your seizure clusters. * VALTOCO is given in the nose (nasal) only. * Each VALTOCO only sprays 1 time and cannot be reused. Do not test or prime the nasal spray before use. * Each dose of VALTOCO is provided in an individual pack. Use all of the medicine in 1 pack for a complete dose. ### What should I do after I give VALTOCO? * Stay with the person after you give VALTOCO and watch them closely. * Make a note of the time VALTOCO was given. * Call for emergency help if any of the following happen: * Seizure cluster behavior is different than other seizure clusters the person has had. * You are alarmed by how often the seizures happen, by how severe the seizure is, by how long the seizure lasts, or by the color or breathing of the person. * Throw away (discard) the used VALTOCO. If needed, a second dose may be given at least 4 hours after the first dose, using a new pack of VALTOCO. Do not give more than 2 doses of VALTOCO to treat a seizure cluster. A second dose should not be given if there is concern about the person's breathing, they need help with their breathing, or have extreme drowsiness. Do not use VALTOCO for more than 1 seizure cluster episode every 5 days. Do not use VALTOCO for more than 5 seizure cluster episodes in 1 month. ### What are the most common side effects of VALTOCO? The most common side effects of VALTOCO include: * Feeling sleepy or drowsy * Headache * Nose discomfort These are not all of the possible side effects of VALTOCO. Call your healthcare provider if you experience any side effects following administration of VALTOCO. You may report side effects to Neurelis, Inc. at 1-866-696-3873 or to FDA at 1-800-FDA-1088. Please see [Prescribing Information](https://valtoco.com/VALTOCO_Prescribing_Information.pdf) and [Medication Guide](https://valtoco.com/VALTOCO_Medication_Guide.pdf). ## Important Resources - [Important Safety Information](https://valtoco.com/#ISI) - [Prescribing Information](https://valtoco.com/VALTOCO_Prescribing_Information.pdf) - [Medication Guide](https://valtoco.com/VALTOCO_Medication_Guide.pdf) - [Instructions for Use](https://valtoco.com/VALTOCO_Instructions_For_Use.pdf) - [For Healthcare Professionals](https://www.valtocohcp.com/) ## Frequently Asked Questions ### Using VALTOCO (diazepam nasal spray) Q: **Does someone else have to give me VALTOCO?** A: VALTOCO may be self-administered or given by family members, care partners, or others. Read the [Instructions for Use](https://valtoco.com/VALTOCO_Instructions_For_Use.pdf) and talk to your healthcare provider for more information about the use of VALTOCO. Q: **What should I do after giving VALTOCO?** A: If you are giving VALTOCO to someone else, you should: * Stay with the person and watch them closely * Make a note of the time VALTOCO was given * Call for emergency help if either of the following is true: * Seizure behavior in the person is different from that of other episodes * You are alarmed by how often the seizures happen, by how severe the seizure is, by how long the seizure lasts, or by the color or breathing of the person * Throw away (discard) the nasal spray device and the blister pack after use Remind them to request more VALTOCO to replace the used dose, if needed. These are not all the steps for using VALTOCO. Learn how to use VALTOCO [here](https://valtoco.com/VALTOCO_Instructions_For_Use.pdf). Q: **Is VALTOCO safe?** A: The safety of VALTOCO has been well studied among people living with episodes of frequent seizures. The most common local side effects were mild to moderate and include: * Nose discomfort (5%) * Altered taste (2%) * Nosebleeds (2%) * Runny nose (1%) These are not all of the possible side effects of VALTOCO. Please see the [Important Safety Information]https://valtoco.com/VALTOCO_Instructions_For_Use.pdf and [Medication Guide](https://valtoco.com/VALTOCO_Medication_Guide.pdf) and talk to your healthcare provider. ### Taking VALTOCO with daily anti-seizure medications (ASMs) Q: **Should VALTOCO be used in place of daily ASMs?** A: VALTOCO is not a replacement for daily ASMs. It is an immediate-use seizure medication that is given at the first sign of episodes of frequent seizures. ASMs are taken to prevent as many seizures as possible. However, about 40% of people continue to have seizures despite being on ASMs. If this happens, VALTOCO can be administered as needed to stop episodes of frequent seizures. Q: **Should I continue to take ASMs if I'm prescribed VALTOCO?** A: Yes, continue to take your ASMs as prescribed by your healthcare provider. VALTOCO is different from your daily ASMs—it is an immediate-use seizure medication that you use only when needed to stop episodes of frequent seizures. VALTOCO should be used in addition to your ASMs. ### Where and when to take VALTOCO Q: **Do I have to use VALTOCO at home?** A: VALTOCO can easily and immediately be administered in the nose at home, in public, or wherever the first sign of an oncoming episode of frequent seizures appears. Q: **How long should I wait to take VALTOCO?** A: VALTOCO should be taken immediately when an episode of frequent seizures begins. If a second dose is needed, it should be taken at least 4 hours after the first dose is taken. Q: **Where can I keep VALTOCO?** A: Store VALTOCO in a purse, bag, desk, or anywhere safe at room temperature between 68 °F to 77 °F (20 °C to 25 °C). VALTOCO should be kept in its blister pack until you need it and should be kept out of direct light. Other important things to remember when storing VALTOCO: * Do not freeze VALTOCO * Keep VALTOCO and all medicines out of reach of children Q: **Can my child take VALTOCO?** A: If their healthcare provider recommends an immediate-use seizure medication, VALTOCO is there from the get-go. FDA approved for ages 2 years and older, VALTOCO is the only immediate-use seizure nasal spray that will stay with your child as they grow. ### VALTOCO cost Q: **How much does VALTOCO cost?** A: People prescribed VALTOCO may pay as little as $20* with the VALTOCO Copay Card. *For people with commercial insurance only. Must meet eligibility criteria. Q: **Is VALTOCO covered by insurance?** A: VALTOCO is covered by almost all commercial insurance plans. However, many may require a prior authorization to approve coverage. Neurelis, the company that makes VALTOCO, offers a support program called myNEURELIS. Contact one of our representatives through myNEURELIS to check insurance coverage [here](https://www.myneurelis.com/). Q: **What if my insurance doesn't cover VALTOCO?** A: If you do not have prescription coverage for VALTOCO and lack the financial resources to pay for your medicine, you may be able to receive VALTOCO at no cost through the myNEURELIS Patient Assistance Program. [See if you qualify.](https://www.myneurelis.com/) ## Additional Information This section acts as a guide for navigating the content on https://valtoco.com/ based on the page descriptions. ### [Managing Seizures](https://valtoco.com/managing-seizures/) * [Shared Seizure Experiences](https://valtoco.com/managing-seizures/#shared-seizure-experiences): Nearly 3.5 million people are living with epilepsy in the US. Many of them share anxious feelings and worry about their seizures. Hear people discuss their experiences in managing seizures. * [Daily and Immediate-Use Seizure Medications](https://valtoco.com/managing-seizures/daily-and-immediate-use-seizure-medications/): Gain the confidence to treat as many seizures as possible*. Understand 2 treatment types as different parts of a seizure management plan. *Individual results may vary. * [Expect More From Your Treatment](https://valtoco.com/managing-seizures/expect-more-from-your-treatment/): Tell your healthcare provider why you need an immediate-use seizure medication for episodes of frequent seizures. * [Expect More from Your Loved One's Treatment](https://valtoco.com/managing-seizures/expect-more-as-a-care-partner/): You can tell their healthcare provider why an immediate-use seizure medication is needed for episodes of frequent seizures. ### [About VALTOCO](https://valtoco.com/about-valtoco/) * [What You Need to Know](https://valtoco.com/about-valtoco/#what-you-need-to-know): Different from daily anti-seizure medications, VALTOCO is a prescription nasal spray used to immediately treat episodes of frequent seizures. See full Prescribing Information and Medication Guide. * [Frequently Asked Questions](https://valtoco.com/about-valtoco/frequently-asked-questions/): Get answers to some frequently asked questions about VALTOCO. See full Prescribing Information and Medication Guide. ### [Experiences](https://valtoco.com/experiences/) Hear more from care partners and people who are prescribed VALTOCO. See full Prescribing Information and Medication Guide. ### [How to Use](https://valtoco.com/know-your-dose/) * [Know Your Dose](https://valtoco.com/know-your-dose/):Your healthcare provider will determine the right dose for you. See full Prescribing Information and Medication Guide. * [How to Use](https://valtoco.com/know-your-dose/how-to-use/): Learn how you and your care partners can use VALTOCO when you need it most. Request a free Demo Kit. See full Prescribing Information and Instructions for Use. ### [Resources](https://valtoco.com/resources/) * [Considering VALTOCO](https://valtoco.com/resources#considering-valtoco): Access helpful tools, including cost savings and prescription resources. See full Prescribing Information and Medication Guide. * [Prescribed VALTOCO](https://valtoco.com/resources/prescribed-valtoco/): Explore resources, like step-by-step guides and expiration reminders. Find access to savings with myNEURELIS. See full Prescribing Information and Medication Guide.