How to Use VALTOCO

Your family members, care partners, and others can promptly administer VALTOCO® (diazepam nasal spray) when you need it most. Here’s how they can do it.

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READY TO USE WHENEVER, WHEREVER

VALTOCO is designed to be administered by just about anyone. It's a good idea to share this information with care partners and loved ones.

If a person appears to be having a seizure, lay them either on their side or back.

1. HOLD

VALTOCO® (diazepam nasal spray) instructions for use (step 1)

HOLD VALTOCO with your thumb on the bottom of the plunger and your first and middle fingers on either side of the nozzle.

DO NOT test or prime; each device sprays only one time.

2. INSERT

VALTOCO® (diazepam nasal spray) instructions for use (step 2)

INSERT the tip of the nozzle into 1 nostril until your fingers, on either side of the nozzle, are against the bottom of the person's nose.

For nasal use only.

3. PRESS

VALTOCO® (diazepam nasal spray) instructions for use (step 3)

PRESS the bottom of the plunger firmly with your thumb to give VALTOCO.

Throw away nasal spray device(s) after use.

If giving the 15 mg or 20 mg dose, repeat the steps and use the second device in the other nostril to give the full dose of VALTOCO.

These are not the full Instructions for Use. Please see the complete Instructions for Use.

Instructions for Use Videos

Look at the packaging of your VALTOCO to see which dosage you are prescribed. Then watch the appropriate video below on how you or your care partners can administer the on-hand rescue medication.

5 mg or 10 mg Dose

VALTOCO® (diazepam nasal spray) instructions for use video (5 mg and 10 mg doses)
 

15 mg or 20 mg Dose

VALTOCO® (diazepam nasal spray) instructions for use video (15 mg and 20 mg doses)
 
VALTOCO® starter kit

TRAIN With Confidence

You and your care partner(s) can be prepared to use VALTOCO with a kit that includes a training device, quick start guide, medication guide, and more.

Get the Demo Kit

Request training for VALTOCO®

Get virtual administration training from a VALTOCO nurse educator who provides instruction on how to use the on-hand seizure rescue treatment. Training is also available by phone.

Request Training

KNOW YOUR VALTOCO Dose

VALTOCO is available in 4 treatment doses. Your healthcare provider will determine which dose is right for you using your age and weight.

 

5 mg

VALTOCO dose, 5mg

10 mg

VALTOCO dose, 10mg

15 mg

VALTOCO dose, 15mg

20 mg

VALTOCO dose, 20mg
more information on seizure treatment

You’ve got resources, including programs and downloadable tools, that can help you on your journey to managing seizure clusters.

What We Have for You

IMPORTANT SAFETY INFORMATION,
INCLUDING BOXED WARNING

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Important Safety Information you should know about VALTOCO® (diazepam nasal spray), CIV

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 depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma, and death.
  • VALTOCO can make you sleepy or dizzy and can slow your thinking and your motor skills. Do not drive, operate heavy machinery, or do other dangerous activities until you know how VALTOCO affects you.
  • 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 of these symptoms, especially if they are new, worse, or worry you:
    • Thoughts about suicide or dying
    • Feeling agitated or restless
    • Acting aggressive, being angry, or violent
    • Attempts to commit suicide
    • Panic attacks
    • Acting on dangerous impulses
    • Trouble sleeping (insomnia)
    • An extreme increase in activity and talking (mania)
    • New or worse anxiety
    • New or worse irritability
    • Other unusual changes in behavior or mood
    • New or worse depression

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.

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 to give VALTOCO
    • 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.
  • Family members, care providers, and other people who may have to give VALTOCO should know where you keep your VALTOCO and how to give VALTOCO before a seizure cluster happens.
  • VALTOCO is given in the nose (nasal) only.
  • VALTOCO comes ready to use.
  • 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.
  • Keep or move the person onto their side.
  • Make a note of the time VALTOCO was given.
  • Call for emergency help if any of the following happen:
    • Seizure behavior is different than other seizures 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 should I avoid while using VALTOCO?

  • 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.

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 for medical advice about side effects. You may report side effects to Neurelis, Inc. at 1-866-696-3873 or to FDA at 1-800-FDA-1088.

Please see full Prescribing Information and Medication Guide for additional important safety information.

What is VALTOCO® (diazepam nasal spray)?

  • VALTOCO is a prescription medicine used for the short-term treatment of seizure clusters (also known as “acute repetitive seizures”) in patients 6 years of age and older.
  • VALTOCO is a federal 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 6 years of age.

IMPORTANT SAFETY INFORMATION

Important Safety Information you should know about VALTOCO® (diazepam nasal spray), CIV

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 depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma, and death.
  • VALTOCO can make you sleepy or dizzy and can slow your thinking and your motor skills. Do not drive, operate heavy machinery, or do other dangerous activities until you know how VALTOCO affects you.
  • 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 of these symptoms, especially if they are new, worse, or worry you:
    • Thoughts about suicide or dying
    • Feeling agitated or restless
    • Acting aggressive, being angry, or violent
    • Attempts to commit suicide
    • Panic attacks
    • Acting on dangerous impulses
    • Trouble sleeping (insomnia)
    • An extreme increase in activity and talking (mania)
    • New or worse anxiety
    • New or worse irritability
    • Other unusual changes in behavior or mood
    • New or worse depression

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.

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 to give VALTOCO
    • 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.
  • Family members, care providers, and other people who may have to give VALTOCO should know where you keep your VALTOCO and how to give VALTOCO before a seizure cluster happens.
  • VALTOCO is given in the nose (nasal) only.
  • VALTOCO comes ready to use.
  • 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.
  • Keep or move the person onto their side.
  • Make a note of the time VALTOCO was given.
  • Call for emergency help if any of the following happen:
    • Seizure behavior is different than other seizures 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 should I avoid while using VALTOCO?

  • 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.

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 for medical advice about side effects. You may report side effects to Neurelis, Inc. at 1-866-696-3873 or to FDA at 1-800-FDA-1088.

Please see full Prescribing Information and Medication Guide for additional important safety information.