Use of second doses of Valtoco® (diazepam nasal spray) across 24 hours after the initial dose for out‐of‐hospital seizure clusters: Results from a phase 3, open‐label, repeat‐dose safety study

Patients with epilepsy may experience seizure clusters lasting up to 24 hours, and little is known about the effectiveness of rescue therapies for that duration. The current labeling of the US Food and Drug Administration (FDA)-approved outpatient treatments for seizure clusters (rectal diazepam, intranasal midazolam, and diazepam nasal spray) allows for a second dose, if needed, for control. These findings support the safety profile of second doses, and the low use supports the effectiveness of diazepam nasal spray across 24 hours.