Drugs Used in Status Epilepticus

NHSL Medicines Guidance
NHS Lanarkshire

Drugs Used in Status Epilepticus

Please refer to the NHS Lanarkshire Management of Generalised Convulsive Status Epilepticus in Adults Guideline for further information.

Specialist initiation (S1)

DIAZEPAM rectal tubes

MIDAZOLAM 10mg/1ml oromucosal solution in prefilled oral syringe (Epistatus®)

  • Where doses cannot be achieved with the prefilled oral syringe use of the unlicensed Epistatus® 5ml vial is acceptable.

 

Specialist use only (S2)

LORAZEPAM injection

DIAZEPAM injection 

LEVETIRACETAM injection (off label use as per above guideline)

PHENYTOIN injection 

Prescribing Notes:

  • Convulsive status epilepticus is a prolonged convulsive seizure for 5 minutes or longer, or recurrent seizures one after the other without recovery in between.
  • Emergency treatment should be sought or given once a seizure has persisted, or there are serial seizures, for five minutes or more. Generalised tonic-clonic status epilepticus is a medical emergency with significant morbidity and a mortality of between 16% and 39%.
  • A possible underlying cause (e.g. hypoglycaemia, hypoxia etc.) must be considered.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

 

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

 

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

 

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.