Helpful VALTOCO resources

These resources can help set patients and their care partners up for success with VALTOCO.

Resources for You and Your Patients
Resources for School Nurses
School nurse video

Patricia McGoldrick, MPA, MSN, CPNP teams up with VALTOCO to present: “Confidence in the Classroom.” Designed specifically for school nurses, this program explains how you can help change the seizure rescue experience at school.

VALTOCO Demo Kit

Learn how to use VALTOCO

To help you and your patients practice how to administer VALTOCO, the Demo Kit contains everything you need to know to use the device with confidence. The Demo Kit also includes the following:

  • Demo device with Instructions for Use
  • myNEURELIS® personalized support and savings information
  • Prescribing Information and Medication Guide
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Resources for you and your patients

Download resources individually below or download the entire resource kit.

Patient Brochure

This guide can help patients understand how to use VALTOCO, what individualized dosing looks like, and the programs available to them.

Get the Brochure—English
Get the Brochure—Spanish
Dosing Card
Dosing Card

Learn about the available VALTOCO dosing options for pediatric and adult patients.

Get the Dosing Card—English
Frequently Asked Questions
Frequently Asked Questions

Get answers to common questions about VALTOCO.

Get the FAQs—English
Prescription Form
Prescription Form

VALTOCO is available to order through US retail pharmacies. To send your prescriptions through Maxor Specialty Pharmacy, use this form.

Get the Form—English
Patient Tip Sheet
Patient Tip Sheet

This guide can help your patients learn how to get their VALTOCO prescription via Maxor Specialty Pharmacy.

Get the Tip Sheet—English
Office Tip Sheet
Office Tip Sheet

Help ensure your patients receive the VALTOCO you’ve prescribed by following the simple steps laid out in this document.

Get the Office Tip Sheet—English
Trade Sheet
Trade Sheet

Print out this trade sheet and keep it handy for when it’s time to place orders of VALTOCO for patients.

Get the Trade Sheet—English
Instructions for Use (IFU)
Instructions for Use (IFU)

Instructions that your patients, their family members, care partners, and others who may need to give VALTOCO should read before using.

Get the IFU—English
Get the IFU—Spanish

Resources for school nurses

Download resources individually below or download the entire resource kit.

School Nurse Frequently Asked Questions
School Nurse Frequently Asked Questions

Review commonly asked questions about VALTOCO so that you’ll be well versed on this seizure rescue medication.

Get the FAQs—English
VALTOCO Information Sheet for School Nurses
VALTOCO Information Sheet for School Nurses

Get important information about having VALTOCO on hand at school so that you’ll be ready to help students when they need it most.

Get the Info Sheet—English
Advocate for VALTOCO: A Letter to Parents of Students
Advocate for VALTOCO: A Letter to Parents of Students

Support parents and care partners of students with episodes of frequent seizures by advocating for the compassionate choice. This letter may help.

Get the Letter—English
School Seizure Action Plan
School Seizure Action Plan

Ensure that a current seizure action plan is on file for students with epilepsy. Review it annually with the student, their parents or care partners, and their healthcare provider. The Epilepsy Foundation has seizure action plan templates like this one available in multiple languages.

Get the Action Plan—English
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Indication

VALTOCO® (diazepam nasal spray) is indicated for the acute treatment of intermittent, stereotypic episodes of frequent seizure activity (ie, seizure clusters, acute repetitive seizures) that are distinct from a patient’s usual seizure pattern in patients with epilepsy 2 years of age and older.

IMPORTANT SAFETY INFORMATION

WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS

  • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Follow patients for signs and symptoms of respiratory depression and sedation.
  • The use of benzodiazepines, including VALTOCO, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death. Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes. Before prescribing VALTOCO and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction.
  • The continued use of benzodiazepines may lead to clinically significant physical dependence. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose. Although VALTOCO is indicated only for intermittent use, if used more frequently than recommended, abrupt discontinuation or rapid dosage reduction of VALTOCO may precipitate acute withdrawal reactions, which can be life-threatening. For patients using VALTOCO more frequently than recommended, to reduce the risk of withdrawal reactions, use a gradual taper to discontinue VALTOCO.

Contraindications: VALTOCO is contraindicated in patients with:

  • Hypersensitivity to diazepam
  • Acute narrow-angle glaucoma

Central Nervous System (CNS) Depression

Benzodiazepines, including VALTOCO, may produce CNS depression. Caution patients against engaging in hazardous activities requiring mental alertness, such as operating machinery, driving a motor vehicle, or riding a bicycle, until the effects of the drug, such as drowsiness, have subsided, and as their medical condition permits.

The potential for a synergistic CNS-depressant effect when VALTOCO is used with alcohol or other CNS depressants must be considered, and appropriate recommendations made to the patient and/or care partner.

Suicidal Behavior and Ideation

Antiepileptic drugs (AEDs), including VALTOCO, increase the risk of suicidal ideation and behavior. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or unusual changes in mood or behavior.

Glaucoma

Benzodiazepines, including VALTOCO, can increase intraocular pressure in patients with glaucoma. VALTOCO may be used in patients with open-angle glaucoma only if they are receiving appropriate therapy. VALTOCO is contraindicated in patients with narrow-angle glaucoma.

Neonatal Sedation and Withdrawal Syndrome

Use of VALTOCO late in pregnancy can result in sedation (respiratory depression, lethargy, hypotonia) and/or withdrawal symptoms (hyperreflexia, irritability, restlessness, tremors, inconsolable crying, and feeding difficulties) in the neonate. Monitor neonates exposed to VALTOCO during pregnancy or labor for signs of sedation and monitor neonates exposed to VALTOCO during pregnancy for signs of withdrawal; manage these neonates accordingly.

Risk of Serious Adverse Reactions in Infants due to Benzyl Alcohol Preservative

VALTOCO is not approved for use in neonates or infants. Serious and fatal adverse reactions, including “gasping syndrome,” can occur in neonates and low-birth-weight infants treated with benzyl alcohol–preserved drugs, including VALTOCO. The “gasping syndrome” is characterized by central nervous system depression, metabolic acidosis, and gasping respirations. The minimum amount of benzyl alcohol at which serious adverse reactions may occur is not known.

Adverse Reactions

The most common adverse reactions (at least 4%) were somnolence, headache, and nasal discomfort.

Diazepam, the active ingredient in VALTOCO, is a Schedule IV controlled substance.

To report SUSPECTED ADVERSE REACTIONS, contact Neurelis, Inc. at 1-866-696-3873 or FDA at 1-800-FDA-1088 (www.fda.gov/medwatch).

Please see full Prescribing Information, including Boxed Warning.

1. Valtoco. Prescribing Information. Neurelis Inc; 2024; 2. Placeholder reference for the FDA approval letter; 3. Data on file. REF-01245. Neurelis Inc; 4. Data on file. REF-01288. Neurelis Inc; 5. Wheless JW, Miller I, Hogan RE, et al; DIAZ.001.05 Study Group. Final results from a Phase 3, long-term, open-label, repeat-dose safety study of diazepam nasal spray for seizure clusters in patients with epilepsy. Epilepsia. 2021;62(10):2485-2495. doi:10.1111/epi.17041; 6. Tarquinio D, Dlugos D, Wheless JW, et al. Safety of Valtoco® (diazepam nasal spray) in children and adolescents with epilepsy: final subgroup results from a phase 3, long-term, open-label, repeat-dose safety study. Poster presented at: Child Neurology Society 50th Annual Meeting; September 29 – October 2, 2021; Boston, MA; 7. Penovich P, Wheless JW, Hogan RE, et al. Examining the patient and caregiver experience with diazepam nasal spray for seizure clusters: results from an exit survey of a phase 3, open-label, repeat-dose safety study. Epilepsy Behav. 2021;121(pt A):108013. doi:10.1016/j.yebeh.2021.108013; 8. Misra SN, Sperling MR, Rao VR, et al. Significant improvements in SEIzure interVAL (time between seizure clusters) across time in patients treated with diazepam nasal spray as intermittent rescue therapy for seizure clusters. Epilepsia. 2022;63(10):2684-2693. doi:10.1111/epi.17385

MyNEURELIS® logo

If your patient was prescribed VALTOCO, myNEURELIS® is here to help them every step of the way. Learn more about the benefits and support offerings:

myNEURELIS.com

Monday through Friday, 8 AM to 8 PM ET

1-866-myNEURELIS (1-866-696-3873)

NEURELIS™ logo

This site is intended for US residents only.

NEURELIS, VALTOCO, MYNEURELIS, PERSONALIZED SUPPORT FOR PATIENTS AND CARE PARTNERS, and the NEURELIS, VALTOCO, and MYNEURELIS logos are registered trademarks of Neurelis, Inc.

Intravail is a registered trademark of Aegis Therapeutics, LLC, a wholly-owned subsidiary of Neurelis, Inc.

All other trademarks are the property of their respective owners.

© Neurelis, Inc. 2025. All rights reserved. US-PRC-23-00258-v4 04/2025

IMPORTANT SAFETY INFORMATION, INCLUDING BOXED WARNING
WARNING: RISKS FROM CONCOMITANT USE WITH OPIOIDS; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS
  • Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required. Follow patients for signs and symptoms of respiratory depression and sedation.
  • The use of benzodiazepines, including VALTOCO, exposes users to risks of abuse, misuse, and addiction, which can lead to overdose or death. Abuse and misuse of benzodiazepines commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes. Before prescribing VALTOCO and throughout treatment, assess each patient’s risk for abuse, misuse, and addiction.
  • The continued use of benzodiazepines may lead to clinically significant physical dependence. The risks of dependence and withdrawal increase with longer treatment duration and higher daily dose. Although VALTOCO is indicated only for intermittent use, if used more frequently than recommended, abrupt discontinuation or rapid dosage reduction of VALTOCO may precipitate acute withdrawal reactions, which can be life-threatening. For patients using VALTOCO more frequently than recommended, to reduce the risk of withdrawal reactions, use a gradual taper to discontinue VALTOCO.
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